I have to respectfully and strongly disagree with Teresa on several points.  First, I will debunk Myth 1:  Healthy breastfed babies at the bottom of the curve grow less than 30 grams per day.  

Here I actually calculated the growth velocity straight from the 3rd percentile of the WHO charts for girls (since they gain a little slower -- boys have a slightly faster rate of growth) and her strong statement that these babies grow at less than the 30 grams or 1 oz a day rate is simply incorrect.  This rule of thumb is really only for the first three months when growth velocity is at its peak. After that ALL babies slow down no matter where they are on the curve.


By day 10 (which according to an ILCA document is the day that babies should regain birth weight), babies on the third percentile are gaining at a rate of 26.0 g/day or 0.915 oz/day or 6.4 oz per week.  

By day 13, the rate of gain hits 30.0 g/day or 1.056 oz/day or 7.39 oz/week

That rate of gain is sustained all the way up to 6 weeks when it is 28.7 g or 1.011 oz/day or 7.07 oz/week

Then as one would expect of any baby, there is a gradual drift down in the rate of gain:

By 8 weeks it is at 24.9 g/ day or 0.88 oz/day or 6.14 oz/week
By 12 weeks it slows down to 20.1 g/day or 0.73 oz/day or 5.11 oz/week


Then, I calculated how a 0.5 oz or 14.17 g/day gain starting on day 3 would compare to the expected WHO standard gain for a baby on the 3rd percentile of the curve.  By day 84, that baby would be 904 g or 31.8 oz lighter than the "standard" baby on that curve.  This puts the baby well below the 0.01 percentile on the curves -- so switching to z-scores this baby would be between -3 and - 4 z-scores.  


So, babies who are gaining a half ounce a day, even on the bottom rung of the curve will not be gaining at the average healthy rate for that curve.  I have seen far too many dreadful looking babies who are NOT meeting their developmental milestones because some health care practitioner stopped looking at the baby and used the half ounce a day rule.  By then, the milk supply has not been stimulated, so regardless of the underlying cause  - whether it was iatrogenically induced by the baby unfriendly hospitals in Manhattan, undetected tongue tie, aggressive sleep training or block feeding because someone thought the fat would help the baby gain better -- the end result on supply is the same.

Best regards, Susan Burger

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