Failure To Thrive / Growth Failure

“Low Intake of milk", “Failure to thrive", “Growth failure" and “Slow gain" are all terms used to describe the circumstance in which a baby is not receiving enough breast milk to grow and pick up weight healthily.

If your baby is growing well and is generally healthy, then he/she is getting enough milk. Growth can be slow at times, but may still be adequate.

Causes of Low Intake of Milk

Problems that the mother may have, that can cause a low milk supply, or cause the baby to have difficulty latching on:

Problems that the baby may have, that can cause low milk supply, laziness and/or latching difficulty:

  • Some babies may have an allergic reaction to something in the mother's milk. 
  • Acid reflux can cause the baby a lot of pain and discomfort.

Other causes of low intake of breast milk:

  • Giving the baby supplements. When is it necessary to supplement? Read more here
  • Scheduling feeds. 
  • Setting time limits for feeds and times for each breast. 
  • Poor latching technique.
  • The use of pacifiers or artificial nipples.
  • Not feeding baby often enough and not breastfeeding through the night. 

Signs and Symptoms of Failure to Thrive 

  • Not enough urine nappies for the baby’s age. 
  • Urine is dark and strong smelling. 
  • Not enough bowl movements. (first few weeks after birth)
  • The baby is not swallowing enough while breastfeeding. 
  • The baby is not gaining weight sufficiently.

Stool and urine requirements of infants per week.

Weight requirements of infants per week and month. 

Weight Variations

Failure to Thrive Tips

  • Let the baby breastfeed as often as he/she wants, without restricting the time.
  • Make sure you have a good latching technique. 
  • Try different breastfeeding positions. 
  • Know your baby’s hunger signs. 
  • Wake a newborn if they sleep longer than three hour stretches at a time. Make sure to breastfeed through the night too. 
  • Keep note of how many urine and soiled nappies your baby is having. 
  • Skin to skin contact is recommended as often as possible and especially during breastfeeding. Many mothers have found that breastfeeding in the bath, can help for maximum relaxation and milk transfer. 
  • Using breast compressions while breastfeeding can help the milk flow faster if the mother feels that she has a slow let down reflex. 
  • Massaging your breasts in-between breastfeeding sessions, can help increase the fat content of milk. 
  • If the baby is struggling to pick up weight and the mother has a sufficient milk supply, She can pump milk into separate containers, keeping the hind milk and foremilk separate. She can then freeze the foremilk for when her baby is a little older. The hindmilk is fattier and more satisfying and will help the baby gain weight faster. 
  • If the mother is using a breast pump, it is always best to use a hospital grade, electric double pump. Making sure that the flange (part that touches the breast) is the right size. 
  • Avoid using pacifiers and artificial nipples. Alternative methods of feeding can be used to avoid the use of these. 
  • The mother can investigate different ways of increasing supply, if this is an issue. She can increase supply with acupuncture, herbsgalactogogues, and certain lactogenic foods
  • Some medications can decrease milk supply, for example some contraceptives
  • The mother should take care of herself, keep calm and eat well, as well as keep herself hydrated by drinking plenty of fluids. 


  • If supplementation is necessary, it is recommended to first try human milk fortifier, which adds goodness and calories to the breast milk. The second best choice would be to use donor breast milk if safe and available and the last resort would be formula.  
  • Supplementation can be done via a SNS or alternative feeding methods. 
  • The mother should pump in between feedings, if she is supplementing, to increase her own milk supply. 

Medela Supplemental Nursing System

Top of failure to thrive page

Tracy Behr, CBC, CLD (CBI)

Reference: Breastfeeding counselor Course information through on Physiology of breastfeeding / breastfeeding problems / Other issues / failure to thrive.

Other pages on breastfeeding problems in connection with this page on failure to thrive

* Low milk supply

* Suck problems

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