I saw a mom this week with a baby who has what I'd call slow weight gain.
Baby is gaining, although not as well as I'd like. Baby is three months
old, exclusively breastfed, and is actually my partner's patient, who is a
pediatrician. My partner is more or less neutral on breastfeeding issues,
and doesn't have a lot of knowledge on helping to solve problems. She is
quick to recommend supplements. Baby was 7#14oz at birth. At 2 mos was
10#2oz. She had happened to have been weighed 2 weeks prior to the two
month visit, and had gained only a few ounces in 2 weeks. Partner told her
to nurse more frequently and advised weighing baby before and after feeds,
and supplementing if not taking adequate amounts (but no advice to mom on
what an adequate amount is, nor does mom have a scale available) Mom never
did either weigh baby or supplement. Mom went to midwife for a check up and
weighed baby there last week. On the midwife's scale, baby had not gained
any weight in 1 month. (Different scales used for weights, though) Mom
brought baby to me for an urgent visit. Baby weighed naked on same scale as
2 month visit was 10#12oz now. This was a 10 oz gain in 30 days. Baby is
alert, active and beautiful. Is now between 10-25% for weight, and also
grew an inch. My only concern is that this baby nurses only every 3-4
hours. Also, mom is back to work and baby takes just 2 4oz bottles of EBM
in about 9 hours. Mom reports that baby just won't eat more frequently, and
if offered, sucks just a few times and falls asleep. They co-sleep, but
baby often nurses just 1 time at night. I recommended more frequent
nursing, breast compression, and offering more pumped milk at daycare. Mom
is concerned about not pumping enough. She currently leaves just the 8 oz
because that's usually all she has available. I gave some tips on pumping
more. Any advice on getting this munchkin to eat a little more frequently?
Mom has a follow up appt with my partner, so I'm sure will be getting more
pressure to supplement if weight hasn't picked up. I'd like to say I can
influence my partner, but that's a story for another day.
Also, her elderly mother in law accused her of starving the baby, and
printed out an "appropriate" diet for her from the internet, which listed
huge volumes of milk baby is supposed to be drinking. (of course this web
site also stated baby should be receiving infant formula or breastmilk, in
that order.) I did give mom some tips for dealing with unsupportive family
members, which I've had a fair amount of personal experience with!
Jennifer Tieman, MD
Family Physician
Mom to 3, and new baby #4 expected 5/31/03
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