Promoting Optimal Weight Gain in Exclusively Breastfed Infants

Promoting Optimal Weight Gain in Exclusively Breastfed Infants

What does exclusive breastfeeding entail? The term "exclusive" refers to feeding an infant solely with breast milk. Generally, it is recommended to exclusively breastfeed the baby for the first 4 to 6 months after birth without introducing solid foods. This practice ensures the baby's healthy growth and development. During initial nursing sessions, breast milk contains abundant immune-active substances, and the milk produced before the breasts are fully emptied is rich in calories. The nutritional value of human milk surpasses that of formula milk, with higher average calorie and fat content. In the first few months after birth, if the baby cannot consume all the breast milk produced, it can be expressed using a breast pump, stored in a sealed container in the freezer, and thawed and warmed for the baby when needed, particularly as they grow and demand increases.

If a breastfeeding child's weight gain is inadequate, seeking assistance from a pediatrician or a certified breastfeeding consultant is recommended. The most common reason is the lack of breastfeeding knowledge on the mother's part and insufficient guidance from healthcare professionals. When mothers of breastfeeding babies with poor weight gain seek pediatric care, we often inquire about the feeding methods employed: How often is the baby fed? Is the frequency sufficient? Does the baby receive an adequate daily caloric intake? Are diaper changes regular? These questions serve as indicators to assess whether the baby is receiving adequate nourishment.

In addition, physicians may inquire: Does the mother breastfeed from one breast per feeding session or both? How long is each feeding session on one breast before switching to the other? Does the baby latch onto the nipple correctly, ensuring a tight seal? Is the milk supply abundant? Is the milk letdown rapid? Does the baby appear satisfied after each feeding? (Remember, the volume of milk expressed with a pump does not necessarily reflect the baby's intake adequacy.) There's no need to measure caloric intake by transferring pumped milk to a bottle; monitoring the baby's weight gain is sufficient. It is recommended to purchase a baby electronic scale, weigh the baby before and after breastfeeding, and calculate the amount consumed during each feeding.

Physical discomfort in the baby can affect feeding. Identifying potential factors inhibiting weight gain, such as conditions like tongue tie, otitis media, thrush, gastroesophageal reflux, anemia, jaundice, poor sleep, fussiness, allergies, and urinary tract infections, is essential. Prompt treatment of such conditions, combined with proper feeding practices, can restore the baby's weight gain.

For underweight infants, child health experts in developed countries advise mothers to carry their babies against their skin, promoting direct skin-to-skin contact. This practice has shown to enhance weight gain. Co-sleeping with the baby facilitates oxytocin release, easing breastfeeding and increasing feeding frequency. Mothers should also learn infant massage techniques to improve digestion and expedite weight gain. Frequent breastfeeding is recommended, with daytime feedings every 2 hours and at least one feeding during nighttime sleep. Frequent feedings stimulate milk production, increase milk intake, and promote both weight gain and extended intervals between feedings. During each feeding, it's advised to allow the baby to empty one breast fully. If the baby appears satisfied, the other breast need not be offered; if the baby seems unsatisfied, offering the other breast until satiated is appropriate. How can you tell if the baby is full? Often, a satiated baby will cease sucking, display contentment, or fall asleep after feeding. If the baby continues to exhibit sucking motions, offering a pacifier can help induce sleep and pacify the baby even after they've fallen asleep.