THE REALITY OF BREASTFEEDING

WEIGHT GAIN

Consistent weight gain is one indication of a healthy infant.  There are others such as alertness, contentment, rounded cheeks.  The issue of weight gain is sometimes overemphasized above the other signs, and parents are often worried unnecessarily about it.

A consistent weight gain of anything between one ounce and one pound a week can be fine in a fully breastfed baby.  It can be useful to discover the parents’ weight gain as infants if there is concern.  Adults who gained weight slowly as infants are more likely to produce children who follow a similar pattern.  Having said this, each baby is different, and within the same family there can be considerable variation.  Some breastfed babies gain weight very quickly to begin with and then gain no weight for months on end but grow taller.  Some gain more slowly but carry on growing at that rate for years.  Logically if a child continued to gain at the rate of growth expected in the first few months of life they would be outrageously large.  My brother worked out that if my daughter continued to gain at fourteen ounces a week, she would weigh a ton by the time she was seven years old... My friends’ babies gained one ounce a week and continued to do so.  My son gained a pound a week at first, weighing thirty pounds at a year, but between eighteen months and three years gained no weight and grew four inches taller.  The point I am making is that we can trust the child’s appetite and their body to make them grow up into adults in the most suitable way for them.  Incidentally, I was told that my daughter was gaining too much weight on my milk.  Fortunately I carried on nursing her, having asked what the health visitor proposed I do about it.  The problem we have is that breast milk and formula are seen as the same thing and they are not.  Plump breastfed babies are designed to withstand infections, during which they may lose up to half their body weight, and survive without permanent damage. The weight that my children put on as chubby infants was converted into growth, and that rounded baby has grown into a tall, slim adult.  I would like to suggest that this process of the child being in control of its food contributes to a healthier attitude to eating later; this is certainly true of my children.  It is strange in a culture obsessed with weight loss in adults to be so obsessed with weight gain in infants.  Maybe there is a connection?  It is possible to force a baby to take more from a bottle - first you can push it into their mouth, then the baby has to swallow or it chokes - but you cannot force him to take the breast: it is voluntary action.  So worrying about over fat breastfed babies is also inappropriate, as their food intake is self directed and their fat is convertible into growth.

The growth charts used for many years have been based on formula-fed babies.  Growth is also not necessarily consistent.  Babies tend to have growth spurts and we warn breastfeeding mothers to expect them.  When your baby seems much hungrier just when you thought you had got the pattern of feeding he liked sorted out, he is changing it because he needs to grow and has increased his appetite.  This means that for a few days he will feed far more often and then settle back into a pattern again, though probably not the same one.

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CATHERINE HOLLAND
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