What is “Faltering Growth”?

Faltering growth means that your baby is gaining weight more slowly than expected.

It is not a disease, and it does not mean you have done anything wrong. Most of the time, it simply means your baby is not getting quite enough calories.

Only around 5% of babies have an underlying medical reason for faltering growth.

Faltering growth can happen to any family, in any situation.
With the right support, most babies catch up very well.

How Do We Know if a Baby Has Faltering Growth?

Your baby may need support if any of the following apply:
(from NICE growth guidance used in the guideline)

• Not back to birth weight by 3 weeks.
• Fewer than 6 wet nappies and 2 soft yellow/orange, £2 sized, stools per day (under 6 weeks).
• Weight dropping across centile lines on the UK-WHO growth chart.
• Baby’s weight is below the 2nd centile, at any birthweight.

If this happens, your health professional will look at feeding, check your baby’s health, and offer immediate support.

Why Does Faltering Growth Matter?

Growth during the first months of life is important for your baby’s:

• Brain development
• Immune system
• Overall health and future growth

Early feeding problems can affect milk intake and supply, so acting quickly helps ensure your baby gets all they need.

The guideline states that milk supply is time‑sensitive, and delays in support can make things harder to correct.

Does Faltering Growth Mean I Need to Stop Breastfeeding?

No
Breastfeeding provides more than calories—it supports your baby’s health, immunity, comfort and your bonding.

• The goal of any plan is to protect breastfeeding, while making sure your baby gets enough milk to grow. This may involve:
• Improving attachment (latch)
• Feeding more frequently
• Expressing milk to boost your supply
• Giving your baby extra milk for a short time (your own expressed milk, donor milk, or formula if needed)

Parents can continue to enjoy a positive breastfeeding relationship even when temporary supplementation is needed.

What Happens If My Baby Is Found to Have Faltering Growth?

According to the guideline:

1. A GP must check your baby’s health

Medical causes (e.g., heart issues, infection, thyroid or metabolic conditions) for slow growth are unlikely, but to rule them out you will be asked to see your GP.

Sometimes, a baby will be seen by a paediatrician.

2. Feeding will be assessed

A qualified breastfeeding professional will look at:

• Baby’s latch and positioning
• Frequency and effectiveness of feeding
• Signs of milk transfer
• Possible tongue‑tie or oral issues (if needed)
• Your milk supply and any factors that may affect it (e.g., thyroid conditions, PCOS, blood loss at birth).

3. A feeding plan will be made with you

Plans usually include some or all of the following (depending on your situation):

Feeding at the earliest signs of interest (aiming for 8–12 feeds in 24 hours)

• Lots of skin‑to‑skin time
• Improving attachment and using breast compressions
• Offering both breasts and switching back and forth
• Expressing milk, especially if supply needs a boost or baby is not feeding strongly
• Recording feeds and nappies
• If extra milk is needed:
• Your expressed milk is the first choice
• Donor human milk may be offered where available
• Formula may be used if other options are not enough or not available

Supplementation is always discussed with you first.

Why Might My Baby Need Extra Milk?

Some babies temporarily need more milk because of:

• Being small or sleepy
• Short or shallow attachment
• Low milk transfer (e.g., tongue‑tie, prematurity)
• Low milk supply due to medical or hormonal reasons
• Recent illness
• Growth spurts or increased needs

Expressing helps protect your milk supply while ensuring your baby gets enough calories to grow.

What Is My Role as a Parent?

You are an essential part of the plan. You can help by:

• Following the feeding plan agreed
• Keeping a simple record of feeding and nappies
• Attending weight reviews and feeding assessments
• Asking questions and seeking help if anything is unclear
• Being kind to yourself—this is not your fault

Your team will work in partnership with you to support your baby’s growth and your breastfeeding journey.

Who Can Help?

• Staff from our 0-19 Service including our Infant Feeding Support Hubs.
• You may be offered a referral to our 0–19 Enhanced Infant Feeding Service.
• You may need family and friends to help look after you, if you need to give extra focus to feeding your baby.

Remember

• Faltering growth is common and usually improves with the right support.
• It does not mean you are doing anything wrong.
• You and your baby deserve supportive, respectful, and evidence‑based care.
• Breastfeeding can continue—and often thrive—after early challenges.

We look forward to supporting you further.