With babies we put so much emphasis on weight. We want to know what they weighed when born, at hospital discharge, at the first week pediatrician appointment, then every month for months on end. Once this information is obtained it is used for anxiety, panic, worries about not enough feeding or too much feeding, worries about a schedule and night feedings and how long should the baby wake before we feed them. When breastfeeding we then wonder how much is taken in at each feeding, perhaps the breasts are not making enough milk, then should formula or donor milk be used, then how much? As you can see, the concerns on weight can spiral out of control very quickly.
Weight is important and it is fun to know but it is not some magic telling number to exactly how your baby is doing or how much intake the baby is receiving when nursing. We see lots of clients as Certified Lactation Counselors after the first week doctor appointment regarding concern on not enough weight gain. When digging a little deeper we often unearth many facts that were not considered.
Here are a few questions we ask:
Were any fluids given during labor? Is so, how much or for how long prior to birth? This can inflate baby's first weight.
When was the baby initially weighed? Did mom get the first hour untouched or was baby weighed immediately?
Was there a BM prior to or after the first weigh?
Did the baby have any type of supplement prior to the first weigh? (sugar water, formula, donor milk)
Did the baby nurse prior to the first weigh?
Was the second weigh on the exact same scale? Often times, scales, even the same make and model, can be up to four (4) ounces different.
On the second weigh did baby eat recently or was baby hungry?
On the second weigh did the baby recently have a BM or wet diaper?
As you can see there are many factors to include when determining weight loss and gain. The first thought, when it is suspected that the baby is not gaining enough or has not returned to birth weight by a certain date, is that intake from the breast is not enough. Many of our clients wonder why we do not do a weigh, feed, weigh as standard protocol at our lactation appointments with them. There is a very simple explanation; it is not an accurate picture of intake. That’s right, a single weigh, feed, weigh does not give you any useful information for the overall picture.
Babies are human. Sometimes they want a snack and other times they want Thanksgiving dinner. This could result in a four ounce difference in intake. Sometimes the baby has a tummy ache or is tired so they do not eat as much at that particular feeding. Other times the baby had Thanksgiving dinner the feeding prior to our visit so now they only want a snack. The only way to get an accurate picture of intake using weigh, feed, weigh is to do every single feed for a 36-48 hour period then average the intake. It is important to keep in mind that your baby is a tiny human, perfect and amazing, but human. Babies have personalities and appetites just like adults so relax and enjoy your baby and try not to stress what the scale says.
A few factors to consider when determining how your baby is doing in regards to weight:
How many wet and dirty diapers does your baby have in a 24 hour period?
Is your baby lethargic and not waking?
Does your baby show persistent feeding cues?
What color is baby’s stool? It should be yellow (no more meconium by day 7)
Is there a stool color other than yellow or green.
Don't get me wrong, we do not want to ignore the scale but we do want to factor in many factors to weight gain/loss. There are times that intake needs to be addressed or supplementation is needed. It is usually a fairly easy fix too! If you are concerned or have questions about your baby, we are here to help!
*Bosom Buddy does have a scale for rent if you are very concerned about weight gain. We encourage 36-48 hours of precise weigh, feed, weighs to get an accurate average. For more information email us