- Some causes for low weight gain in breastfed babies
- What can I do to increase my baby’s gain weight?
- Additional information
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Some causes for low weight gain in breastfed babies
It is recommended that you work with your pediatrician and a board certified lactation consultant if your baby is having weight gain problems.
First, it’s important to determine if baby is having a genuine problem with weight gain. Take a look at Normal Growth of Breastfed Babies for more on this subject.
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Following is a quick sketch of some things to look into when baby is not gaining well. This is by no means complete.
- Poor breastfeeding management is the most common cause of low weight gain –.is baby taking in enough calories?
- Is baby having enough wet and dirty diapers? This is an indicator of how much milk baby is taking in.
- What is baby’s nursing pattern? Is baby nursing frequently enough? Some things on baby’s side that might interfere with nursing frequency include jaundice, sleepy newborn, distraction and pacifier use.
- Is mom letting baby determine when to switch sides, or is she switching after a set time?
- Is baby latching well and transferring milk adequately?
- Is mom’s milk supply adequate? (Remember that pumping output is not a useful indicator of milk supply.)
- It is not necessary to pump and bottle feed or to give formula to determine whether baby is getting enough calories. There is a specialized scale (often available for rent from your lactation consultant or hospital) that can be used for pre- and post-feed weights to determine whether baby is taking in enough milk. There is a special procedure that is used for getting these weights – make sure the person doing the weighing is familiar with it.
- See Is baby getting enough milk? for more information.
- Evaluate baby for medical problems that might interfere with weight gain.
- Babies who are sick (with even a minor illness) often slow weight gain or even lose weight.
- A few common things that can affect weight gain are ear infection, thrush, reflux, anemia, allergies, tongue-tie, and urinary tract infections.
What can I do to increase my baby’s weight gain?
There are several simple things that have been proven to help with weight gain:
- Stop or decrease solid foods, particularly if baby is younger than 6 months. Most solids foods have fewer calories and nutrients than breastmilk, plus they tend to replace (rather than add to) the higher-calorie, more nutritious breastmilk.
- Sleep close to your baby (this increases prolactin and frequency of nursing).
- Learn baby massage — this has been proven to improve digestion and weight gain.
- Carry baby throughout the day in a baby carrier; get as much skin to skin contact as you can. Both of these things have been shown to improve weight gain.
- Nurse often – at least every 2 hours during the day and at least once at night. Frequent nursing increases baby’s milk intake.
- Make sure you’re allowing your baby to completely finish one side before you offer the other by waiting upon her cues that she is finished; i.e. pulling off herself and looking satisfied, going to sleep, changing from an active suck/swallow to more of a pacifier suck, etc. Always OFFER the second side, but don’t worry if she doesn’t seem to need it. It’s much more important that she be allowed to completely finish one side than that she nurse both sides. By doing so she will be assured of reaching enough of the richer, more caloric hindmilk that helps her to go longer between feedings.
- Use breast massage and breast compression during breastfeeding. If you’re pumping, use hands on pumping techniques.
- Pump or hand express for a couple of minutes before nursing. This will remove some of the foremilk so that your baby receives more of the richer, higher calorie hindmilk.
- If supplements are medically indicated, breastmilk is preferred over formula as a supplement (exceptions to this are rare), and the average fat/calorie content of mom’s milk is higher than that of formula. Mom can pump for 5-10 minutes after nursing (don’t interrupt or shorten the nursing session to do this), and offer this higher-fat hindmilk to baby as needed. This is also an option for moms who normally offer expressed milk when they are separated from baby.
See also What affects the amount of fat or calories in mom’s milk?
Additional information @ 
- What affects the amount of fat or calories in mom’s milk?
- Got Milk? Milk Supply Issues
- Calorie and fat content of various milks
- Calorie and fat content of common baby & toddler foods
Breast compression
- Breast Compression by Jack Newman, MD, FRCPC
- Stutte PC, et al. The effects of breast massage on volume and fat content of human milk. Genesis 1988; 10:22-25.
- Bowles BC, et al. New benefits from an old technique: alternate massage in breastfeeding. Genesis 1987/1988; 9: 5-9,17.
- Iffrig MC. Nursing care and success in breast feeding. Nurs Clin North Am. 1968 Jun;3(2):345-54.
More
- Protocol to manage breastmilk intake by Jack Newman, MD, FRCPC
- Slow Weight Gain Following Early Good Weight Gain by Jack Newman, MD, FRCPC
Weight gain from Children’s Hospitals and Clinics Minneapolis and St. Paul, MN. Some children who are eating solids and have trouble eating enough to gain weight may need extra calories. Here are some easy ways to add calories to foods.