I have been a lactation consultant a long time. 17 years, to be exact. Add on the years I trained before becoming certified and I can say I’ve been working with breastfeeding families for about 20 years now. Probably one of the biggest concerns I see from parents is weight gain with their breastfed baby. It’s a source of stress, anxiety and concern for most parents. How do you know your baby is getting enough milk to gain weight? What happens if your baby does not gain weight?
There is nothing more devastating to a parent as when you go take your baby in for a doctor appointment only to find out that their weight is not where it should be. When you are breastfeeding, it feels like that is ALL you are doing. How could it be that the baby didn’t gain weight?
Asking the Right Questions
There are always questions to ask. As a lactation consultant, there are always questions we need answers to before jumping to any conclusions. We can’t just jump to low milk supply. We need to do a bit of detective work first. There is also a big difference between gaining slowly and not gaining at all. Did the baby gain any weight? Are they meeting milestones? Are they having wet and dirty diapers? This is an important question. The diaper output tells us whether your baby is hydrated (wet diapers) and whether they are being nourished (dirty diapers). It tells us if they are breastfeeding well.
How Much Weight Gain is Normal?
Breastfed babies are expected to gain half an ounce (15g) to an ounce (30g) a day for the first few months of life. This is the expectation, although some doctors would prefer to see a baby at the 1 ounce a day mark. If your baby is gaining slowly, more like a half an ounce a day, this may be their growth pattern. Looking at overall growth is necessary too; looking at how the baby is growing in length and head circumference is important as well.
Is It Low Supply?
One of the first things we want to do for a baby who is not gaining well is make sure they are being fed. Contact a lactation consultant who can help with assessing a feeding for you. This would include making sure baby is latching well, transferring milk. Pre and post feeding weights can also help to determine how much milk is being transferred at that feed. This can be a key piece of the puzzle. Expected milk transfer depends on the age of the baby, but if transfer is low, we now have our answer to the weight gain issue. Now comes the part where we need to find out why. More detective work, we can’t just assume its low milk supply. There are 2 people involved in this breastfeeding relationship, and we need to determine where the downfall is.
Oral Assessments
Pumping during this time may be necessary, especially if the baby needs some extra milk. Doing a full oral assessment on the baby is also necessary. Some babies have more trouble with organizing their suck, swallow and breathing or they may have a weak or immature suck pattern. Any of these things can result in a lower milk transfer. Oral ties should be ruled out as well, as they can also impact milk transfer. The tricky thing is, if the baby has one of these scenarios happening, that can cause low milk supply over time.
How Milk Supply Works
Milk supply is dependent on how much milk the baby is taking and how well they are feeding, so if they are not feeding well, this can lead to a decrease in how much milk the body is making. Pumping can help to make up for some loss in stimulation, but finding the answer to the problem is crucial for ongoing breastfeeding success.
Work With a Lactation Consultant
It is important to work with a lactation consultant to determine the reason for low or slow weight gain. This isn’t something to tackle on your own. A lactation consultant can help you determine the source of the problem and make a manageable plan for you to work with while making sure your baby is getting the milk they need to thrive.
