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"Is my breastfed baby getting enough milk?"
By Rebecca Hardy, mother of Alice , 14 months.

You've been to the weigh-in clinic and have been told that your breastfed baby is 'under-weight'. Hardly surprising since the growth-chart your baby is being measured against is for bottle-fed babies! But good news times are changing.

'Help - my baby's underweight!'

Breastfeeding? Been told your baby isn't gaining enough weight? Join the club. The fact is many breast-fed babies fail routinely to meet the growth standards of the baby charts. But, this isn't because breastfed babies aren't growing well, it's because the charts are based on the growth of formula-fed infants, who tend to put on more weight than breastfed ones.

The truth about growth charts

This issue has even caught the attention of the World Health Organisation and Mercedes de Onis, a representative of the WHO says: "The problem is that by these (the current UK ) charts, breast-fed babies seem to be growing poorly from as early as two to three months. This may make paediatricians recommend the mothers to introduce complementary foods or wean the baby, because the baby seems to not be growing well. But the problem is not that the baby is not growing well, it is that the standards do not reflect the growth of breast-fed infants."

Changes are afoot

The good news is that these old charts are on the way out. New WHO charts, based on the optimum growth of breastfed babies, not formula fed ones, are soon to be introduced. But there remains a great deal of controversy as to why they have taken so long.

To growth expert Tam Fry, from the Child Growth Foundation, these 'flawed' charts are nothing short of 'a scandal'. "The fact is we have been misadvising our mothers for the last 20 years. How awful it is for a mother to want to breastfed and then be forced to switch to the bottle to bring them up to speed, based on inaccurate charts."

Babies and childhood obesity

This hasn't only resulted in babies been overfed (which many experts agree, may have contributed to the UK's current problem with childhood obesity - according to the new WHO charts, British babies are significantly overweight), but it has also caused millions of mothers significant stress. All at a time, lest we forget, when we are sleep-deprived, hyper-anxious about our newborns and vulnerable to post-natal depression.

Stress for baby, stress for mum

I first came a cropper with these charts when I was being routinely chastised for Alice 's alleged failure to put on enough weight. To say this was a source of stress is putting it mildly. I was quizzed about my eating habits, booked in for an emergency doctor's appointment and told to test Alice for a urine infection (I did - a complicated, unpleasant procedure which involved putting a carton-like contraption in her nappy which Alice distinctly didn't enjoy). Why? Was she losing weight? Was she failing to gain any weight at all? No, she was simply not following the percentile line.

Other mothers tell similarly distressing tales about force-feeding their babies uneccessary bottles. When Mair's second baby, Joe, was only 10 days old, they were hospitalised for two days, due to slow weight gain. "They then kept weighing him and insisted he had some formula. I did - he only had one ounce, so he couldn't have been hungry - this was supposed to be this dehydrated starving baby! They did some tests but the results came back saying he was fine."

Take a long-term view

Of course, there's nothing wrong with being hyper-vigilant about our baby's health, but in many cases, the advice is just plain wrong. Rosie Dodds of the National Childbirth Trust say the problem lies with some health visitors over-interpretation of the charts - that the baby's growth should stick rigidly to the percentile line. Tam Fry agrees: "It is best to watch the weight gain over a month, not a fortnight, as babies have spurts. The growth chart should go up and down like a mountain landscape. Take a short-term view and you tie yourself in knots."

The good news is that these new charts will be introduced and breastfeeding women will start to get the proper advice they need. Meanwhile, if you do think your milk supply is down, take comfort from mother-of-three Linda who, when her baby's weight was languishing, found homeopathy did the trick (although it may not work for everyone). Her milk started coming in - and her baby was fine.

Help & Support:

World Health Organisation breastfeeding advice http://www.who.int/topics/breastfeeding/en/

NCT breastfeeding
http://www.nct.org.uk/breastfeeding/

NHS breastfeeding advice
www.breastfeeding.nhs.org

For a Department of Health leaflet on breastfeeding
http://www.dh.gov.uk/en/Publicationsandstatistics/
Publications/PublicationsPolicyAndGuidance/DH_4084370

La Leche breastfeeding support
www.laleche.org.uk

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