You’re looking at the smiling, roly-poly baby on the diaper box and wondering how your newborn is going to get there, especially because they’ve actually lost weight since birth.
Before you panic, hear this: It’s normal for a healthy, full term, breastfed newborn to lose 7 to 8 percent (or a little more) of their birth weight in their first few days.
By the time they reach 2 weeks of age, most newborns will have regained their birth weight. By the end of the first year, they should have tripled their weight.
Sometimes, though, a baby may not gain weight as expected. Learn more about why your baby may not be gaining weight and how to address the issue and encourage healthy weight gain.
It’s a flurry of feedings, diaper changes, and all-nighters. Suddenly, you’re past the 2-week mark, and you’re concerned your baby isn’t gaining weight. What now?
To gain weight, your baby’s total calorie intake must be greater than their calorie expenditure. There are three reasons why the coveted weight increase may not happen:
- they’re not taking in enough calories
- they’re not absorbing the calories they do take in
- they’re burning too many calories
Not taking in enough calories
Healthy, full term, breastfed babies typically breastfeed every 2 to 3 hours. Formula-fed babies need 1.5 to 2 ounces of formula about every 3 hours. As their tummies grow, the time between feedings increases, but some babies may not get the calories they need. Why not?
- Sleepy baby. Newborns can be sleepy, so if you find yourself trying to wake up your baby or struggling to keep them awake, resort to gently tickling their feet, removing blankets or swaddles, or easing open their diaper. Short or infrequent nursing sessions may also mean that your baby won’t be taking in enough calories.
- Learning curve. Babies need to learn how to coordinate sucking, breathing, and swallowing. Some may take a little longer than others to get it all down.
- Latching issues. Both you and your baby contribute to a successful latch. For your part, watch out for engorgement, which can make latching on challenging. For your baby’s part, ensure they’re latching on deeply. To breastfeed well, as much as possible of the lower part of your areola must be in your baby’s mouth. If you’re struggling to get a good latch, work with a lactation consultant to rule out any issues, such as a tongue tie or lip tie.
- Starting solids. Pediatricians advise starting solids after 6 months of age, when a baby is showing readiness. Even after starting solids, the majority of their calories will come from breast milk or formula for the duration of the first year. Sometimes there may be a lull in weight gain when beginning solids. Make sure that your baby is still getting frequent breast milk or formula feeds even after starting solids.
Not absorbing the calories they do take in
Some babies may be taking in enough calories — but not absorbing them. Here’s why it could happen:
- Reflux. Gastroesophageal reflux (GERD) could cause your baby to frequently spit up what seems to be the entire content of their stomach. The timing and amount of spit up may affect their ability to absorb enough calories at a feeding.
- Food allergies and sensitivities. A small percentage of babies have a food allergy or intolerance. Immediately seek medical care if you suspect an allergy. Gluten and dairy products can be challenging for your food-sensitive baby to digest and may irritate their gut, leading to diarrhea. If you’re breastfeeding and your baby is suffering from sensitivities, consider tracking your diet to evaluate whether a dietary change may stop the diarrhea. If your baby is formula fed, try changing the formula.
- Celiac disease. The first signs of celiac disease could show up shortly after starting solid foods like cereals. This allergy to gluten and the accompanying stomach pain and diarrhea make it difficult to absorb sufficient nutrients.
- Jaundice.
Research has shown that babies with severe jaundice are more likely to experience weight loss.
They’re burning too many calories
Some babies need extra calories because they quickly metabolize the calories that they take in.
- Premature babies. Babies born before 37 weeks need more calories than full term babies. However, since their brains aren’t fully developed, they may lack some of the neurological functions needed to eat well. Keep working on breastfeeding — it’ll get easier as they develop. You can discuss whether supplemental feeding is necessary with your providers.
- Breathing difficulties. Babies with breathing difficulties need more calories to make up for the extra effort that they need to exert themselves and promote tissue growth.
- Heart disease. Research shows that children with some heart diseases expend
40% more energy . When coupled with a loss of appetite, they can struggle to gain weight.
Trying to figure out whether your baby is gaining enough weight can be worrying. You have enough to think about each day as a parent of a newborn without stressing about every feed.
The first step in getting rid of this worry is ensuring that you take your baby to their regular checkups with their healthcare provider.
Monitoring their growth curve
Your pediatrician will use growth charts that are specifically geared to your child. Boys and girls gain weight at
Keep in mind that the growth charts that your pediatrician uses should align with whether you’re breastfeeding or offering formula.
If you’re breastfeeding, your baby should be measured against the World Health Organization (WHO) growth standard charts, as these charts reflect growth for breastfeeding infants.
In contrast, the Centers for Disease Control (CDC) growth reference charts reflect the growth pattern of all infants regardless of the feeding method.
Monitoring their calorie intake
Bottles come with markers designating how many ounces you’re giving your little one, but that’s not the only way to measure intake. You can tell whether your baby is taking in breast milk by watching how they suck and swallow.
Typically, they’ll have short, rapid sucks to encourage letdown and then slow to about one suck per second when letdown happens. Watch their throat rise and fall as they gulp. Still not sure? Do a diaper check. If your baby has 6 or more wet diapers in 24 hours, you’re in good shape.
Some lactation counselors may help you weigh your baby before and after a feeding. Test weighing is endorsed by the WHO and may give you a sense of what your baby is taking in during a feed.
Failure to thrive
Babies and children grow at different rates. Genes play a role too: Slender parents are likely to have slender children. But if a child shows a continued growth deficiency, they may become undernourished. Your pediatrician may diagnose this as failure to thrive.
Preventing and treating failure to thrive is important. When children don’t gain sufficient weight, their overall growth and development will suffer. They may not grow as tall as they should, and skills like walking may be delayed. Their cognitive function may likewise be affected.
Kids need to get enough calories to learn and develop properly. As such, kids diagnosed with failure to thrive need continued medical supervision to address this issue. You may work with a dietitian, therapist, or other providers to address weight gain and other concerns.
Fortunately, there are plenty of things you can do to help your baby gain weight.
The first step is to rule out any complications that could prevent your baby from getting the calories they need. Reach out to your pediatrician if your baby appears to have difficulty swallowing, vomits between feeds, seems to have a food allergy, or has reflux or diarrhea.
Done that? Consider trying the following:
Boosting your milk supply
If you feel that your milk supply isn’t sufficient to meet your baby’s demands, don’t worry — there are strategies to increase it.
Simply keep your baby close by, breastfeed every hour or two, and rest up. Your wonderful body will answer to the increased demand by increasing production.
Furthermore, make sure that you’re taking your postnatal supplements. Alternatively, research shows that
Increasing baby’s calorie intake
For breastfed babies, make sure that your baby is getting your hindmilk. It has a higher fat content than foremilk, so make sure that you encourage your baby to finish the milk in the breast that you offer first.
For formula fed babies, talk to your provider about the calorie count of your formula. Sometimes they’ll suggest changing the type of formula or ratio of formula powder to water. Be sure to do this under the guidance of a healthcare professional, as using too much or not enough water when mixing formula can be dangerous.
What’s more, you can supplement your baby’s calorie intake with your own expressed milk or formula. If you plan to continue breastfeeding, best practice is to offer the breast before you offer the bottle.
If you think that your baby isn’t gaining weight, don’t worry alone. Consult your healthcare provider and follow their recommendations. Within a short time, you should see a difference.
Remember that babies come in all shapes and sizes, and as long as your little one is following their own growth curve, you don’t need to worry.