Written by Charlotte
Checklist for improving weight gain in breastfed babies

1. Scales: Check out the weighing protocols. Time, clothing, scales and floor surface can all make a big difference. If a clinical weight is required due to concern over growth digital scales are essential. Mechanical scales that are moved are often very inaccurate

2. Did the mum have a c-section or drips during delivery? The can inflate birthweight and/or reduce initial production.

3. Hereditary factors: Are the parents - short, thin, fat….. Did anyone in the family have ’slow gain’?

4. If HV is pushing formula supplements, ask to be referred to a paediatrician. If she’s really concerned, she should have done that anyway!

5. Consider a galactagogue to increase milk supply ie: fenugreek capsules
galactagogue

6. Lots of skin-to-skin with baby, so he/she learns being close to mummy’s boobies is a nice place to be.

7. If baby is not demanding to be fed, learn to read the hungry signs. Crying is the last sign of hunger. Watch for snuffling, moving about in sleep, rooting against blankets, sucking fingers etc.

8. Does baby have a dummy? Crucial hungry signs can be missed if baby is sucking on a comforter.

9. Get positioning checked by someone experienced (usually NOT a HV or MW) http://www.wiessinger.baka.com/bfing/howworks/latchtalk.html

10. Is the baby feeding effectively, with plenty of strong suckling and deep swallows, or just lots of flutter sucking?

11. Is the baby’s poo the right colour/consistency? Is the baby urinating frequently.

12. Count the time between feeds from the BEGINNING of one feed to the beginning of the next. You need to be feeding between 8 and 12 times in 24 hours.

13. Learn the technique of Breast Compression

14. Visit a BF counsellor or Breastfeeding group/clinic.

15. Does baby sick up a lot? Could he/she have reflux?

16. Might there be a foremilk/hindmilk imbalance? Not enough hindmilk can affect weight gain. (see point 11, a foremilk imbalance usually displays as green stooling rather than standard mustard/yellow/seedy/curdy.)

17. If baby is resisting extra feeding, do something different – feed lying down, feed in the bath, take baby’s clothes off, wrap baby up – anything different.

18. Is baby feeding at night? Night feeds are very important for increasing supply.

19. If supplements are to be given, expressed breastmilk is by far the preferred option. A hospital grade double breast pump is going to be more effective for expressing and stimulating supply than an ordinary hand pump. You can hire pumps from:
http://www.ameda.demon.co.uk/nursingmother.html
http://www.centralmedical.co.uk/expression.htm

20. Did the baby have a very difficult birth? This could result in a disorganised suck - which cranial osteopathy would help with. http://www.bfar.org/craniosacral.shtml

21. Does the baby have tongue-tie?

22. Is HV using a breast from birth chart? http://tinyurl.com/6×5lb The standard charts are not accurate for bf babies as they have been shown to gain 7% less than FF babies. http://tinyurl.com/4nxyp

Things that won’t help

Formula supplements may help with weight gain but will seriously compromise breastfeeding and destroy the virgin gut. If supplements have to be given, expressed breast milk is the preferred option.

Bottles/teats/dummies can all compromise breastfeeding. If supplementation is necessary use a cup, spoon or syringe instead.

Remember:

Breastfeeding is about protecting your baby from allergies, illness, obesity, diabetes, childhood cancers, SIDS and improving IQ and dental formation. It also protects mums from breast cancer and osteoporosis.

Formula feeding is about putting on weight (quite often too much) and that’s it!!