Reassurance for baby’s growth and development includes multiple observations, including weight gains but not just weight alone. The World Health Organisation (WHO) has produced charts as a guide from birth to two years, http://www.infantchart.com. A combination of factors including the mother’s knowledge, inform the baby’s growth and developmental progress. Weight gain may be different for each baby.
Important factors to consider come with information about family history, fetal growth in pregnancy, the type of labour and birth outcome, separation or non-separation of mother and baby from birth and early breastfeeding, particularly over the first 72 hours. These factors play a significant role in the individual baby’s reasonably expected weight gain. Observing and listening carefully to the mother’s knowledge of herself and her baby are primary to the baby growing and developing satisfactorily?
Robyn talks with Cassie to reassure her about whether her baby is gaining enough weight.
Progressive signs of growth may be associated with intermittent plateaus that show a flattening on the graph for a period of time. Progressive weight loss is concerning. Loss of appetite may lead to temporary weight plateau or weight loss. Intermittent weight loss or slow weight gain may not necessarily be a concern. To understand the individual baby’s growth and development it is important to talk with the mother to obtain a detailed history of any events that may have occurred. These could be changes in sleeping, teething, illness, vaccination, introduction of foods and development of physical activities such as crawling and walking.
Most babies grow along or between percentiles, which range between the 5th to the 95th. For example, some babies will grow around the 25th percentile which may be regarded as low but when the family history is discussed it maybe reasonable for this baby so long as the other factors are satisfactory; others will grow between the 25th and 50th percentile while others may be as high as the 75th and up to the 90th.
In summary, a detailed history of the big picture compliments knowledge of growth, development and individual weight:
Knowledge of the progress of pregnancy, labour, birth and breastfeeding
Feeding from both breasts regularly around 7 times in 24 hours
Encourage a ‘rest to digest’ period after the completion of each breast
Understanding the baby’s cues for requesting the second breast
Observing an alert, active baby with good muscle tone
Observing healthy skin colour and good skin turgor
Observing the baby communicating his/her needs
Being aware that the baby is maintaining normal body temperature
The baby is sleeping well between feeds
Frequency of the baby’s urine and pooh consistent with feeding
Volume, colour and consistency of baby’s urine and stools (pooh)
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