Go read the Disclaimer again. I am not a doctor. This is not medical advice. Seriously.
Well Baby visits and the charts associated with them have a shady history.
Well baby visits involve height, weight and head circumference measurements, which are then compared to charts. Then the health care provider will manipulate your baby in a number of mildly mysterious ways that they should be happy to explain to you as they are doing them (or before or after, if they are concentrating, which is good). Generally they are checking for correct development of body parts, especially some of the major joints like the hips, and they are also checking for the presence or absence of various reflexes.
Your health care provider will emphasize to you that a particular measurement is not meaningful; the trend over time is the only useful information to be gained by measuring your baby. Hopefully they also know that whether the baby is breastfed, partially or exclusively formula fed, influences infant growth patterns. If this is not the case with your health care provider, you might consider getting a different one.
If your baby is not gaining, or seems to be losing weight (and you think this is happening, too; if you think it's a measurement error, get the baby remeasured.), the health care provider will be very worried, and will want to do something about it. If you see yourself that your baby is not as healthy as you think your baby should be, you probably want to do something about it, too.
Babies that do not get enough to eat do not do well and they can die. Usually everyone agrees that the baby would do better if the baby were eating more. The question lies in how to get that to happen. A lot of pediatricians resort early and often to formula, although they may call it "human milk fortifier" or supplementation. If that baby gets calories not from you, your milk supply will not increase and you will wind up weaning. Better health care providers will refer you to a lactation consultant, or otherwise help you find someone to help you figure out why breastfeeding is not getting enough food into your baby. A really good lactation consultant, after making sure there are no major problems (latch or suck not what they should be, or possibly something as simply, and quickly correctable as a tongue tie), will suggest that you take your baby to bed with you for a couple days and do nothing but feed the baby and rest. They'll even suggest that you stack diapers and a pail by the bed and do diaper changes without even getting up, if you do not have help at home to handle the rest of baby care. Of course this is reasonable; it's more or less what we do as adults to care for ourselves when we are ill, but with the baby, it helps to maintain the bond, ensure good communication between mama and baby and thus early feeding on early cues, and prompt feeding with no delays because the parents are trying to get other (important! but not compared to keeping a baby alive. Hopefully. Otherwise you're a refugee or something and I feel awful for you and hope you all make it.) things done. In an ideal world, your baby's health care provider might suggest this to you; hopefully, yours will not argue with the idea if a lactation consultant (or you) suggest it as a first trial at helping the baby gain weight.
All too often, pediatricians (and other health care providers) adopt a watch-and-wait strategy with poor or no weight gain in a fresh baby, until the baby is so badly off they can suggest some sort of formula prescription, or additional medical testing. That's only better than unnecessary invasive testing (like, say, barium enemas to check out the bowel). Furthermore, the watching is not without problems. Daily weigh-ins (sometimes a weight check before and after a feeding) are incredibly stressful for mama and baby, not to mention taking up a lot of time and disrupting the bond that should be maintained carefully. Strongly resist a strategy that involves frequent weighing. If you cannot get your health care provider to refer you to a lactation consultant and you cannot afford one yourself, you won't be able to afford formula either. If you still want to cheap it up, just call La Leche, and they'll send someone to your home and won't charge you anything.
While our exclusively breastfed baby has gained fairly consistently over his first six months, many breastfed babies gain very quickly, then taper off and gain very little. This initial early gain can frighten pediatricians, because they are trained to believe that human breastmilk is just another creepy bodily fluid. Recent attempts to convince them that breastmilk is better than formula and solid foods are only slowly being accepted.
As a result, a baby that gains a lot (and I do mean a lot, like a pound a week for the first four months in one story I was told) may result in advice to start solid foods early, because the breast milk is "too rich". Because it will be difficult to get the baby to swallow any food, the recommendation may be for something like iron fortified rice cereal, a food which no one thinks is in anyone's long term best health. If your pediatrician suggests this, get yourself to a La Leche League meeting and get some support. And also get help learning how to maneuver such an awkwardly large young baby.
Well Baby visits are also when vaccinations are given.
During a Well Baby visit, you will be asked a bunch of other questions, including some designed to assess your baby's development compared to other babies.
Copyright 2006 by Rebecca Allen.
Created February 2, 2006 Updated March 8, 2006