Weight monitoring of breastfed babies in the United Kingdom – interpreting, explaining and intervening

Abstract

Weighing infants in their first 6 months is an important aspect of growth monitoring and a common activity of child health care services worldwide. During the same 6 months, support for establishing breastfeeding and the promotion of continued exclusive breastfeeding are important activities of health professionals. Parents and health professionals may perceive conflicts between achieving both robust growth and continuing breastfeeding. In this narrative review, the literature on weighing breastfed babies in the United Kingdom is examined. A companion paper examined issues of growth charts, scales and weighing frequency and accuracy. This paper considers issues of interpretation of the plotted weight values for individual breastfed babies, noting the complexities of growth patterns, which may lead to difficulties of accurate identification of those individuals whose growth merits further investigation. Little attention has been given to issues of explaining the interpreted growth curves to parents and this issue is explored and noted as of importance for further study. Research evidence on choosing appropriate interventions to improve the growth of breastfed babies is reviewed. The paucity of such evidence leads to suggestions for future study. This review gathers together a wide range of literature from many different perspectives, with the hope of informing weight monitoring practice so that this can both identify infants whose weight may be of concern, and who may need appropriate intervention, and support continued breastfeeding.

Breast feeding practices and views among diabetic women: A retrospective cohort study

“…Only two women stopped breast feeding due to poor weight gain in this study. However, in a review of the literature, Sachs et al (2006) suggested that poor breast feeding technique leading to lack of sufficient milk production or poor understanding of the physiology of breast feeding may be the underpinning factors for 'perceived insufficient milk syndrome'. Ferris et al (1993) reported inadequate milk supply and greater disease severity in a higher proportion (33%) of diabetic women; this study had a smaller sample and focused on insulin-dependent diabetic mothers.…”

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“…There has been little investigation of how health professionals interpret babies' weight charts in practice and how information is given to mothers [12]. There is similarly little investigation into how women understand the messages they are given and how they use these in their on-going feeding decisions.…”

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“…Midwives appeared to see offering to weigh the baby as a key way of supporting, whereas B f N supporters were quite wary of weighing. The wariness on the part of the B f N supporters to weighing may reflect a more in depth knowledge of the challenges that weighing may create to breastfeeding women, as recently summarised by Sachs et al [43,44]. B f N supporters also placed more emphasis upon responding to baby cues rather than using more instrumental approaches such as the measurement of external parameters to ascertain well-being and growth.…”