The Term Infant with Problems: Evaluation of poor weight gain

Evaluation of an infant seen for poor weight gain includes:

1. Obtaining a routine history of feeding including frequency and duration.

2. Asking the mother if she is having any pain with the nursing. Pain may cause stress which may inhibit her release of prolactin and oxytocin.

3. Evaluation of the infant's stooling pattern. Infrequent stools (less than 3 to 4 per day) may be a clue that the infant is not getting enough milk.

4. A routine physical examination of the infant with attention to the mouth and evaluation of sucking.

5. The maternal history of breast surgery.

6. A maternal breast examination.

7. Observation of the feeding, concentrating on positioning. Is the baby latched on properly and sucking? Is there a swallow for every two to three sucks by the baby?