Growth of Breastfed Babies
It is common to wonder whether your breastfed baby is growing as he should be, and while diaper output is one good indicator of whether he is getting enough milk, progress on growth charts is also a tangible measure.
The World Health Organization (WHO) issued its most recent Child Growth Standards, using a world-wide sample of over 8,000 children in April of 2006. To view the report and charts, visit their website — the links to the charts are near the bottom of the page.
The new charts will be an invaluable tool for parents and healthcare providers as a way of detecting under-nutrition, overweight and obesity, and other growth and nutrition-related conditions at an early stage in a child’s life. The premise of the study is that the gold standard in infant nutrition is exclusive breastfeeding for the first six months and continued breastfeeding after the introduction of appropriate complementary foods.
Growth charts can be a useful tool to monitor a baby’s growth “at a glance,” but they have some shortcomings. For example, the charts do not adjust for genetic differences (short parents tend to have shorter children than tall parents) or racial or ethnic differences. It can also be easy to be troubled if your baby is at the bottom or top of the charts; however since they show a distribution of normal weight gain, some babies must be on the lower and higher centiles.
If my baby is growing well, why does he suddenly want to nurse constantly?
Your baby may have been breastfeeding at fairly regular intervals, but now, it feels as though you are spending the whole day with the baby at your breast! There can be many reasons why your baby has increased breastfeeding. These might include that your baby is experiencing normal “frequency days” (another term for days when a baby suddenly seems endlessly hungry) or your baby is fighting an illness. Whatever the reason, finding a comfortable place to breastfeed your baby with lots of snacks and water for you might make this time pass more quickly.
Sometimes a sudden increase in breastfeeding can precede a baby getting sick. Increased breastfeeding can provide valuable protection from illness, as your baby will be receiving antibodies and immunities that your body has made especially for your baby during this time.
Other times an increase in breastfeeding can be related to a baby reacting to something that you ate. If your baby has signs of allergy, or if you have noticed that your baby’s breastfeeding patterns change with eating certain foods, you may want to find out more about allergies and food intolerances. This page should be helpful.
Some babies also pick up their breastfeeding for other reasons. Are there significant changes in your life, for instance a move or a vacation or visitors in the house? Have you been away from your baby more than usual recently? Is your baby starting to teethe? Often changes in routine or new stages of development in the baby trigger increased desire to breastfeed for comfort and reassurance.
In general, frequent breastfeeding times that last several days are to be expected at various points in your baby’s early months. For some babies, this might happen when they are around 3 weeks, 6 weeks, 3 months and 6 months old. The LLLI book, THE WOMANLY ART OF BREASTFEEDING, calls these “frequency days”. It is not known exactly why breastfeeding babies follow this pattern. Research has established though, that the best way to maintain your milk supply is to breastfeed following the cues your baby gives you. Allowing your baby to breastfeed more frequently on the days your baby indicates the need, will increase the satisfaction both of you derive from breastfeeding. You will be more likely to have a full supply and your baby will be more likely to grow well!
On those days when all you feel you’ve done is breastfeed, give yourself credit for what you’ve accomplished – meeting the needs of your baby and helping him to learn to trust you! You might enjoy reading the pages on this site about the importance of breastfeeding as you deal with your baby’s frequent breastfeeding times.
My baby is gaining weight slowly. Is my milk of poor quality?
Generally, except in famine conditions, the quality of a mother’s breastmilk is not greatly influenced by her own diet. Even if a mother’s diet is less than optimal, her breastmilk is still the perfect milk for her baby.
However, the quantity of breastmilk can be determined by many factors. It is certainly possible that your baby is fulfilling his genetic destiny by being tiny. But it is important for the baby’s health care provider not to be too blase about his size if he appears (and is) unhealthy in addition to being small. If he has suddenly fallen off his own growth curve, or his head circumference is lagging, or he is delayed developmentally, then a change may need to be made in his feeding. If he is having scanty or few bowel movements, then it is possible that he is not getting enough to eat. If he is sleeping through feedings regularly, and not feeding effectively or efficiently when he does nurse, then again it is possible that he is not getting enough to eat. He could be one of those easygoing babies who doesn’t complain much when hungry, so he is not “demanding” or giving cues that he needs more food to grow optimally. If a pacifier is being overused, this can cause a reduction in milk supply. Certain medications and hormonal birth control can also reduce milk supply. Postpartum depression also sometimes plays a role in under-feeding a baby. Careful consultation with a medical practitioner can determine whether any of these factors are involved.
I’d like to diet and lose some weight, but will the quality of my milk be affected?
A general rule of thumb is that your weight loss should be gradual, about one pound per week, and you should eat a balanced and varied diet including foods naturally rich in calcium, zinc, magnesium, vitamin B6, and folate. Moderate exercise, with your doctor’s okay, is beneficial and appropriate for a nursing mother. Sometimes just a brisk half-hour walk with your children in the stroller in the morning can help. Remember that your body has retained some extra fat stores in order to nourish your baby in the early weeks, but as your baby gets a bit older and begins solids around the middle of his first year, those fat stores will be a bit less necessary. You may find that the weight falls off at that point, too, without too much effort on your part.
Many nutritionists suggest that nursing mothers not try to lose weight purposely for the first two months post partum, because during that time the mother needs to recover from childbirth and build a good milk supply. Crash diets, fad diets, and very quick weight loss are not recommended; gradual weight loss, the safest way, is considered no more than 4 pounds per month.
Another thing to think about is whether you are eating more processed foods that may be convenient but may not be high in nutrition. Sometimes mothers of small children spend so much time preparing nourishing meals for their little ones they forget to eat well themselves!
Resources for Additional Information
My baby needs more milk – an article from La Leche League GB that helps with understanding how to tell whether your baby is getting enough milk and working out an approach if they need more.
THE WOMANLY ART OF BREASTFEEDING La Leche League International keynote title includes important references and resources for the breastfeeding mother. Its vast depth of factual information makes this book a necessary source for breastfeeding mothers, and its warm, friendly tone makes it a classic worth reading again. THE WOMANLY ART OF BREASTFEEDING is the definitive guide, bringing the importance of mothering through breastfeeding into the 21st century. Softcover, 465 pages.