Breast-feeding and baby growth
How many new mothers give up breast-feeding because they are told that their baby is not "thriving" - solely on the grounds that their babies' weight gain does not fit the weight charts?
I am the mother of four children, three of whom are now grown up, and the last is 14 years old. All were breastfed, the first for nine months, the second for one year, the third for eighteen months and the last into toddlerhood. All were bigger than average at birth: the eldest - my only daughter - was 8lbs, my eldest son 8lbs 4oz, the middle son a whopping 9lbs 4oz, and the last 9lbs. I was looked after by my local GP practice and registered with the child health clinic. I was supposed to attend weekly for the first few months for weighing the child as well as for the routine vaccinations. The babies' weight gains were plotted on charts at the clinic and I was given charts to keep track of their weight gain.
At the start, all four were on or close to the 90th percentile, being rather big babies. Between three to six months all steadily gained weight, but gradually crossed the percentile lines reaching about the 50 percentile about the middle of the first year. Despite steady weight gain, by their first birthdays, all four had moved off the chart and were now apparently lighter than 90% of babies.
This was scary stuff. With my older children, I quickly stopped attending the child health clinic except for the immunisation days. Although the babies were weighed at the same time, the child health team were too busy to give much thought to whether or not the baby was making expected progress. In any case the babies were well and looked bright eyed and lively and I wasn't grumbling or looking tired and stressed. In this way we stayed below the child health team radar.
Moreover, our visits to the doctor were very rare. In the first ten years of my children's lives we had a total of three prescriptions for antibiotics, across all four of them, for a middle ear infection, impetigo and a chest infection. My eldest son has never had antibiotics or any illness other than an occasional cold, and my daughter was late into her teens before she needed to be treated for tonsillitis.
I was lucky not to have been pestered by the child health clinic for neglecting my babies as the charts clearly showed that their weight growth was much slower than the average. Yet despite this my daughter is now 5ft 8ins, a full inch and a half taller than me. My eldest son is six foot tall, my middle son - the heaviest as a baby- is 6 ft 2 ins, and my youngest is growing like a weed. All are lean and in fact my middle son who is a keen rugby player, weighs 200lbs , and only maintains this weight by daily weight-lifting. He loses weight quickly as soon as his training slacks off. It seems that my children's slow start as babies has not resulted in stunted growth in adulthood!
It seems clear to me that the "growth charts" are based on average weight gain of "formula fed" babies and that breast fed babies do not grow in the same way in the first year of life. In fact a breast fed baby cannot take more than it needs and as long as the milk supply is adequate, the baby is suckling properly and fed regularly, the supply will exactly match the baby's requirements for optimum growth.
Childhood obesity is now recognised as a serious health issue as the numbers of fat children are increasing across the developed world. It seems entirely probable that the problem begins with excess weight gain in the first year of life, particularly as it is in this time that the fat cells are laid down. A child who stays lean in its first year has much less chance of becoming a fat child later.
If you are breastfeeding, and you and your baby are well and happy, forget the growth charts. Weigh every month and if your baby is gaining weight then don't allow the comparison with some notional average gain deter you from feeding your baby yourself. You will know if your baby is not "thriving" - it will be miserable and wakeful and look poorly. In those circumstances you may need to reconsider your feeding regime and to seek proper advice.