Breastfeeding

Monitoring baby's growth

In the experience of the women who talked to us, the most common method of monitoring their baby's growth was by regularly having their baby weighed. This is usually done by the health visitor, and checking his/her progress against standard growth charts. Most women found it reassuring when their baby put on weight as expected.

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However, not all babies put on weight at a rate that matched the growth charts and this worried their mothers. Many found themselves under pressure to introduce infant formula (see 'Getting Support for Breastfeeding') or solid foods such as baby rice and this increased their anxiety even further. Others questioned the knowledge base and belief in breastfeeding of their advisors and the accuracy of the growth charts in use prior to 2007, which neither reflected the normal growth patterns of a breastfed baby (because they were developed for infant formula fed babies) nor took into account regional, genetic or ethnic differences.*1

When their baby seemed not to be putting on enough weight, many women began to question their milk supply and sought help from health professionals or breastfeeding counsellors who often recommended increasing the number of breastfeeds in a day. A few women mentioned the idea of a 'baby-moon' as a way of increasing their milk supply or really teaching a baby to breastfeed. This meant going to bed with the baby for a couple of days, doing nothing but breastfeeding when the baby wanted and having someone else look after them both, the housework, meals and other children. A few women used breastmilk expression and medication in an attempt to improve their milk supply.

Paradoxically, some women even questioned their milk supply when their baby was gaining weight, usually because he/she seemed fussy and dissatisfied at their breast. This often occurred at busy or disruptive times of the year such as Christmas or summer holidays and when the mother was also very busy with a toddler.

Several women talked about a “weighing culture” and felt that too much emphasis was put on weight gain at the expense of other ways of telling if a baby was growing well (see also 'Cultural aspects of breastfeeding'). They felt that having their baby weighed regularly was putting unnecessary pressure on themselves. Some said that it felt like an exam that they had to pass and, if their baby hadn't put on the required weight, then they had failed. Several mentioned the effect that health visitors, who do the weighing, had on their confidence with breastfeeding depending upon how much weight their baby had lost or gained. One woman called health visitors the “weight police” and another said that she gave her baby infant formula to keep her health visitor happy. Several women, usually the more experienced mothers, made the conscious decision not to become part of that culture and not to have their baby weighed regularly but to trust their own judgement about her/his growth.

Most women who experienced pressure over their baby's weight were told that their baby was underweight but one woman was told that her breastfed baby was overweight.*2 A few women talked about the temptation to make comparisons between their baby and other babies in terms of size and development and how this could become competitive and cause unnecessary worry. The mother of a premature baby felt that weight gain was a major parameter in determining when her baby could go home from hospital.

*Footnote 1: Recently-published charts developed by the World Health Organisation (WHO) and based on babies who were exclusively breastfed are now available. They are not yet in widespread use in the UK, though some health professionals will be using them. The new charts reflect a similar growth curve internationally with very little difference between culturally diverse groups. Growth charts tend to show smooth lines but an exclusively breastfed baby's weight does not follow this pattern, especially if weighed frequently (see 'growth spurts' in 'What daily life is like with a breastfed baby'). Recommendations from recent research (2006) call for fewer, better quality weighing sessions and more emphasis on breastfeeding effectiveness and women's satisfaction with their breastfeeding experience. Other ways of monitoring a baby's growth include how quickly they grow out of their clothes, how big they feel (for example, putting your hands around the baby' s middle as the father in Interview 37 above says), alertness, happiness, feeding well, achieving developmental milestones, increasing length and head circumference.

* Footnote 2: There is no evidence that an exclusively breastfed baby can be overweight or will become obese in later life. 

Last reviewed September 2015

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