No, not inconceivable. (Though go to the top of the class for recognising the Princess Bride quote. Bonus point if you know which character says it 😉 )
In this case, the word is Average. It gets bandied about lots. In discussion of children’s school achievement. Talking about pay scales. It is so often abused in the news. And this week, I’ve allowed health professionals to beat me with it as though it were a stick.
Average weight gain for a breastfed baby is 30g (or 1 oz – which isn’t the same even though she used them interchangeably) proclaimed the doctor on Tuesday night. So we need to weigh him on Thursday and see that he’s putting weight on, 60 g. Put aside for the moment that their scales weren’t that accurate and let’s think about what this means.
This means that they are expecting the average weight gain to occur every day for two days. Even though the baby they are looking at isn’t average to start off with – he’s small. Even though average does not imply in any way, shape or form, daily. Instead what this means is that if you measure a sample of babies over a period of time, add the weight gains up, divide by the number of babies and the length of time, that’s where the 30g comes from. (I assume. There are other ways you could get to it I suppose, but that seems like a sensible approach to me. Actually I went searching. Kellymom has a different set of measurements that seem much more appropriate and reached in a very sensible way)
What it doesn’t mean is that all babies will achieve this every day. In fact, it’s pretty much guaranteed that very few of them will. Kind of like if you look for an average height 12 year old in a class of them, you won’t necessarily find any child of that height. (My own 12 year old is the height of an average 14 year old. Intriguing, eh? And she was a slightly small baby.) So what was I thinking when I agreed with the doctor yesterday that there should be a weight gain of around 200 grams by next Friday?
I was thinking that a highly trained professional ought to know what he was talking about. I was thinking that he is supposed to be there to first do no harm. Not that he was ticking boxes, causing stress (which works against breastfeeding and indeed good parenting), and had absolutely no good reason to suggest that 200g was a reasonable weight gain for this child, this week.
Now, it’s entirely possible that he could gain that weight. He’s done more than that before. But it’s also entirely possible that while being healthy and well fed he won’t achieve the bizarre target of the average. And at that point, if all is well, if he’s alert, happy, growing, and still filling nappies with gay abandon (which trust me, he’s doing at the moment) I hope you will all remind me to tell any nosey parker unsupportive health professional to take a running jump.
Average indeed.
Comments
28 responses to “"You keep using that word. I do not think it means what you think it means."”
Great post. Western medicine in general often leaves me baffled
I think it does many of us.
And by any definition of average, 50% of the population will be ‘better’ and 50% ‘worse’ (or taller/shorter, heavier/lighter etc.) I never did get a health visitor to understand that. I’d say if Tigerboy is gaining weight and pooing he should be fine. None of my 4 got up to birthweight in a month – not even the bottle fed one,
Chin up!
D
Yes, I should have been explicit about that. It does seem to stretch a lot of ppl doesn’t it?
Hi Jax
I am only just catching up with blogs and I just wanted to say I am so sorry for the stress you have had.
I agree with the comment above, if Tiger boy is gaining weight and pooping then I would say, he sounds like he is doing fine.
None of mine reached their birth weight by a month, My oldest was almost two months before she reached her birth weight and there is nothing wrong with her.
Take care of yourself
Hannah xx
Thanks Hannah, I’m working through it now.
I think you’re being very sensible about all this. As I mentioned before the weight gain he has had does not necessarily sound scary. Try two ounces in a month! I really hope that one way or another it all settles soon for you.
That must have been terrifying. Retrospective hugs.
The other ridiculous thing that isn’t taken into account is relativity ie what happened immediately prior to weigh in: if day 1 weighing happens just after a feed, & day 2 weighing happens just after a nappy filler & just before a feed it might seem like no gain/loss, just because relative to their size these events make big difference (even as adults difference between weighing first thing & after a meal can show big change). Which is why, as you say, these are guidelines to be used over considerable period of time & only then as a tool to determine if further thought needed. These days everything is about ticking boxes, filling forms, protecting against potential claims& not about using brains
Jax has he regained his birthweight yet?
Yes, within five days.
Do the weights you have so far all sit on the same line on his weight chart (3 points is already enough to indicate a trend)?
No, they leap about. In Crisis of confidence. I listed them out, basically he put on nearly 9 oz in a week, then 6 oz over the next two weeks. That looks more plausible for his birth weight, the 9 oz gain put him a centile up.
What I’m trying to figure out is if the things the health professionals have in front of them would cause alarm. If they would, whether this is due to inaccuracy or lack of data or whatever then we can figure out what to do about it.
Big hugs
A
I’m not sure the hospital doctors really looked at the weights except the last one. Is there anything there to cause alarm?
My daughter always fell off the weight charts and in the early days there was great concern that she never gained the average amount for an average baby. Like Tigerboy she was small. As you say, all children are different. My daughter was always on the second centile, which was considered low and I was made to feel as if I’d failed. I was worried sick and became obsessed with numbers on the scale. She is eight now and happy and healthy. And guess what – she’s still on that second centile!
I confess this is new to me, previous kids have obediently followed centile lines (not that I bothered much with weighing after no 1) so this has come as an unpleasant shock. The worst thing about it is how quickly you lose confidence in yourself.
Send me dates and weights off list and i’ll get the expert to look at them. Alison@sauer-consultancy.com
He regained his birthweight quickly and has not lost weight. Both good! I doubt there is anything wrong but will check facts with our IBCLC expert (she’s very good and involved in writing NICE guidelines and such things). My instinct tells me you are being bullied by well meaning but badly informed health professionals. There may be some improvement in feeding possible (there usually is at this stage btw, it’s all about new babies and learning and as you know no two babies are alike. Carol will tell you hers was and remains a challenge!)
Sorry doing this on a phone means it doesn’t work so well.!
I know the feeling. Will drop you a mail.
As someone who was also warned about a similar thing I hate the word average. My youngest son was born at 10lb 13 oz (not average) and lost more than 10% of his birthweight and the Midwives would not ‘sign him off’. I had to keep having him weighed until in the end they didn’t see a weight gain of any huge significance and just agreed he may just not have a huge appetite but was doing everything else (eating, drinking dirty nappies)
He is still not a big eater and I recently compared his and his older Brothers ‘Red health books’ At 15 months my youngest and biggest born baby still does not weigh as much as his older brother did at 12 months and yet the older brother was born 2lbs lighter – no average in our family and not sure what average means.
I can imagine the stress and frustration you feel and hope it ends soon
L x
It’s so easy to become worried about something like this, because the medical professionals are supposed to know best, but in this area they don’t always. But we all worry about the possibility of our baby being the one who has a big problem, however much we know. After huge weight gain stress with Rosemary, when they weren’t going to let her out of SCBU until she was gaining that mysterious 30g a day, I determined I would not be cowed next time. But I was. They quote scary statistics at you – the main one being that a 15% weight loss would mean federal to hospital. What I should have done was refuse weighing.
Good luck. I’m sure it will all turn out perfectly.
Babies are stubborn little things, and seem to put on weight at their own pace. My little boy was the opposite and putting on a pound a week from the beginning, and they never tell you to feed them less so they stay average! As long as you have a happy healthy baby you are fine x
Absolutely. I am fortunate in having a paediatrician for a sister so I have always taken what the well-meaning (I hope, at least!) health visitors have said with a fair old dose of cynicism. I was advised by the most sensible of them to stop weighing my little one as she’s a very fussy eater (SCBU at birth due to feeding problems) and it was stressing me out far too much. All I ever commented on for most of her babyhood was “Yes, plenty of wet and poo-ey nappies, thanks”.
Average. Pah.
May I have my extra point for Inigo Montoya?
I’ll remind you! xxx
Hi Jax – did you mail me dates and weights? Haven’t found them. If you do it I can get an analysis back to you pronto. In the meantime I would like to suggest that you offer to have babe weighed on the same scales weekly at about the same time of day at the baby clinic. Calibration, the same scales and accuracy are important at this stage. If they challenge his weight gain I suggest you counter with number of wet and dirty nappies, number of feeds, lack of any evidence of failure to thrive and smaller baby = less average day to day weight gain.
In the meantime get the dates and weights to me and we will look at them. I can do nothing more without this data.
A
Xx
Was still in draft. On way to you now.
Great… X