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From:
Emily Samansky <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 26 Jun 2013 22:03:35 -0400
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Breastfeeding Answers Made Simple has growth velocity charts, page 860 (Table D.1).  My understanding is also that WHO does not have actual data for the first two weeks, but the velocity charts include weight gain increments for 0-4 weeks.  If I'm multiplying correctly (used to working in ounces!), 4 ounces per week in the first 4 weeks would put a boy's gain at almost the 5th percentile -- not great but not disastrous.  From 4 weeks to 2 months, however, 4 ounces per week is quite a bit under the 1st percentile.  26 g gain per day puts a baby boy just above the 5th percentile for gain between 4 weeks and 2 months, 30 g per day just shy of the 15th percentile.  Girls gain less across the board, of course, an ounce less per week if not more.  I have found the growth velocity charts very useful in counseling mothers.  For instance, it is on the lower end of the range of normal (5th percentile) for a male or female baby to lose weight between 8 and 12 months.  I regularly get moms asking about introducing formula or giving 3 solid meals per day in those months, convinced their milk has suddenly dried up.  A thorough discussion often reveals a baby still nursing upwards of 6 to 8 times a day, once or twice overnight, with a few solids thrown in, and baby has just started sitting or crawling.  

To add to the "my baby was OK" discussion as well, my daughter was gaining 4 ounces per week as a young infant and was not OK.  I got awful support from an outpatient IBCLC at a local hospital, sad to say, and didn't know enough to go to LLL or find a private IBCLC to help.  The pediatrician's only solutions were formula or solids at 4 months, and I refused both.  I could have turned things around significantly earlier if someone had understood how badly I was screwing things up but how to get around the wall I had put up, convinced she was "just small."  When I help a mom through LLL who seems set on a disastrous course, I sometimes think of me and what type of support might have convinced me that something was wrong.  The numbers mattered, but the communication mattered more.

Emily Samansky
LLLL, Andover, MA

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