As with any breastfeeding concerns, it is important to identify the source of the problem. Supporting individual to improve their latch and positioning is best practice, however medical assessment or further interventions may be required.

When the healthy term infant is effectively breastfeeding, the initial weight loss will stabilize quickly and then reflect a steady weight gain. For more information, see Toronto Public Health’s Breastfeeding Protocols: Signs of Effective Breastfeeding (Appendix A).

Adequate Weight Gain for Breastfed Babies

  • May lose an average of 7 – 8% of their birth weight in the first few days after birth
  • Should regain their birth weight by 10 – 14 days of age
  • Should be gaining weight daily by 4 – 6 days of age
  • Should gain 25 – 35 g (0.9 – 1.2 oz.) per day for the first 4 months of age

Weight Concerns

  • 7% weight loss that continues after 3 days is an indicator for early assessment and support of breastfeeding
  • Weight loss of more than 10%
  • Birth weight not regained by day 10 after birth

Note: Some infants take longer to regain their birth weight. If breastfeeding technique is improving, supplementation may be avoided.

Related Information for Your Patients

If breastfeeding must be interrupted or stopped for a medical reason, always consider the risks posed by using human milk substitute (i.e., infant formula).

Medical Indications for Supplementation

The Breastfeeding Protocols and E-Learning Modules are intended to support health care professionals and organizations in accessing education for the provision of evidence-based breastfeeding services and the creation of a Baby-Friendly environment.

Health professionals can play a positive role in influencing the breastfeeding culture of our community by following three easy steps:

1. Talk to Your Patients Early

Discuss infant feeding during prenatal visits. Educate patients and families on the value of exclusive breastfeeding to 6 months, as well as the risks of replacing breast milk with human milk substitute (infant formula).

A 2017 study of Toronto mothers found a significant drop in exclusive breastfeeding between 4 – 6 months and identified groups less likely to breastfeed.

Refer Patients to Toronto Public Health (TPH) Services

TPH breastfeeding clinics offer individual consultations by health care professionals both prenatally and after the baby is born. At the clinic, families can have their baby weighed and their breastfeeding concerns addressed.

Educate Yourself and/or Your Staff

The Breastfeeding Protocols for Health Care Providers are intended to promote, protect and support effective breastfeeding for the families of healthy term infants.

Breastfeeding E-learning Modules have been developed to support the education of health care providers and the provision of evidence-based breastfeeding support. The e-learning modules are based on the Breastfeeding Protocols for Health Care Providers (2013).