Baby feeding well but not gaining weight
Managing Poor Weight Gain in Your Breastfed Infant
Managing Poor Weight Gain in Your Breastfed Infant | Johns Hopkins MedicineSometimes, a breastfed baby will gain weight more slowly than he or she should. This could be because the mother isn't making enough milk, the baby can't get enough milk out of the breast, or the baby has a medical problem. Your baby's healthcare provider should evaluate any instance of poor weight gain. Often, a certified lactation consultant can help. Below are some general tips for addressing poor weight gain in a breastfed baby.
Check the schedule
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Watch for signs from your baby that he or she wants to feed. Your baby should wake and "cue" to breastfeed about 8 to 12 times in 24 hours by rooting, making licking or sucking motions, bobbing his or her head or bringing his or her hand to the face or mouth. It is important for you to recognize these feeding cues and put your baby to your breast when he or she cues. Don't wait for your baby to cry. Crying is a late feeding cue. Usually a baby latches and breastfeeds better if he or she does not have to wait until he or she is crying, frustrated, or too tired to feed. Putting a baby off to try to get the baby to go longer between feedings and frequently offering a pacifier instead of the breast when a baby demonstrates feeding cues are often linked to poor weight gain.
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Many mothers find milk production increases and babies' weight gains improve if they and their babies let chores and activities go for 2 or 3 days, so they can breastfeed, more or less, around the clock. When a baby is not breastfeeding, the mother holds him or her skin-to-skin on her chest, which often helps her become more sensitive to the baby's feeding cues.
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If your baby is a "sleepy" baby who does not cue to feed at least 8 times in 24 hours, you will have to wake the baby to feed frequently--about every 2 hours during the daytime and evening hours and at least every 3 to 4 hours at night until weight gain improves.
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It can help to write down when your baby nurses, on which side, and for how long for a full 24 hours, if not longer. Take this record to your healthcare provider or lactation consultant to help find and fix the problem.
Latching and positioning
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Be sure your baby is mainly uncovered during breastfeeding. A baby that is bundled papoose-style may get much too warm and comfy, and he or she is more likely to doze off too quickly during feedings. If there is a chill in the air, drape a sheet or light blanket over you and the baby, as needed.
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If your baby falls asleep within minutes of latching on, massage your breast as he or she nurses. This can provide a burst of milk and re-trigger sucking. You can do this by stroking downward and inward on the breast.
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Make sure your baby is latching on correctly. The latch should be comfortable to you. Your baby's lips should be flanged outward like "fish lips. " The tongue should be under your breast. A large amount of your breast tissue should be in the baby's mouth.
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In general, avoid "switch nursing." That is, breastfeeding at one breast for a few minutes, then the other, and then back again. This may interfere with your baby getting enough of the calorie-rich hindmilk, which your baby gets more of as a feeding continues on one breast. However, the "switch" strategy sometimes stimulates the "sleepy" baby so he or she wakes up and starts sucking again.
If your healthcare provider recommends supplementing
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Use your own expressed milk first for any alternative feedings.
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Use an alternative feeding method if it is recommended by your healthcare provider or a certified lactation consultant (IBCLC). There are many alternative feeding options, so let them know if a recommendation does not "feel right" for you. Alternative feeding methods include:
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Several methods require assistance from a professional, such as a certified lactation consultant (IBCLC) so you can use them correctly. Depending on your baby and the cause of the problem, some methods may work better than others. Also, discuss bottle nipple type with the IBCLC if you bottle-feed any supplement. Some types of bottle nipples are less likely to interfere with breastfeeding than others.
Maintaining or increasing your milk supply
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Pump your breasts after as many daily breastfeedings as possible, especially if you are uncertain whether your baby is effectively removing milk during breastfeeding. Many women find that trying for 8 times per day is manageable and helpful for their milk supply.
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Pumping will remove milk effectively, so your breasts will know to make more milk. Pumping will also express supplemental milk for feeds. Milk can be removed from the breast by manual hand expression, a hand pump, a battery-powered pump, or an electric breast pump. If frequent and prolonged pumping is anticipated, a hospital-grade, electric pump can be very helpful.
Checking baby's weight
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Your baby should be weighed on a frequent and regular basis until he or she is gaining weight at a satisfactory rate. Digital scales are available that allow a healthcare provider or a certified lactation consultant (IBCLC) to get precise pre- and post-feeding weights to measure how much milk a baby takes in during a particular breastfeeding. Although this can be helpful, babies take in different amounts at different feedings throughout a 24-hour period. Therefore, a professional may recommend that parents rent this type of scale so a baby can be weighed before and after different feedings. They also may suggest recording only a daily or weekly weight, depending on the situation.
Call your baby's healthcare provider
If your baby ever shows signs of dehydration, call your baby's healthcare provider right away. Some signs of dehydration in a baby include:
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Fewer stools and wet diapers than usual
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Dry lips
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Sunken fontanelle (soft spot)
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Dark circles around the eyes
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Appearing more tired than usual
If breastfeeding is properly managed, yet the baby still is not gaining enough weight, it is likely that some other factor is affecting milk production or the baby's ability to breastfeed effectively. Always consult your own, and your baby's healthcare provider.
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Why a child does not gain weight: Top 5 main reasons
Do you ask yourself why a child does not gain weight every day when you look at your baby's thin arms and legs? We will help you find the answer to it and tell you what to do so that the arrow of the scales starts to rise up.
For many mothers, the ideal baby is a plump butuz with chubby cheeks. If the baby is thin from the cradle, then in most cases this causes concern for parents. Sometimes absolutely in vain! It is often enough to change very little for the little one to start gaining weight. And most importantly - to understand the reasons for the lack of weight of the baby.
See also: "5 rules to keep your baby healthy"
Reason 1: Your baby is not gaining weight because he is not eating enough milk.
This is possible even if the baby spends half a day at your breast. There may be several reasons: the little one does not suckle well, falls asleep while eating, you do not have enough milk. To find out how much milk the little one drinks at a time, weigh it before and after feeding, and write down the indicators. Then be sure to show your records to the pediatrician.
If it turns out that the baby eats less than the norm, the doctor will teach you how to properly attach the baby to the breast, if necessary, recommend drugs that increase lactation. In some cases, the doctor may recommend supplementing the baby with formula (if the baby is less than four months old) or vegetable puree (after 4-5 months).
REMEMBER ! A formula-fed baby may also not eat enough. Sometimes a baby needs a larger portion than recommended for his age. If the baby is not gaining weight well, write down how much mixture he eats per day. Your pediatrician will review your notes and may recommend increasing the dose or changing the formula.
Reason 2: The child is not gaining weight because he does not like the taste of new foods.
Many babies categorically refuse to change their breast or bottle for a spoon. They refuse fruit and vegetable purees, cottage cheese, cereals. If the baby is naughty and refuses to eat from the first days of the introduction of complementary foods, do not worry. Be consistent and offer him complementary foods every day - sooner or later, the baby will taste adult food and enjoy it.
REMEMBER! Never give up and refuse to introduce complementary foods. After six to seven months, one mother's milk is not enough for the normal growth and development of the crumbs. The baby needs more calories, vitamins, nutrients. If you do not introduce complementary foods on time, the baby's immunity may weaken and even develop anemia.
Cause 3: The child is not gaining weight because you did not properly formulate the diet.
And you don't even know about it! Maybe your little one's diet lacks fat? You should add 3-5 g of vegetable or butter per 100 g of vegetable soup. If the baby is not gaining weight well, this amount may be higher. Thin peanuts are also recommended to add oil to cereals and some desserts.
Also, the cause of underweight child can be monotonous diet and too much sugar in the dishes that you offer the baby (sugar impairs the absorption of nutrients by the body).
REMEMBER! If your baby is slender, do not give him juice often (especially with pulp). They are quite high-calorie: in 100 ml about 40-60 kcal. After them, the child may refuse the main meal.
Cause 4: The child is not gaining weight because he is very active.
If a baby cannot sit quietly in one place, he constantly crawls, rolls over, actively waves his arms and legs, then he naturally spends a lot of energy on this. Accordingly, fat does not have time to be deposited, because the calories received with food are quickly consumed.
REMEMBER! If your smart baby slowly gains weight, but rarely gets sick, develops well and is in a great mood, there is nothing to worry about.
Reason 5: The child is not gaining weight because he is sick.
If your baby is developing well and suddenly stops gaining weight, you should talk to your pediatrician about it. Sometimes the cause of this phenomenon may be some diseases (for example, cystic fibrosis, celiac disease).
REMEMBER! Also, the presence of parasites in the baby's body can cause a deterioration in appetite and low weight.
Source 4mama.com.ua
how to help them develop?
The birth of a small child is not uncommon today. Often, such babies are born on time or a little earlier, but due to a lack of weight, they can significantly lag behind their peers in development. Pediatricians and neuropathologists closely monitor the child's condition, because a child's body weight deficiency is a risk factor for changes in the neurological status, functional disorders of the cardiovascular and autonomic nervous systems. But because of their weakness, underweight children do not eat well, and the rate of weight gain in children born with low body weight determines their further physical and psychomotor development and the formation of the immune system.
How much should a newborn gain in weight?
To assess the development of your child and the compliance with the norm of the main indicators (height, weight), you can contact a pediatrician or independently - according to existing tables. In the first months, the child is actively growing, adding up to 25-60 grams per day. Small children with adequate nutrition can increase body weight more intensively than their peers. For the first month of life, children should gain up to 1.3-1.7 kg. After 5-6 months of life, the intensity of weight gain decreases somewhat - in 30 days, the increase can be only 400-700 grams.
The length of the child's body increases by 4-7 cm during the first month, and after 5-6 months of life, growth increases less intensively - by 2-3 cm. But parents should understand that these figures are approximate. Each child is individual. Its weight and height depend on many factors: heredity, the quality of the mother's nutrition, the state of health of the newborn, the severity of childbirth.
Why is the child not gaining weight well?
The main cause of underweight in the neonatal period is the baby's refusal to breastfeed. Small children have poor appetite and spend most of the day sleeping. Often, parents have to wake up the child for a long time, and after a few minutes of sucking on the breast or a bottle of formula, the newborn falls asleep again. Children are especially sleepy, in whom pronounced physiological jaundice was observed in the first days of life.
As a result, after the next weighing, the doctor can tell the mother that the newborn has not gained weight at all or the increase is insignificant. If the situation does not improve for several months, the mother and baby may be hospitalized for a comprehensive examination and tube feeding in a hospital setting.
Sometimes the cause of low weight gain lies in non-compliance with breastfeeding tactics. Pediatricians recommend applying the baby to only one breast during feeding so that it sucks out the "hind" milk, which is of particular energy value and rich in nutrients. Due to their inexperience, mothers offer both breasts to newborns. In this case, the child sucks the upper milk without making any effort and quickly falls asleep, slightly satisfying his hunger.
If the baby has had an infectious disease, has been ill for a long time, suffered from a high temperature or an intestinal disorder, then the monthly weight gain may be significantly less than usual. In this case, the timing of the introduction of complementary foods is also shifted, and during the period of illness, in general, many children practically refuse to eat, which is reflected in their weight. Parents should actively communicate with the pediatrician, if necessary, ask him questions of interest and adhere to all recommendations.
How to help a child gain weight and catch up with their peers in their development?
If you are breastfeeding, pay special attention to your diet. Drink as much liquid as possible: low-fat milk, compotes, hypoallergenic juices. Your diet must include boiled or baked meat. Take extra vitamins (as advised by the doctor). Breastfeed your baby immediately after waking up, when he is active, in a good mood and does not want to sleep.
But sometimes women's milk is produced in insufficient quantities or the baby does not have enough strength to suck it out. In this case, it is necessary to start supplementing with special infant formula as soon as possible. For children prone to allergic reactions, special hypoallergenic products are intended, which can be bought at a pharmacy, having previously discussed the mixture option with a pediatric nutritionist or pediatrician. Small babies are not adapted to intensive sucking, so the nipple on the bottle must be soft and pliable so that the child can fill up without problems.
In addition, to increase the rate of weight gain and, accordingly, for the proper growth and development of the child, it is recommended to give courses of preparations containing L-carnitine (levorcarnitine), an essential vitamin-like substance that has anabolic properties and has proven itself well for normalizing body weight in case of its deficiency. In addition, by increasing the secretory and enzymatic activity of gastric and intestinal juices, appetite and digestion improve. One of these drugs is Elkar, containing an aqueous solution of L-carnitine. Elkar is included in the "National program for optimizing the feeding of children in the first year of life" as a means of correcting malnutrition of the II degree.
In children, in contrast to the adult body, where levocarnitine is among the substances produced, the synthesis of this compound covers only 1% of the required amount. Of course, the required amount of L-carnitine is found in breast milk, but if natural feeding is impaired or impossible, the drug must be added to the diet.
In underweight children, psychomotor development is often retarded, which can subsequently manifest itself in the form of speech defects, instability of the nervous system. Elcar improves the energy supply of brain activity, which will help to avoid or reduce the degree of development of functional failure in various areas of the child's neuropsychic response (motor, emotional-motivational, vegetative, cognitive spheres).