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From:
Jean Ridler <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 26 Jun 2013 13:19:39 +0200
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So true, Pamela.  There are of course great variations in weight gain
patterns, and here the WHO growth charts are useful.

I also see the other side of the coin - breastfeeding going really well and
baby gaining well for the first couple of months (450g/week) then slows down
somewhere around 8 weeks - to be expected unless baby is an elephant.  But
mother is not usually told to expect this or given any explanation when it
does happen - mothers are distraught and believe it's a sign that their milk
is drying up.  Of course there could be an underlying problem, but more
often than not I find it's a lack of understanding and confidence.  Many
women I see do not know anyone who has breastfed for more than a few weeks
and it’s as if they are expecting breastfeeding to fail.

Jean Ridler  RN  RM  IBCLC
Cape Town, South Africa

> Yep, that sounds about right to me.  As a rule of thumb, the paeds
> that I used to work with liked a weight gain of roughly 30g/day from
> hospital discharge until 3 months.  This is not absolutely carved in
> stone, of course, but if a healthy baby is breastfeeding well, they
> will gain at least this amount - sometimes as much as 250-400g a
> week.  And if the baby is not breastfeeding well - as evidenced by
> consistently lower gain - then the quicker the reason is identified
> and addressed, then the better it will be for the baby's nutrition
> and the mom's on-going milk supply.  There's always a reason for low
> gain - if you can just find it.  In practice, however, I find so
> often that clinics and health visitors and such will reassure a
> mother that a breastfed baby doesn't need to gain so much, and the
> baby starts falling down the chart - and eventually someone wakes up
> and sees that the baby is really not doing well, and it's often too
> late to kick-start the milk supply again in time to prevent formula
> supplements.  It's just so much easier to take careful anticipatory
> care in the very early weeks and jump in quickly with a little tweak
> before the whole thing turns into a train-smash.
> 
> Just my 0.2ml
> 
> Pamela (who does a disappointingly large number of analyses of weight
> charts for "exclusively breastfed" babies who are being referred to
> Social Services for very low gain/failure to thrive when it's often
> too late to avoid really necessary large formula supplementation -
> can you tell I feel strongly about this???)

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