Download weight gain

THE BREASTFEEDING ANSWER BOOK
BACKGROUND NEEDED
BASIC INFORMATION
153
four ounces (57 to 113 grams) per week from six to twelve months (Butte 2000; Haschke 2000;
Cohen 1995; Dewey 1992a).
Growth in length and head circumference are positive signs of normal development. Growth
in length averages one inch (2.54 centimeters) per month and head circumference about onehalf inch (1.27 centimeters) per month during the first 6 months. Growth in head circumference
indicates brain growth.
How much has the baby grown in
length and head circumference?
WEIGHT GAIN
Weight checks can be inaccurate if different scales are used or if the baby wears different weight
clothing for different weighings. If this is the case, suggest the mother have the baby weighed
again, using the same scale and the same clothing the baby wore at the previous weight check.
Were the same scales used each time,
and was the baby undressed or wearing
the same weight clothing?
If the doctor says the baby is doing well (other than weight gain) this is a good sign. If the
baby is developing well and seems healthy and alert, despite the fact that he’s gaining slowly,
reassure the mother that her baby is doing well and that by discussing her circumstances in
more depth there will most likely be specific things she can do to help her baby’s weight gain
improve.
What has the doctor said about the
baby’s health other than weight gain?
It is important to clearly distinguish between slow weight gain and failure-to-thrive. Some
mothers whose infants fit into the profile of the slow weight gain baby are sometimes mistakenly told that their babies are failure-to-thrive—a serious condition that requires immediate
medical intervention. True failure-to-thrive is usually due to organic causes such as infection,
anatomical abnormalities, heart defects, malabsorption, gastrointestinal, endocrinological, and
chronic diseases or nonorganic causes, for example, breastfeeding mismanagement.
Has the doctor diagnosed the baby as
having slow weight gain or failure-tothrive?
The following characteristics will help to distinguish between slow weight gain and
failure-to-thrive.
Slow Weight Gain
• frequent feeds,
• active sucking and swallowing,
• mother experiences regular let-downs,
• pale urine; six or more diapers soaked daily,
• seedy or soft stools, frequency within normal ranges,
• infant is alert and active,
• appropriate developmental milestones met,
• good muscle tone and skin turgor,
• weight gain consistent and continuous although lower than average.
Failure-to-Thrive in a Baby Younger than One Month
• still losing weight after the first week,
• infant does not regain birth weight by two weeks,
• weight loss greater than 10 percent of birth weight,
• little or no growth in length and head circumference,
• evidence of malnutrition, dehydration—sunken fontanel, grayish pallor, lethargy,
loss of fat layer under the skin, strong urine, inadequate stools,
• weight below 10th percentile at one month,
• refusal to feed from birth (Tolia 1995).