I have practiced pediatrics for 22 years.  I have seen MANY babies under
birth weight at 2 weeks of age and 3 weeks and even a few under birth weight
at 6 weeks of age.  Those 6 weekers were VERY scary babies.

I have done:

UAs
CBCs
EKGs
thyroid panels (mother and baby)
daily office follow-up
multiple LC housecalls
SNS supplementation 2-3 times/year
and many other tests and follow-up patterns.

I have diagnosed maternal hypothyroidism about once/decade.

Other than that, I cannot recall ONE SINGLE BABY whose slow weight gain was
the ONLY sign of a serious disease or problem.  In other words, with good
follow-up and lactation consultation and reassurance from a few simple tests,
slow gaining babies can be watched and helped.  They rarely need
supplementation via SNS but this can help a few babies.

This may not be a representative sample and will undoubtedly trigger a spate
of responses about babies who were gaining slowly as a sign of some large
problem.  I know this happens but it is extraordinarily rare.  Zebras.

There are multiple sources which talk about the ideal or minimal
daily/weekly/monthly weight gain for a baby.  There are BF growth charts and
requests for more growth charts.  In my opinion, this is not valuable data.

Jay Gordon, MD, FAAP, IBCLC

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