I see this question often on the boards. Most recently, someone noted an unexplainable weight loss from 15.6 to 14lbs across two weeks in her four month old baby.
This can be troubling… Or not. Weighing babies is a funny and inexact science.
If you weigh them one week and you weigh them after they’ve had something to eat, just before a growth spurt (where they’ve done the rapid weight gain but haven’t shot up in inches yet), just before a bowel movement, or with a full diaper…
And then weigh them two weeks later just BEFORE a meal, just AFTER a growth spurt, just after a bowel movement.. Then they can appear to have lost weight. If baby was slightly constipated when you first weighed her, and then worked out the constipation or had a bout of diarrhea, baby might seem to have lost weight.
The proper way to weigh an infant is to first weigh a 5lb dumbell, a 10lb dumbell, the 5 and 10lb dumbells, and a thing or two that weigh a few ounces. Make sure that each weight is registering properly with your scale. This makes sure that the scale hasn’t slipped between uses. One of the most common reasons for “weight loss” in infants is an improperly calibrated scale. Make sure that your scale is accurate. Then strip your child of all clothing and diapers. Weigh your child. Do this a few times across the day, and pick the lowest weight.You’ll see trends of slight weight gain and slight weight loss across the day and across weeks. But you should see a general steady increase across the LOWEST number from month to month. You should also see an increase in head circumference, and length of your child’s body. Stalling or reversal of growth in head circumference or length of your child’s body are far more troubling than weight loss. But keep in mind that those measurements can be inaccurate depending on who took them, how they took them, or how squirmy your child was. I noticed that at my pediatrician’s office one nurse was very careful to measure from the tip top of my son’s head to the flat bit of his heels, and that she made sure his back was not arched. Another nurse seemed to include his tippy toes in the measurement. Not surprisingly the two measurements were almost an inch different- even though they were taken within 10 minutes of each other. Had these measurements been taken a few weeks or a month apart my son might have seemed to have lost or stalled in growth.
Expect periods of slight loss just before or after milestones (ie: sleeping through the night, starting solids, starting to be able to push up or roll over, starting to talk, popping a tooth, starting to crawl, starting to be able to sit up, starting to walk..) regardless of whether or not that milestone is associated with increased activity. Babies tend to dip slightly in weight just around milestones.
Also examine your feeding practices. Have you recently started CIOing or doing sleep training? that can cause weight loss. Have you started objecting to “pacifier sucking”? that can cause weight loss. Have you introduced solids? That can cause weight loss. (And besides, solids shouldn’t be introduced until 6mos at the soonest in breastfed babies.) Have you introduced bottles recently? Started having dad rock the baby to sleep for night wakings instead of waking up to nurse? Has baby become more interested in the world and less interested in nursing? Any of those things can cause weight loss. If you suspect that a change in your life is causing weight loss, you need to try adding more nursing sessions. Keep in mind that the more empty your breasts are at a feeding session, the higher the fat content of your milk. So if you’re going too long between feeding sessions, you run the risk of feeding your child a lot of lower-fat milk. Try increasing the frequency of feedings and see if that reverses the weight loss trend.
Has baby become LESS active? Sleeping more? Lethargic? Does baby produce fewer than 6-8 wet diapers per day? If any of those are true you might have a problem that you can work on and solve. (Take a nursing holiday where you strip baby and you down to have skin to skin time, nurse frequently, consider taking marshmallow root herbal supplements to increase the fat content of your milk, make sure you’re not doing anything to hurt your milk supply ie: discontinue hormonal birth control… etc.) But if baby is just as active as always, sleeping the same amount (or slightly less), and playful and engaging.. Making 6-8 wets (soaked diapers count as two), I wouldn’t worry too much unless you start seeing a trend of weight loss, change in body tone, or lethargy.
And if you see any of those, remember- there are ways to fix those situations without resorting to formula in most cases.
EDITED TO ADD:
Sometimes infants DO lose weight and it’s a cause for concern.
Some causes of weight loss in a baby that is producing 6-8 wets/day: An intolerance to something in mom’s diet (solution: elimination diet), a lack of probiotics in the infant’s system (solution: hypoallergenic infant probiotic), foremilk imbalance (solution: block nursing. Finish one breast per feeding, or one breast for several feedings before offering the other breast.) Sleepy baby (Solution: Wake to nurse). Baby not nursing frequently enough (Solution: nurse more frequently so that baby gets the high fat hindmilk as well as foremilk)
If baby is producing 6-8 wets/day, mom’s milk supply is FINE and other causes should be investigated.
This is really informative. If you are concerned about weight loss you should also be sure that your baby is weighed on the same scale at each visit. My pediatrician always sees us in room #6, so I know my son is always being weighed on the same scale. This can make a big difference.
Also, I hear a lot about women who are nursing being forced or coerced to supplement with formula if a newborn baby hasn’t reached his birthweight by the second week of life. What isn’t taken into account is that often a newborn’s birth weight is inflated by mom having an IV during labor. My labor was really short, only about 3 hours at the hospital on the IV, but my son was VERY water logged when he was born. His weight was 8 pounds but I don’t think that he would have been that heavy without the IV fluids!
Yes, when a mom has had IV fluids baby can appear to lose massive amounts of weight and cause a general panic. A newborn baby whose mom has had IV fluids can lose up to 20% of their weight and be just fine. A baby whose mom has NOT had IV fluids shouldn’t lose more than something like 7-10% of their birth weight. Scary, eh?
I think that generally you can tell by how many wet diapers the baby is putting out. If baby is putting out large numbers of wet diapers, it’s a sure sign that baby was somewhat water-logged. My son was making about 5 soaking wet diapers a day for the first 3 days of his life before my milk came in. I had IV fluids for the two hours before he was born.
Babies really only need to make one wet diaper per day of life to be considered “ok” (so one wet diaper in the first 24 hours of life, two in the second 24 hours of life, three in the third 24 hours of life, and so on until baby is making 6-8 wets or mom’s milk has come in. Once mom’s milk comes in a “soaked” diaper counts as two.)
So if you have IV fluids and your pediatrician is concerned because baby isn’t gaining weight back fast enough, try to take that into consideration.
You DO want to be concerned about weight loss in an infant, but sometimes the reasons for concern are not what they appear. If your baby is losing weight, investigate the possible reasons before jumping to conclusions.
Very informative post…thanks
Parents must be cautious about their child’s weight till they get the age of years. USDA research says, each phase of the development of a child has its own critical nutrition requirements. 75% of the brains capacity develops between birth and the age of three. By age five, the development of the brains is 90% complete. Starting at the age of two, children should eat moderately low-fat food to avoid health problems later. Between ages eleven and sixteen, children often experienced a major growth spurt.