How Much Should a Baby Gain Each Week

What is normal for breastfed babies?

The World Health Organization growth standards ¹ are the best reference for growth in the kickoff ii years as they reflect the growth of healthy breastfed babies.

The general guidelines for weight and growth measurements are:

• a baby loses five-10% of birth weight in the beginning week and regains this by 2 weeks²

• birth weight is doubled by 4 months and tripled past 13 months in boys and 15 months in girls^ane

• nascency length increases one.5 times in 12 months¹

• birth head circumference increases by about 11 cm in 12 months¹

However, all babies abound differently and these are simply general guidelines. If y'all are concerned about your baby'southward growth, contact your medical adviser for a thorough assessment of your baby's general health and wellbeing.

Babe weight losses – the early days

Normal weight loss

It is normal for babies to lose weight after they are born, no matter what or how they are fed. It is normal for breastfed babies to lose weight for the get-go 3 days later on birth. Weight loss in newborns is expressed as a percentage of the birthweight. A maximum weight loss of 7-10% in the first week is considered normal.²

Exclusively breastfed babies are perfectly adapted to survive on the small volumes of colostrum they receive in the first few days. After this, their mothers begin to make large volumes of breastmilk which so provides all the fluids, energy and nutrients they need and they will regain their birthweight by 2 weeks after birth.ⁱⁱⁱ

Regardless of the percentage of weight loss, what'due south most of import is for health care providers to determine what the overall clinical picture of the breastfeeding mother and baby pair is. For case, in that location is a significant divergence betwixt a 2 day former baby who has lost 10% of his birthweight and who is sleepy and not latching well may need more than support but a 2 day old baby who has lost 10% and is feeding frequently and well is more reassuring.

Epidurals and intravenous fluids

Fluids given to a mother intravenously (in a "baste") during the birthing process (eg with induction of labour or an epidural) can be passed onto her foetus via the placenta. This may upshot in a baby beingness born with actress fluids on board which will go removed when he/she urinates. This may make information technology appear as though the baby has lost an excessive amount of weight.^iv,v More recent evidence indicates that when a typical amount of intravenous (Iv) fluids are administered, there is negligible effect on the foetus weight and subsequent postnatal weight loss.⁶

Further research is needed to establish if higher amounts of4 fluids given to the female parent in labour/birth are associated with excessive weight loss in healthy, term, exclusively-breastfed, newborn babies and if then under what circumstances.

What is a Growth Nautical chart or a Percentile Nautical chart?

Growth charts are used to help follow and assess a baby's growth. Your baby'due south weight tin be plotted against a weight-for-age growth nautical chart. Historically, these charts have been compiled by measuring the weights of hundreds of different children at each historic period. The most common type of growth nautical chart is a percentile chart where these hundreds of weights are and so divided into 100 equal groups. These groups are then plotted on a graph or listed in a table.

If your baby record book does non contain the World Health Organisation growth standards, you lot may like to print out and put them in your volume. Chiefly, the World Health Organization growth standards are based on healthy, exclusively breastfed babies from six countries across five continents. These more accurately bear witness how a normal baby should grow. You can find the World Health Organization child growth standards percentile charts and tables here:

The simplified World Health Organization child growth percentile field tables, which are very easy to read, can be found at: Girls , Boys

How practise I read a Growth/Percentile Chart?

It is the pattern of growth over fourth dimension, rather than a single measurement or percentile, that is important.

The following instance explains how you should read a percentile chart:

• iii% of children will exist below the 3rd percentile and three% of children will be above the 97th percentile
• 15% of children will exist below the 15th percentile and fifteen% of children will exist in a higher place the 85th percentile

• 50% of children volition be below the 50th percentile and 50% of children will be above the 50th percentile

The 50th percentile is an 'average, 'not a pass. That is, 50% of the good for you population is beneath this line and fifty% is to a higher place information technology.

If a infant's height or weight is 'off the chart' (above the 97th percentile or below the 3rd), there is a higher take chances of something existence incorrect and it is wise to check with your medical adviser. In many cases though, all is well. 3 in every 100 normal babies volition weigh less than the 3rd percentile, often because both parents are small.

Does it thing if my babe doesn't 'stick' to a percentile line?

Usually, no. Percentile charts are derived from the averaged measurements of hundreds of babies and so they bear witness "smoothed" growth curves, which private children shouldn't be expected to follow exactly. They tin and do abound faster or slower at times.

It is not uncommon for a baby's weight-for-age to cross percentile lines over the course of the first half dozen months. A large report in the United states constitute that about babies (77%) crossed weight-for-age percentile lines in the kickoff 6 months, with 39% of babies either moving up or moving down two percentile lines. From nascence to half-dozen months, larger babies tended to put on weight more slowly (on average) and smaller babies put on weight more chop-chop. This may be because birth size relates more than to nutritional conditions in the womb than to genetic potential for growth. As this grouping of children got older, they were much less probable to cross two weight-for-historic period percentile lines, only it did nevertheless happen.^vii See Table one for more particular.

Even so, if a baby has persistent low weight gains with a pattern of weight proceeds indicating dropping percentiles at a faster rate than expected, it's of import to seek medical advise.

Table ane.

Historic period	Percent of infants and children crossing 2 percentile lines – weight-for-age	Percentage of infants and children crossing 2 percentile lines – weight-for-height
Birth to 6 months	39%	62%
6 to 24 months	6–15%	twenty–27%
24 to 60 months	1–v%	6–15

My baby has had persistently depression weight gains. Is my baby getting enough breastmilk?

Many mums who are worried that their baby is not gaining enough weight are also worried that their baby is not getting enough breastmilk.

These are some reliable signs of adequate milk intake.

Recall - what goes in must come out!:

• Later 5 days of age a minimum of 5 heavily wet disposable, or vi-eight very wet fabric nappies, in 24 hours.

• Pale urine (wee). If your baby's urine is dark and evil-smelling, this is a sign that your babe is non taking in enough milk.

• Good-sized, soft poos. Under the age of half dozen-8 weeks, your baby should have 3 or more than runny poos a day, most the size of the palm of your baby'south hand. After this age, it can be quite normal for a baby to poo less often, fifty-fifty once every seven-x days, as long as when your baby does a poo, there is a large amount of soft or runny poo coming out!

In improver to the 'what goes in must come out' signs in a higher place, other reliable signs that outcome from an acceptable milk intake in a healthy baby are:

• Babe has some weight gain after the initial weight loss soon subsequently nascence, and some growth in length and caput circumference. (Are your baby'south clothes getting snugger?)
• Baby looks like she fits in her skin - with expert skin color and musculus tone.

• Baby is coming together developmental milestones.

For more information well-nigh how to tell if your babe is getting plenty milk, refer to the commodity Low Supply  on this website.

My baby is getting plenty breastmilk. What'southward causing the low weight gains?

If your baby appears to be underweight, with wrinkly, loose skin and nonetheless has a good nappy count indicating enough milk intake, it may be that your baby has an underlying medical condition which is causing a slow weight proceeds. There are many weather which could affect weight proceeds. Some of the common ones include:

• infection (anything from a cold to a urinary infection)
• airsickness or frequent posseting (eg pyloric stenosis or severe reflux) - can mean a babe does not retain enough milk to grow

• a severe allergy to foods in the mother'south diet could be a crusade of depression weight gain.

Your medical counselor volition exist able to help you investigate these and other areas.

My baby is getting plenty breastmilk. Is my baby just meant to be small?

Some adults are naturally petite and so are some babies. If your baby appears to be happy and healthy, is meeting developmental milestones, does not announced underweight (does not accept loose wrinkly skin) and has a practiced moisture/pooy nappy count, then your babe's depression weight gains may be due to family unit factors (genetics).

I think my baby is NOT getting enough breastmilk. What tin I practice?

• Is your baby feeding often plenty? The simplest and most effective fashion to increment your infant'due south milk intake is to breastfeed more often. Babies need at least 6 feeds in 24 hours in the start few months. For most babies, six will not be plenty; they need 8-12 feeds in 24 hours (or more) to take in enough milk.
• More frequent feeding also means your breasts are relatively 'emptier' (they are never completely empty), which ways that your breasts volition speed upwardly milk production, increasing your milk supply. For more data on how to increase your milk supply refer to the article Low Supply on this website, or refer to the Australian Breastfeeding Association booklet, Increasing Your Supply, available for buy from the Australian Breastfeeding Association.
• Is your baby feeding according to his or her private need? This helps ensure your baby receives the breastmilk he or she needs.
• Have you only been offer one breast per feed? Some babies only need 1 chest per feed, other babies need both. Some babies start off just needing one and change every bit they grow older. You could attempt offering your baby the second breast.
• Try offering top-up breastfeeds after your baby'southward normal breastfeeds.
• Is your babe sleeping longer at night? Long night sleeps (and therefore missed feeds) tin likewise decrease your infant's milk intake and weight gain. You might consider waking your baby during the night to feed or fit in actress daytime feeds.
• Is your babe attaching and suckling effectively? Babies who are failing to thrive may have a poor sucking activeness, then they don't empty and stimulate your breasts plenty. Face-to-face assessment of this by an International Board Certified Lactation Consultant (IBCLC) or Australian Breastfeeding Association counsellor tin exist very useful. You can find an IBCLC near you at this website: Find a Lactation Consultant .
• Does your baby have a tongue-necktie? Some babies with an inductive tongue tie may non be able to remove milk likewise from the breast. ^viii Seeing an IBCLC can help piece of work out what might be going on and refer onto an appropriate wellness professional (eg medical professional person, paediatric dentist) who can make the diagnosis and release the natural language-tie, if necessary.
• Have yous been using a nipple shield? Provided a nipple shield is used properly, it should not crusade supply problems. All the same, if your baby's weight gains continue to be low, it could be that your baby is not transferring milk well through the shield. Consult a lactation consultant or an Australian Breastfeeding Clan counsellor to cheque that your baby is fastened properly on the shield and the correct size nipple shield is beingness used.

What are developmental milestones?

Developmental milestones are normal skills and abilities that babies and children acquire as they grow. These include events such as smile for the first time, turning their head towards a sound, bringing their hand to their rima oris, holding their caput steadily without support, rolling from tummy to back and taking a first step.

Developmental milestones tend to appear in a predictable society and the this link takes y'all to information about what kind of milestones to look at each age.

My baby was gaining weight well and now all of a sudden things take slowed down. What's going on?

• Have there been whatever changes in your baby's behaviour? For example has your infant been taking fewer feeds every bit a result of sleeping longer at night?
• Have yous been trying to feed at gear up times instead of when the baby indicates?
• Have you lot (the mother) been stressed or unwell? For some women this tin can cause a temporary dip in supply.
• Have you just started a new medication such equally the contraceptive pill? Could you be pregnant? These factors tin crusade a dip in your supply.
• Has your babe been ill? Even a small common cold tin can disrupt feeding and weight gain for a week or two.
• Has your babe previously gained well and is at present slowing down normally? It is very normal for an exclusively breastfed infant's weight gain to slow down at 3-4 months. The Earth Health Organisation child growth standards, based on healthy breastfed babies, assistance demonstrate this.

In most cases of sudden weight change, a 'wait-and-see' approach is justified if your baby seems happy and the other indicators of growth and wellness are fine. If there seems to be a temporary low supply problem, offer a couple of extra breastfeeds a day tin can aid avoid a more than serious situation. If yous are concerned, see a medical advisor.

References

1. WHO Multicentre Growth Reference Study Group. (2006). WHO Child Growth Standards based on length/height, weight and age. Acta Paediatrica (Oslo, Kingdom of norway: 1992). Supplement, 450, 76-85.

two. Noel-Weiss, J., Courant, Grand., Woodend, A.K. (2008). Physiological weight loss in the breastfed neonate: a systematic review. Open up Med 2(4), e99–e110.

Bertini, G., Breschi, R., Dani, C. (2015).Physiological weight loss chart helps to place loftier-risk infants who need breastfeeding support. Acta Paediatr 104(10), 1024-1027

Grossman, X ., Chaudhuri, J.H ., Feldman-Wintertime, L ., Merewood, A .(2012).Neonatal weight loss at a Usa Babe-Friendly Hospital. J Acad Nutr Nutrition 112(three), 410-413.

3. Macdonald, P. D., Ross, S. R. M., Grant, L., & Immature, D. (2003). Neonatal weight loss in breast and formula fed infants. Athenaeum of Disease in Babyhood-Fetal and Neonatal Edition, 88(vi), F472-F476.Noel-Weiss, J., Courant, G., Woodend, A.K. (2008). Physiological weight loss in the breastfed neonate: a systematic review. Open Med, 2(4), e99-e110.

Bertini, G., Breschi, R., Dani, C. (2015).Physiological weight loss chart helps to identify loftier-risk infants who demand breastfeeding support. Acta Paediatr 104(10), 1024-1027

Grossman, X ., Chaudhuri, J.H ., Feldman-Winter, L ., Merewood, A .(2012).Neonatal weight loss at a United states of america Babe-Friendly Infirmary.J Acad Nutr Diet 112(3), 410-413.

4. Noel-Weiss, J., Woodend, A.Thou., Peterson, W.Due east., Gibb, Due west., & Groll, D.L. (2011). An observational study of associations among maternal fluids during parturition, neonatal output, and breastfed newborn weight loss. International Breastfeeding Journal half dozen: nine.

5. Watson, J., Hodnett, E., Armson, B.A., Davies, B., Watt-Watson, J. (2012). A randomized controlled trial of the effect of intrapartum intravenous fluid management on breastfed newborn weight loss. JOGNN 41: 24–32.

Hirth, R., Weitkamp, T., Dwivedi, A. (2012). Maternal intravenous fluids and babe weight. Clinical Lactation 3: 59–93.

6. Eltonsy, Southward ., Blinn, A ., Sonier, B ., DeRoche, S ., Mulaja, A ., Hynes, W ., Barrieau, A ., Belanger, M . (2017). Intrapartum intravenous fluids for caesarean delivery and newborn weight loss: a retrospective cohort report.BMJ Paediatr Open 1(1), e000070

7. Mei, Z., Grummer-Strawn, L. Yard., Thompson, D., & Dietz, W. H. (2004). Shifts in percentiles of growth during early on childhood: assay of longitudinal data from the California Child Wellness and Development Study. Pediatrics, 113(6), e617-e627.

eight. Geddes, D.T ., Langton, D.B ., Gollow, I ., Jacobs, L.A ., Hartmann, P.E ., Simmer, Chiliad . (2008). Frenulotomy for breastfeeding infants with ankyloglossia: result on milk removal and sucking mechanism as imaged by ultrasound. Pediatrics 122(1), e188-94.

© Australian Breastfeeding Association Jan 2019

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Source: https://www.breastfeeding.asn.au/bf-info/common-concerns%E2%80%93baby/baby-weight-gains

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