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 Episode 241 – Scales

Today’s topic is normal newborn weight loss and weight gain. I am going to cover what to expect for the time period between the first few days to the 14th day leading onto the first 4 weeks of a babies life.

It is not appropriate to put every mother/baby pair in the same box and expect mothers supply or their babies weight gain to be the same. However, healthcare providers are aware of averages in the weight loss and weight gain department. You know that I am all about empowering parents. I would like you to know what the normal range is so you can be a partner in your babies health care. We take these averages in mind, along with the crucial information that mothers share about their breastfeeding history. We take all of this into consideration as we work with mom and baby. We add this to the information and observations during a consult, and we come up with a care plan that’s goal is to ensure we are taking care of both mom and baby. This means that we are mindful of her milk supply and her babies need for proper intake.

First topics I want to cover is – The Scales -My general rule of thumb when it comes to this topic is: Don’t take the scales and the numbers too seriously, without weighing other important factors.

Their are 2 main reasons for this advise:

1. What scale is used can vary – first weight check, peds visit, visit with me
2. What your baby is weighed in can vary -naked at birth, different diapers, cloth/disposable, outfit, onsie, hats, mittens socks
3. disposable diaper is about half ounce. cloth with wrap can be 4-6 oz. short sleeve onsie – 3 oz, long sleeve onsie with socks can be 7 oz

While these are approximate figures, You can begin to see the variables in scales and outfits and why I don’t take what the scale says as the main source of information particularly when deciding on a care plan.

The main concern that I have is that the weights from one visit to the next can be to such a degree that it would make it seem like your baby is not getting enough and gaining enough. Enough of a weight loss can send someone into a tailspin and strongly urge you to begin supplementing when, there is not need to do so. I have also seen the opposite side to that coin – After a full evaluation, I determine that your baby is not gaining well per feeding or overall. Now, I am the one suggesting supplementing when perhaps your provider was not.

What else am I looking at and evaluating during a consult as I determine how things are going with breastfeeding??

1. I am inquiring, when did your baby last eat,
2. What was your baby weighed at the drs office. Is this the same as the previous weight check?
3. A disposable diaper? Cloth diaper with wrap? Summer cotton onsie? Long sleeve onsie with pants and socks?
4. I am providing a comprehensive evaluation that includes assessing -your breast and nipple anatomy, your babies oral cavity, position and latch, milk transfer during the feeding, your medical history as it relates to breastfeeding. I am not listing everything that we cover, but just a few items. I want to give you an idea that it is not all and only about your babies weight.

If I make a decision based solely on the scale, this can have a very negative impact. If I base things soley on weight, and the scale tells me that your baby lost 4 oz when I think they should have gained 4 oz, I am going to be telling you to begin supplementing your baby. I am going to suggest a whole pumping and supplementing routine. This is quite taxing on the new mother. This sometimes causes moms to become very frustrated, perhaps angry, sad, depressed, feeling like you can’t go on like this.

If this is necessary, than so be it. What if though, it was totally unecessary and perhaps this care plan has pushed you to the brink and you give up on breastfeeding because it is just, understandably all too hard. That would be horrible.

Your pediatric office might give the same advise if the numbers on the scale are telling them to be concerned. – Common practice though is to tell you to start giving your baby formula from a bottle. Since you have been EBF your baby and they have not gained, it is often assumed you don’t have enough milk for your baby. Which is quite crazy as I cannot tell you the large number of moms I have worked with who have had bursting boobs, they are so filled with milk, but through our time together we learn that there is a good reason your baby is having great difficulty transferring the milk from your breast to their mouth.

I have an inquiring mind. I also want to know answers to some of the following questions:

Feedings – I will be asking you very specific questions about feedings and how they are going. This list of questions is an extremely important part of the whole evaluation. I find that some parents may report their baby is feeding well solely based on the time spent at breast. Perhaps on the amount of feedings in a 24 hour period or the output.

Here is the basics that we are looking for.

Normal weight loss- 4-5 oz in the first 4 days. Perhaps even another ounce or two. However, by Day 5, your baby should be on the gaining end of things, at the rate of 1/2 oz per day. So you see if your 8 lb baby, went down to 7.10 oz by Day 4, and on Day 5 began gaining 1/2 oz per day, he would be right on target to meet his 2 weeks back to birth weight expectation.

At the 2 week date, he should continue to gain weight at the rate of about 1 oz or 6-7 oz per day, at least until he is 5 months old. Gaining at this rate, would enable him to double his birthweight at 6 months old.

Once babies are 6 months old, it would be fairly normal for them to gain at the rate of about 1/2 oz per day. This is within the normal range and would put your baby at triple their birthweight at 1 year old, which is the expected norm.

While I do not put all moms and babies in the same projected guidelines, as each pair is different, I still expect to see you fall somewhere in the average range.

If your baby did not quite double birthweight by the time he is 6 months old, but has all the other developmental milestones that we are looking for, then his a bit less then expected is not much to write home about. The same thing goes if he did not triple birthweight by the time he is 1 year old.

The bullet points in this breastfeeding bites show:

1. Average weight loss for newborns is 4-6 oz in the first 4 days of life
2. By Day 5 to begin gradually gaining so they are back to birthweight at 2 weeks old
3. From that point on gaining about 1 oz per day until 5-6 months old where they begin gaining about 1/2 oz per day
4. They should double their birthweight at 6 months and triple their birthweight by 1 year old
5. Mothers and babies deserve to have a complete lactation evaluation as breastfeeding and appropriate weight gain is a very important health issue
6. Don’t let the scale alone decide how well your baby is doing.

Knowing this information will put you in a good position to be a partner in your babies healthcare. Knowing that the scale should not be the only determining factor in deciding how well breastfeeding is going will help you be the best advocate for you and your baby.

I am so glad you are here with me for our Breastfeeding Bites series. You can download my free checklist titled: Signs that breastfeeding is going well. Just go to: www.allaboutbreastfeeding.biz/bfsigns.

Lori J. Isenstadt, IBCLC

Lori j Isenstadt, IBCLCLori Jill Isenstadt, IBCLC is a huge breastfeeding supporter.  She has spent much  of her adult life working in the maternal health field. Once she became turned on to birth and became a childbirth educator, there was no stopping her love of working with families during their childbearing years.  Lori became a Birth doula and a Postpartum doula and soon became a lactation consultant.  She has been helping moms and babies with breastfeeding for over 25 years.  Lori founded her private practice, All About Breastfeeding where she meets with moms one on one to help solve their breastfeeding challenges.  She is an international speaker, book author and the host of the  popular itunes podcast, All About Breastfeeding, the place where the girls hang out.  You can reach Lori by email at: [email protected] or contact her via her website:  allaboutbreastfeeding.biz/contact

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