When a baby is diagnosed with failure to thrive, it means that he is not gaining weight like he should. It is normal for a newborn baby to lose some weight after birth, even as much as a 10 percent weight loss is considered normal. Your breastfed baby should be back to his birth weight, however, by the time he is 2-3 weeks old. After he is about three weeks old, he should start gaining around 4-10 oz per week until he is around six months old. If your breastfed baby is not gaining weight or if he is losing weight, he could be diagnosed with failure to thrive. Most doctors consider a baby to be failing to thrive when his weight falls below the fifth percentile or if a baby's weight drops by two major percentiles. (The 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles are considered major percentiles.)
When your baby is not gaining weight or losing weight, it can be very upsetting. A breastfed baby with failure to thrive may be having weight gain difficulties due to poor latch or sucking and swallowing issues, gastroesophageal reflux, metabolic disorders, milk-protein intolerance, or insufficient milk supply. If your baby is not getting enough breast milk, either because he is having issues with sucking and swallowing or because your milk supply is insufficient, you may need to supplement your baby with formula.
Here are some ways to tell if your baby is getting enough breast milk:
He has 6-8 wet diapers a day
He has several mustard colored stools per day during the first month. (After he is a month old, his stools may be less frequent and he may go a day or two without a bowel movement)
You can hear him swallowing when he nurses
He is nursing every 2-3 hours
Some warning signs that your baby is not getting enough breast milk:
He has less than 6 wet diapers a day
He is extremely fussy or lethargic
He makes a clicking noise when he nurses
He doesn't have a bowel movement at least once a day during the first month
His stools are very dark colored, not seedy and mustard colored
Getting your baby to a healthy weight may require supplementation with formula. However, this does not mean that you cannot continue breastfeeding or that baby will not be able to exclusively breastfeed eventually. Talk to your doctor and see if he can refer you to a lactation consultant. A lactation consultant can help you determine how much milk your baby is taking in when he nurses and she can also assist you if you are having breastfeeding difficulties. She can determine exactly how much breast milk your baby is taking in by weighing him before and after nursing. She can also work with you on ways to improve your milk supply, determine if your baby has anything hindering him from getting enough milk when he nurses, and she can help you to monitor your baby's weight and progress.
Patty Hone is a wife and mother to four kids. She is also the cofounder of JustMommies.com. For more mommy tips visit JustMommies' mommy blogs and be sure to check out Justmommies Baby Names at http://www.justmommies.com/baby-names/
