Expert / 1 October, 2018 / My Baba
Worrying about how much weight your baby is gaining is a common concern, not helped by family, friends and even strangers repeatedly asking, ‘How much does he weigh now?’ The good news is that there is no set figure for how much weight your baby should put on – every baby will have their own pattern. Here are five top things to remember.
Hearing that your new-born has lost weight can feel alarming but it is completely normal however they are fed. Most breastfed babies lose around 6–7% of their birth weight by day three. They then start to regain weight, and most will be back to their birth weight by around two weeks.
Babies put on fat in the last weeks of pregnancy to help them through the early days whilst you both get to grips with breastfeeding. The first milk you make (colostrum) is only made in very small amounts. It is full of immune properties that help protect your baby which is more important than volume at this stage.
If your baby loses more than 10% of their birth weight this should be monitored. You should have feeds observed to check your baby’s latch is efficient. Guidelines state that you should be supported to continue breastfeeding frequently and express milk in between, giving it to your baby if a top up is needed. Only if your baby continues to lose weight might you need to give a little formula whilst continuing to increase your supply.
It’s normal to worry about whether your baby is getting enough milk, but there are other useful signs to look for rather than just how much weight your baby gains. As well as thinking about what’s going in (are they feeding at least every 2 – 3 hours?), pay attention to what is coming out. By the end of the first week they should be having at least 6 wet nappies and 2 dirty ones a day (although after 6 weeks some babies have fewer dirty nappies). Can you hear your baby swallowing? Are they alert? Do they look hydrated?
Your baby’s weight will be plotted on a chart to track their growth over time. These charts show the expected growth of babies from the lightest babies (1st percentile) to the heaviest babies (99th percentile).
Some people will tell you that as the 50th percentile is ‘average’ that’s where your baby should be. This is nonsense – all that a baby being on the 50th percentile means is that half of babies weigh more and half less than them. We wouldn’t expect all adults to be average weight, so why would babies be?
What is more important is that your baby roughly follows their own percentile line. If they were born for example on the 25th percentile, you would expect them to follow that 25th centile. If they moved a long way from it, then there might be an issue. However sometimes babies who change their percentile in the early weeks are just settling into their natural pattern.
Your baby’s growth will start to slow down at around four months old but this isn’t a sign your milk isn’t enough or they need solid foods. It is just a normal slow down – after all, if your baby continued putting on weight at the same rate they did in the early weeks they would be around 45kg by the time they were 3 years old!
At around four months babies often start feeding lots and waking up more. Some people might tell you this is a sign they are not getting enough milk but this is just a stage whilst they go through a big developmental leap. Research shows that if you wait it out, they will start sleeping more again and feeding less soon.
After the first few weeks, babies who are formula fed will gain weight more quickly than babies who are breastfed (although there are definitely exceptions for both). There are lots of reasons for this including bottle fed babies having more milk and more quickly, but it’s important to remember that breastfed babies don’t gain weight too slowly – they are designed to grow at this rate. Also breastfed babies still grow in length and head circumference at the same rate as formula fed babies, they are just less likely to be overweight.
Comparing your baby and worrying about how well they are growing is natural. It’s easy to leap from ‘my friend’s baby is bigger’ to ‘I can’t be making enough milk – but is your baby feeding frequently (at least every 2 – 3 hours)? Having lots of nappy changes? Are they growing? Are they happy? Are they hydrated? That is what matters. If in doubt do not hesitate to contact your health professional or an expert in breastfeeding such as a lactation consultant who can look at the bigger picture and help you if any changes are needed.
Professor Amy Brown is based in the Department of Public Health, Policy and Social Sciences at Swansea University in the UK where she leads the MSc in Child Public Health. With a background in psychology, she first became interested in the many barriers women face when breastfeeding after having her first baby. Three babies and a PhD later she has spent the last twelve years exploring psychological, cultural and societal barriers to breastfeeding, with an emphasis on understanding how we can better support women to breastfeed and subsequently raise breastfeeding rates.
Amy Brown, Breast Feeding Uncovered
The Positive Breastfeeding Book by Amy Brown is published by Pinter & Martin