Normal Newborn Weight Gain

A Pediatrician Explains How Much Weight Newborns Gain in the First Two Weeks

Mother holding sleeping baby
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Q. Our grandchild went to the doctor this morning for her two-week check up. She was born at seven pounds, four ounces and 19 inches. Four days later (my daughter had a c-section) she left the hospital at six pounds, 11 ounces. At the jaundice check up, she weighed seven pounds, one ounce, and now (at 13 days) she weighs only seven pounds, six ounces and is 19 3/4 inches. The doctor said that everything is normal. I don't agree! He said that breastfed babies gain slower. Not THAT slow!

She has reflux, but she doesn't throw up much when strictly on the breast. We also keep her upright for at least an hour after eating. She sleeps in her infant seat so she will retain all she eats. I stressed that my daughter needed to eat cultured yogurt and drink buttermilk because the baby's dirty diapers show only "colored water". There is absolutely NO consistency. My daughter said that she needs to eat more meat. I think the baby needs some Kaopectate or something. We have tried Enfamil with iron as a supplemental bottle, but baby throws it ALL back up. What can we change? I am seriously concerned. Sincerely, Granny, Mississippi

A. First, let's talk about your grandchild's weight. There are two main factors I consider. 

  • Analyze her weight at two weeks. Most babies lose weight during the first week and then get back up to their birth weight by the time they are two weeks old. Since your grandchild has not only met her birth weight but is now over her birth weight by two ounces, at day 13, your pediatrician is probably right that she is growing just fine.
  • Analyze her rate of growth. Newborns usually gain about two-thirds of an ounce each day. So if she was seven pounds, one ounce at about six days of life, then she gained five ounces over the next seven days, which is still well within normal expectations. So, at the moment, you likely don't have to worry about your grandchild's weight. It sounds like she is progressing as she should. 

    Next, let's talk about your grandchild's bowel movements. Very loose stools can also be normal for breastfed babies. If it is really a problem, Kaopectate definitely wouldn't be the answer. The first step would probably be to stop supplementing with formula, since you describe that making her worse, and maybe have mom stop eating and drinking dairy products. This guide to colic in the breastfed baby discusses other problems that might cause a breastfed baby to have watery stools.

    Since you feel so strongly that something is wrong, you likely should schedule another appointment with the baby's pediatrician for another weight check to make sure that she continues to gain. You might also try to go to this visit with your daughter so that you can express your concerns and get an explanation from the doctor. If you are still not satisfied with the doctor's responses, you might consider getting a second opinion from a lactation consultant or another pediatrician.

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