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Thread: Weight gain anxiety

  1. #1

    Default Weight gain anxiety

    My baby girl only gained 8 oz from 5 weeks to 8 weeks. Shes exclusively breast fed and I thought we were doing well. She is now above average weight (11 lbs 12 oz) but was a big baby (8 10). Our pediatrician (new to us, we had a different doc with our first) wasn't concerned, but then I started researching a few days later and the numbers seem off. We'll call the doc on Monday but in the meantime, what do people think?

  2. #2
    Join Date
    Jun 2009

    Default Re: Weight gain anxiety

    Hi meowmeow2017!

    Average gain rate from the end of the first 7-14 days of life until about 3 to 4 months is 5-8 ounces per week. Because most babies lose weight for a few days after being born, and then take a few days to regain that weight, it is important, when possible, to measure weight gain by the lowest known weight, rather than birth weight. Doing so gives you a more clear picture of actual gain rate.

    If your baby weighed 8 pounds 10 ounces at birth, and at 8 weeks weighs 11 pounds 12 ounces, then baby has gained an average of 6.25 ounces since birth- well within normal parameters. If you know and can measure it from lowest known weight, which is usually lower than birth weight, I think you will find that baby actually has gained a bit faster than that, averaging it out.

    So taken over all, your baby's weight gain seems entirely normal. So no reason to be too concerned at this point. However since the numbers over the last few weeks are inconsistent with weight gain norms, you may want to look at the situation in more detail. 1) by figuring out if weight gain rate really did reduce substantially and is now well below what it was before, and 2) if it is, why that is.

    To figure this out, It would help to get more details.

    First off, is there any other reason for concern aside the numbers on the scale(s)? Is baby pooping within normal parameters (3-5 times in 24 hours or more?) How many times a day does baby nurse- at least 8-12? Is nursing comfortable for you?
    About how long are nursing sessions typically? Does baby prefer to nurse from one breast per session or two? Are you taking any hormone based birth control? Have you taken any measures to try to reduce milk production, such as block nursing?

    Have you considered scale error? It sounds like you changed doctors. Were the 5 week weight check and 8 week on different scales? Differences in calibration causes scales to not match up. And the difference can be a lot. A half pound or even more. To be sure weight checks are accurate, it is important that:
    Same scale is used every time
    Baby is naked or in a dry diaper only
    A digital, medical quality infant scale is used
    The person taking the weight is careful, non-rushed, knows what they are doing, reads the scale carefully and verifies the weight number has been read and recorded correctly, and any unit conversions be double checked.

    Once you have figured out if there really is a problem, if it turns out there is, the next step is to figure out what the problem is. When a baby is not gaining as well as expected, the usual assumption is mom does not make enough milk. But in fact there are several other reasons a baby may not be gaining well or not getting enough milk.
    Last edited by @llli*maddieb; March 4th, 2017 at 11:30 PM.

  3. #3

    Default Re: Weight gain anxiety

    Thanks maddieb!

    My baby is a grazer - 12+ times per day of 5-10 minutes on one side (she either falls asleep or is just done). When we rented a scale for a week she averaged about 2 oz per feeding. It's comfortable usually for both of us. She's had plenty of wet diapers but a bowel movements on average only every other day. Plenty of gas! In this time period in question I got a Mirena IUD and she got a mild cold. Her lowest weight was 8 lbs 3 oz but she was at her birth weight by day 4 (I think, seems impossible/was a blur).

    I had no idea scales could be so off. We rented a Medela scale for a week and perhaps will again. The two weights I mentioned above were on two different scales in the same office/practice.

    I also forgot to mention that she gets a bottle or two of breast milk (3-5 oz every 2 hours or so) approximately every 3 days (while I'm out/working).

    Thanks again for your reply!

  4. #4
    Join Date
    Jun 2009

    Default Re: Weight gain anxiety

    First I realized I made a little error in my post above, it sounds like you understood anyway but I will correct it anyway: If your baby weighed 8 pounds 10 ounces at birth, and at 8 weeks weighs 11 pounds 12 ounces, then baby has gained an average of 6.25 ounces since birth Of course I meant 6.25 ounces per week since birth.

    Ok. so grazing and one sided nursing are entirely normal, assuming baby is getting enough to eat. If there is any question that baby is not getting enough to eat, given your baby's patterns then a relatively easy change that might help would be to encourage baby to nurse a bit longer and nurse the other side at least some of the time. Breast compressions may help, unless the reason your baby nurses so shortly is a fast milk flow. Breast compressions increase milk flow, that is why you do them. Search online Jack Newman compressions to find an article on that.

    AFTER about 6 weeks, poop every other day might be normal and ok, some babies who are getting enough milk do go to this pattern at that point. But before then, such infrequent poops are not typical (although it might rarely happen ad be fine) But in general, such a pattern could indicate baby is not getting enough milk, especially if weight gain is also slow. Is this a recent change or has baby always pooped in this manner?

    Bottles for work- since baby is perhaps not gaining well, I do not want to say make bottles smaller at least until weight gain is figured out. But just FYI, the rule of thumb for separations is baby gets 1 to 1.5 ounces of milk per hour of separation, and ideally bottles given on cue rather than on a schedule.

    Why does it matter? 1) if baby eats too much when separated from mom, baby may not nurse with normal frequency or effectiveness when with mom, harming milk production. 2) large bottles teach baby to expect large meals at the breast, and that is not biologically normal. This may over time lead to breast refusal. 3) Overfeeding with bottles leads to mom not being able to "keep up" when she pumps, leading to unneeded stress and worry. 4) Large meals from bottle may indicate baby is being fed too quickly and they are not being given a chance to regulate their intake as they do at the breast. Typical bottle positioning leads to this. This is why a breastfed baby is best fed using paced bottle feeding technique and positioning.

    More: http://www.llli.org/docs/00000000000...astfedbaby.pdf and https://www.youtube.com/watch?v=UH4T70OSzGs

    How long are the separations from baby and are you able to pump frequently with an effective pump during those separations? If you are away from baby long enough baby needs a bottle, it is important that you pump.

    Mirena IUD- well, officially I think these are considered ok for milk production. But anecdotally many moms have perceived them as problematic for their milk production. Since we are not sure what is going on, I would not worry about that yet, but you may want to talk to hcp about what you would do if you wanted it removed.

    Illness would explain a temporary drop in weight gain rate if the illness caused baby to nurse less or baby was vomiting.
    Last edited by @llli*maddieb; March 5th, 2017 at 12:16 PM.

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