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From:
Rachel Myr <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 23 Mar 2010 19:08:06 -0400
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There is one piece of information I am curious to know as I read about this boy who is about 7% below birth weight at two weeks.  
What was his net loss of weight, and when was his lowest weight reached?  My money is on him reaching bottom around day five or six, rather than what I consider a physiologic norm of reaching bottom within the first three days and then regaining whatever was lost over the next three. If milk was really slow to come in, he may have hovered around his lowest weight for a few days before starting to gain.  
To my mind there are not enough data points in the post to draw any conclusions about his weight *gain*.  All we know is in relation to birth weight.  If he lost a significant amount more than 10%, and there are several things in the original post that point in that direction (slow start, milk coming in late, dark green stools the first week) it could be that he is actually gaining like gangbusters and is well on his way to regaining his loss, which you will find out when he is weighed again in a day or two.  

If the pediatrician knows what his lowest weight was and when it happened, it could be that the pediatrician is not as lackadaisical as it could seem.  There is nothing else in the description that would make me nervous.  Sure, his weight is a concern, but since he is peeing and pooing and feeding frequently and his mother is an experienced breastfeeder, I would wait until next weigh-in to suggest anything beyond ensuring that what he is doing at the breast is feeding.

If his weight is the same or less at the next weight check then even I might be tempted to do a pre-and post feed weighing, but not at this point, if he is still on the way up from an initial big loss.   If weight gain is not convincing at next check, I know I would probably try to stretch him out and measure his length.  I see a few babies every year who really do feed constantly and stubbornly refuse to get roly-poly, opting for the less popular 'long, lean and mean' look instead.  They end up getting looked askance at by their health care providers because they are extreme outliers on the growth curves - way long for age and way 'underweight' for length, while still staying healthy and happy as though they had every right to grow the way they do.  

Remember, slimness is not a diagnosis, it is only a sign that you should look more closely at the baby to make sure his weight is not a sign of illness or some other underlying problem.

Rachel Myr
Kristiansand, Norway

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