Slow growing baby - inadequate milk supply?

by Melissa
(Olathe, Kansas)

Hi Liz,

I'm concerned about my baby's slow weight gain - she has gained only 1 pound in her 2 months. My pediatriation isn't overly concerned, but I am of course as the paranoid nursing mom!

At birth - 7 lb, 12 oz
at 2 weeks - 7 lb 6 oz
2 months - 8 lb, 12 oz

Some background on my prior breastfeeding experience - This is my third child, and I breastfed my first two babies, but with some difficulty fron latch at the beginning, and then milk supply issues once I returned to work. I nursed for 8 months for my first child, and 10 months for my second. Both of my older children grew very slowly, and were also in the 10th percentile for growth; my oldest daughter actually didn't gain any weight at all from her 4-6 month check ups, and both were really skinny babies. Once I began pumping, my milk supply dwindled down and it is very difficult for me to maintain. (I'm getting ready to go back to work the first week of November)

My new baby, Jillian, seems to be the best nursing baby I have had so far. She latches well, she nurses and seems content after her feedings, she goes 3 hours between feedings, and sometimes sleeps for longer stretches at naps and night. She is wetting adequate diapers, and having dirty diapers every 2-3 days. I co-sleep with her, so she nurses as she pleases all night. My concern is that after having 2 prior slow growing babies, and milk supply issues, is there something more I can do to ensure my baby is getting enough to eat? Would it be beneficial to pump full time during the day, and continue to nurse at night to maintain my supply?


I would really love an opinion on what would be the best way to make sure my baby is getting enough, or some reassurance if there really is nothing to worry about! Thank you in advance for your time and expertise.

Melissa

Answer from the lactation consultant

Breastfed babies commonly gain 4-7 ounces a week for the first few months. Your child has gained 1.5 pounds from so 20 ounces in 8 weeks and 16-56 would be "normal" so she is on the low end but still within normal limits.
You said she is having good wet diapers but did not say how many. She should be having 6-8 per 24 hours and it is highly unusual for her not to have a BM daily.
My suggestion would be to either have a consultation with a local lactation consultant OR for you to rent a baby scale so you can do some before and after feed weights to see how much she is taking in.
Lastly, take care of yourself. Are you taking prenatal vitamins, getting 2700 calories a day (this is a lot more than most people think is necessary for good breastmilk production) and drinking lots of fluids? These things are imperative for good milk supply.
I would keep on nursing and do the above then go from there. As far as milk supply and pumping working goes, here is a page I wrote on that subject: pumping tips
Let me know if you have any further questions.
Liz Pevytoe, RN, IBCLC