How to Get a Breastfed Baby to Gain Weight
Sometimes a breastfed baby may struggle to proceeds weight, either non gaining weight at all or not gaining enough weight to stay on their growth curve. This article looks at the possible reasons for non gaining weight and what to practise to get breastfeeding back on track and baby well fed. This is a companion article to Understanding Your Babe'southward Weight Nautical chart and Supplementing an Underweight Baby.
It is important to stay in close contact with a wellness care professional person if your baby is non gaining weight as expected as they will cheque for any underlying health concerns and be able to monitor your baby'south weight regularly.
What are the reasons for a breastfed baby not gaining weight?
#i Not enough milk
In most cases the reason for not gaining enough weight is because the babe is non getting enough breast milk. There could be many potential reasons for this from bug of poor latch, breastfeeding on ane chest per feed or on a schedule, to other causes of low milk supply such every bit insufficient glandular tissue, hormonal issues, delayed onset of lactation and more. An International Board Certified Lactation Consultant (IBCLC) is the ideal breastfeeding specialist to help you find the Reasons for Low Milk Supply.
#ii Health issues for babe
Sometimes underlying health bug with the baby may be identified equally the cause of poor weight gain e.g. animate or cardiac bug, neurological issues, milk allergy, anaemia, genetic syndrome, low or high muscle tone, or undetected tongue tie (see below). Occasionally, lactose overload can be a crusade of low weight gain.
#3 Ane matter leads to another
Once a infant is underweight they tin can become very sleepy and not very interested in feeding. Or they may seem hungry, merely quickly autumn asleep at the chest instead of actively feeding. This type of exceptional feeding causes a mother's milk supply to drop which adds to the problem of low weight proceeds in a roughshod bicycle.
Is my baby gaining enough weight?
If your babe is gainingsomeweight, you may wonder if you lot actually practice need to be worried or whether information technology is inside normal limits. It may aid to read Is My Baby Getting Enough Milk? and Understanding Your Baby's Weight Chart. The World Health Organisation (WHO) weight charts prove the expected growth curves seen in salubrious breastfed babies. There are separate charts for boys and girls since they grow slightly differently. You tin can download these charts and plot your babe's weight yourself (weight for age 0-6 months GIRLS & BOYS) so you can run across how your babe's growth compares. There are also growth apps that can record baby's weight on your phone that use the same charts.
Normal gain
The WHO charts show that weight gains of 30g‑40g per 24-hour interval in the kickoff 3 months are to exist expected when a infant is growing well. This slows down betwixt 3‑6 months to an average gain of 20g per day.
Crossing centiles?
If your baby is gaining less than around 30g‑40g per day in the first 3 months or less than about 20g per twenty-four hours betwixt 3‑half dozen months, their growth bend may outset to drift away from their weight-for-age bend. It may brainstorm crossing the pre-drawn centile lines in a downward direction. Meet Agreement Your Baby's Weight Chart for more data on centiles and examples of curves that show faltering weight gain.
Crossing centile lines on the WHO nautical chart may just be a sign that your baby's nascence weight was inflated, perchance you were on an Iv drip during labour. Or it may hateful that your baby is destined to be tiny and petite just like his parents, or long and lean like Uncle Larry. Or it may be because he has been poorly recently. Yet this can't exist established by someone who has never seen y'all and your babe on Dr Google or in a Facebook thread. If your breastfed baby is consistently non gaining weight (or negligible weight) consider seeking the help of an IBCLC lactation consultant to work with you and your health professionals; sooner rather than later. At that place is no advantage to waiting to see if the problem disappears.
Hungry or satisfied?
In addition to monitoring weight proceeds, it is useful to be aware of some typical characteristics of both an underweight baby and one who is getting enough milk:
- The hungry/underweight baby.A baby who has non had enough milk may be tense, with his arms aptitude at the elbow and held close to his body. He may fall asleep with his hands in tight fists and look worried with a frown on his face. A hungry babe may seem fussy and desire to stay at the breast for long periods which may be mistaken for breastfeeding "continuously" but actually he is not actively sucking or swallowing milk. Fussy behaviour or difficulty sleeping might also be attributed to colic, reflux, silent reflux or intolerance to mother's diet instead of hunger. Alternatively a hungry baby may slumber a lot and be mistaken for a "adept baby". A very underweight infant tin can have loose peel and facial features that expect like a little onetime man and he may have infrequent moisture or dirty nappies. Signs of dehydration include dry out lips and mouth, drowsiness, and dark, concentrated urine.1
- The babe who is total.When your baby has had plenty milk or is total to satiety he will usually autumn asleep and permit go of the chest on his own after a period of active sucking and swallowing. He will have relaxed hands and probably a 'milk drunk' satisfied expression. He volition accept enough of wet and muddy nappies each day and good weight gain (encounter Is My Baby Getting Enough Milk? for more than data).
Adjacent steps
In an platonic scenario the health visitor or midwife will pick upward on genuine poor proceeds at the kickoff sign of a problem and refer the female parent to a breastfeeding specialist to protect breastfeeding and ensure the baby gets more milk. A close centre will be kept on the baby's weight proceeds by weighing regularly (east.g. weekly or more often). An IBCLC lactation consultant will usually take a full medical history, study the baby's weight nautical chart, lookout a breastfeed from start to finish and put a plan in place to increase baby's intake of milk to get them dorsum on track.
Step one: feed the babe
If a baby is considerably underweight it may have fourth dimension to build his mother's milk supply and formula may be needed at offset unless donor milk is available or unless the infant is of an age when solid foods can fill the gap. Mothers who can't admission donor milk and are reluctant to utilize formula may need gentle counselling to understand that the priority is to rebuild their babe'south bodyweight and energy levels; they need more than nutrient. It can help the female parent to retrieve of formula as a necessary medicine to supplement directly breastfeeding.
If a mother tin can pump enough breast milk and then that can and should be used equally the supplement instead. Simply we have to presume that for whatever reason, the infant is not able to become plenty milk from the chest themselves and the showtime dominion is to become the baby fed… to satiety (i.e. until they are full).
How to supplement the underweight baby
Top-up supplements tin be given to a baby by an open cup, by supplementing at the breast (when a pocket-sized tube delivers supplement aslope the nipple (see pictures below) or past finger-feeding (baby suckles a finger with a feeding tube attached). A bottle can too exist used to give supplements after each breastfeed and may exist a good pick for the underweight baby who keeps falling asleep without feeding well. Although bottles can sometimes cause problems breastfeeding for some babies due to nipple preference or confusion, these Tips to Bottle Feed a Breastfed Baby tin help. Topping upwardly by canteen earlier a breastfeed is another choice. See our care program: Supplementing an Underweight Baby for much more information. With more than milk inside him, your infant will have more energy to breastfeed effectively.
Step two: build mother's milk supply
With infant's calorific needs met in the short-term, work can begin on maximising a mother's milk supply. After breastfeeding from both breasts for a combined full of around xx-30 minutes, fourth dimension spent pumping or paw expressing will stimulate the breasts more than effectively than continuing to breastfeed for hours at a fourth dimension with a infant who isn't really drinking (and isn't gaining weight). Come across How to Make More Breast Milk and How to Increase Milk Supply When Pumping for ideas to maximise your supply.
Catch up growth
If your baby has been brusk on calories for some time, there will normally exist good catch up growth in one case they are getting more milk. Gains of at least 56g per daytwo can be expected for several days or longer. Weight gains up to 120g per solar day could be possible 3. Your baby may becomevery interested in feeding and may accept more and more supplement when their appetite returns and they starting time to grab up.
All children with failure to thrive need additional calories for catch-upwards growth (typically 150 percent of the caloric requirement for their expected, non actual, weight).
Unless the infant has an underlying medical problem, failure to brainstorm catch-upwards weight gain means insufficient supplement is being given.
Sentinel out for poor advice
Hopefully your wellness professional will be very knowledgable about breastfeeding. Unfortunately they may non be or you may come up across poor advice from elsewhere. Advice to keep to ane chest "to attain the hind milk" will generallyreduce your milk supply (read more hither and here). Advice to feed more oft or for a certain number of minutes isn't helpful if that baby isn't very skilful at feeding, why spend more time doing something that already doesn't work? Alternatively the advice yous hear may be to supplement with formula—without addressing the underlying breastfeeding issues. Keeping to i chest or suggesting formula instead of breastfeeding without actively trying to increase a mother'due south milk can undermine breastfeeding and cause early weaning.
Seek a second opinion
At the other extreme, a health professional or the female parent herself may exist then pro-breastfeeding that she is overly optimistic about the low weight proceeds picking upwardly before long all on its own. They may continue to monitor the situation without taking action when weight gain is as low as 12g per solar day or fifty-fifty less. They may retrieve that if baby is following his ain curve he is OK, even if it is well beneath the chart. If this is the case for you, request for a second opinion from a paediatrician volition ensure that your babe is fit and good for you and there are no health concerns. After all a few healthy babies will be on the 1st centile. If not, an IBCLC tin aid you make a tailor made plan to increase your milk supply and get your baby taking more calories.
NICE guidelines
Squeamish (National Plant for Health and Intendance Excellence) guidelines recommend further medical assessment for unpleasing growth if a babe's weight falls across two or more centile spaces if birthweight was between the 9th and 91st centiles and a fall beyond one or more centile spaces if they were born below the 9th centile.4
Avert Dr Google and Nurse Facebook
When a mother desperately wants to breastfeed, and is worried most her baby, she may wait to search engines on the internet and social media platforms. She may detect breastfeeding forums where mothers reassure her that their babies didn't gain much weight either merely they were fine, and that she is doing cracking, and that breastfeeding is the best thing for her baby. They may tell her "carry on hun" or another favourite "information technology sounds merely like a tongue-tie". Still these cheer leaders oftentimes don't ask whatsoever of import questions; they can't see the babe's weight nautical chart; they are not trained breastfeeding specialists. Following this kind of communication may lull the mother into a fake sense of security while her baby continues to fail to thrive and her milk supply gets less and less.
A note on natural language-tie
Although it may be the latest trend on Facebook, non everything that goes wrong in the breastfeeding world is about natural language-tie. Many low weight gain babies will show poor tongue action considering they are very tense and very hungry. Yeah, at that place may exist a tight frenulum (the membrane under the tongue), just permit your IBCLC or experienced tongue necktie practitioner advise yous, not Dr Google. Dividing a tongue tie and and then expecting everything to plow out not bad as if by magic is lulling yous into a false expectation. If a baby is 25-xxx% beneath their expected weight for age, your milk supply is probable already compromised and waiting effectually for the magic on the tenuous basis "it can have 2‑3 weeks to work out how to utilize their tongue" tin can mean 2‑3 more than weeks of slipping behind in calories.
Prevention is better than cure
Unfortunately IBCLCs do come across babies thirty% below their expected weight in the community. At this point at that place may already exist a referral to a paediatrician. Social services may even have been called. And anybody volition be worried. By getting the correct assistance as soon as there are early on concerns, this upsetting situation tin can hopefully be avoided.
The consequences of inadequate intake of breast milk range from hyperbilirubinemia, infant hunger, and slow weight gain to life threatening, and even fatal, dehydration and starvation.
Summary
A infant who is very under weight may not be able to breastfeed finer and his mother'southward milk supply may be very low. An activity program involves increasing a baby's calorie intake with supplements, building his female parent's milk supply and finding the underlying reason for low weight proceeds. At that place are lots of ideas on this website for increasing your milk supply to get y'all started, but for specialist help consult an IBCLC lactation consultant alongside your doctors. Choose 1 who can spend the time needed to take a full history, brand an individual intendance plan and liaise with your wellness care professionals.
Source: https://breastfeeding.support/baby-not-gaining-weight/
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