The Wide Range of Normal

Since it’s World Breastfeeding Week, we wanted to write a post about the wide range of normal with breastfeeding.

The photo in the post is of two babies from our practice. The “little” boy was born on May 20 and the girl on May 30. Both are feeding well. Both are gaining appropriately. There is well over five pounds difference between them (despite a difference in birth weights of about one and a half pounds)! There’s a “fat baby bias” for sure! People often assume that big babies are healthier and petite babies aren’t getting enough to eat…until 3 months later when they decide the big babies are being overfed and will be obese children. In fact, regardless of growth trajectory, babies who are given formula before 6 months are 25% more likely to be obese later in life. (Note: this study shows the delivery mechanism of feeding at the breast is an important factor.)

So what’s normal? Exclusively breastfed babies should gain about 5-7 ounces per week starting from when the mature milk is in (about 3-5 days after birth) for the first 4-6 weeks. Occasionally a gain of 4-5 ounces per week is also acceptable, but in that case there should be a check-in with an IBCLC to make sure everything else is going well. And if there’s more than 7 ounces per week? No worries! It’s likely a temporary state–breastfed babies tend to be slimmer by a year of age, but even if that’s not the case there’s nothing to be concerned about as they’re following their own genetic destiny!

Weight gain isn’t the only thing where breastfeeding takes the blame unnecessarily. Sleeping through the night (or not), separation anxiety (or not), and fussiness (or not) are all areas where people–usually well meaning grandparents and aunties, but sometimes even doctors–are quick to point the finger at breastfeeding. But the truth is, babies are sometimes fussy, wake at night, and may prefer mom to any other human being on earth. They are people with opinions and preferences and it is shortsighted to blame all the things on breastfeeding. And that’s just silly. Remember: breastfeeding is the biological norm. It is the standard that should be used to compare other growth patterns and behaviors. Not the other way around.