Low weight gain in a breastfed infant: what could be the reasons?
Low weight gain in a breastfed infant can have various causes, but it should always arouse the interest of parents. Does weight loss in a breastfed infant require consultation with a doctor? Why does a newborn baby not gain weight, how do you know when your baby is full?
In this article, we present the most common causes of low weight gain in a breastfed infant.
Why a newborn breastfed not gaining weight how do you know when your baby is eating?
According to the recommendations of the WHO and the Polish Society of Gastroenterology, Hepatology and Child Nutrition, exclusive breastfeeding is the most recommended method of feeding infants in the first 6 months of life.
However, at the beginning of breastfeeding, women usually have a lot of doubts: is the newborn gaining too little weight? How to check if there is enough breast milk? Successful feeding indicators help you to control whether your baby is full when drinking only breast milk.
There are 3 basic indicators of successful infant feeding: the number of poops and wet diapers (urine volume) per day and the correct weight gain of the baby.
Low weight gain in a breastfed infant: check that all indicators of successful feeding are normal
Check that all indicators of effective feeding are within normal limits.
Number of stools passed per day
We check how many stools, the so-called poop*, gave the child within XNUMX hours:
- 1-2 days after delivery: about 2-4 poops (meconium);
- 3-4 days after delivery: between 2-5 poops;
- 4-7 days after delivery: 2-6 increasingly heavy poops;
- 1-6 weeks after delivery: 3-8 poops or more;
- 6 weeks - 6 months after giving birth: 3-5 poops, but it can also be less or more. During this period, the number of stools is no longer considered a reliable indicator of successful breastfeeding.
*a poo is considered to be any blot on a diaper that has a diameter exceeding approx. 5 cm
Expert advises
Stool can be passed even after each feeding, but it can also be less, e.g. when a child poops once a day, but other indicators say that he eats healthy, no need to worry about it.
Number of wet diapers per day
If it seems to us that a breastfed newborn is not gaining enough weight, let's check if the amount of wet diapers (urine) per day is correct:
- 1-2 days after delivery: 1-2 wet diapers/day;
- 3-7 days after delivery: 3-6 wet diapers/day;
- 8th day after delivery - 6th week of the child's life: approx. 8 wet diapers/day;
- 6th week onwards: approx. 6 wet diapers/day.
Hint - when your baby pees, the wetness indicator on most diapers will change color.
Weight gain norms
When wondering why a newborn is not gaining weight, first of all, let's regularly check whether the child's weight gain is within the norms (for children between the 25th and 75th percentile):
- 1 quarter of life:
-1 week postpartum: physiological weight loss in a breastfed/bottlefed infant (peak weight loss usually occurs on the 3rd day postpartum);
– 2nd week after birth: body weight gradually increases (approx. 28 g/day). On day 8-10, the baby should return to its birth weight;
– 3-4 weeks after giving birth: approx. 240-270 g/week;
– 2 months of age: approx. 210-300 g/week;
– 3 months of age: approx. 150-210 g/week. - 2nd quarter of a child's life:
3-6 months of age: 119-126 g/week. - 3nd quarter of a child's life:
6-9 months of age: 84-91 g/week. - 4nd quarter of a child's life:
9-12 months: 63 g/week.
With a small, daily weight gain of a breastfed infant, it is worth remembering that children often gain weight by leaps and bounds, so it is recommended to weigh the baby every few days (on the same scale), unless the midwife or doctor recommends otherwise.
Why the newborn does not gain weight: how breastfeed often, how long should one feeding session last, and what about this dragon?
No weight gain in a newborn, weight loss in a breastfed infant? How often should you put your baby to the breast?
Expert advises
Perhaps the baby eats too rarely - it is recommended to feed on demand, already at the first signs of hunger in the child. A newborn, as well as an infant in the first months of life, may report to the breast even every 1-2 hours and this is completely normal. When wondering why a newborn is not gaining weight properly, let's first of all make sure to put him to the breast about 8-12 times a day (approximately every 3 hours), including at least once at night.
Why isn't a newborn gaining weight—perhaps they're breastfeeding for too short a time? How long should a single breastfeeding session last? One feeding lasts between 5 and 45 minutes. We don't forcefully remove a baby from the breast after 15 minutes just because we've heard that, for example, after that time, the baby stops eating and uses the breast as a "pacifier." This is an outdated view that isn't reflected in current knowledge about lactation.
When the baby detaches himself from the breast and is still restless, we offer him the second breast (we will also start the next feeding from this breast).
A pacifier? If so, when? It's recommended to introduce a pacifier to a breastfed baby around 6-8 weeks of age, when lactation begins to stabilize. Delaying or skipping feedings (especially at night) by giving your baby a pacifier is not recommended. This can disrupt lactation and contribute to poor weight gain in a breastfed baby.
If your baby is losing weight, you should discuss pacifier use with the CDL.
Weight loss in a breastfed infant may have other reasons: what?
It's worth verifying whether the breastfeeding method is optimal for your baby. A newborn may not be gaining weight because the breastfeeding position is uncomfortable, preventing them from taking in milk effectively. The baby may also have difficulty latching on effectively.
Expert advises
Despite proper breastfeeding, breastfeeding may be difficult due to factors such as decreased muscle tone, a too-short sublingual frenulum, or impaired tongue function. A baby should cover most of the areola with their mouth, suck, and swallow steadily, without audible slurping or smacking.
Weight loss in a breastfed infant may be the result of expanding their diet too quickly. Before 6 months of age, do not give your baby water or teas or introduce complementary foods unless specifically recommended by a doctor. Poor weight gain in a breastfed infant may also be related to factors such as gastroesophageal reflux, food allergies, or metabolic disorders (although these are relatively rare).
When your newborn is not gaining weight properly, it is a good idea to consult your midwife, pediatrician and CDL in the first instance. Even after the neonatal period, a small gain or even a decrease in weight in a breastfed infant should always prompt parents to consult their pediatrician and the CDL.
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