Bf and DS going down percentiles but seems healthy

[Sciencegeekmum]

Hi,

I'm a new mum to a 9w old son. I would like to exclusively breastfeed but my DS has been falling down the percentiles since birth. We've been through a number of issues which I'll summarise below but essentially I think my son is now healthy and want to stop my hv coming round to weigh him every week as it's stressing me out!

Firstly DS had pneumonia when he was born and put on antibiotics for a week. I had a 3rd degree tear and a retained placenta which was removed in surgery. DS didn't even latch on for the first 3 days and combined with trauma to my body, I had no colostrum to even express to give DS. So the doctors put him on formula and I'm sure this was the start of my body playing 'catch up' with milk supply which continues now.

I persevered with bfing and pumping. DS had a tongue tie which was snipped at 6 days old. He lost about 10% of his weight so they wouldn't allow us to leave hospital until we showed them we could supplement with formula and his weight increased overnight.

Since then he's dropped through the percentiles, from 91st to 25th. Then he began to gain weight and follow the 25th. Then last week I haemorrhaged (for the second time since birth) and had to have surgery to remove the pieces of placenta that were still in me (despite having had surgery before for this). Also as bf still hurts, went to tongue tie clinic and found DS still had 75% tie! This was snipped on Monday. On Tuesday he was weighed again and although gained weight, he's now on the 9th percentile.

We are now only supplementing 60ml a day and I feel instinctively that DS is healthy and gaining weight; he's producing loads of wee and poos every 2-3 days. But I'm still on hv's books and she's coming to weigh him again next week. I really get worked up about these visits and just want them to stop but I'm no good at confrontation. I just think if we were left alone I would stop worrying so much! Is it possible to prevent these weigh ins? As you can see from the story there's plenty of reasons why his weight gain has been slow to begin with but I now feel as though we should be left alone to get on with life! But I'm frightened I'm on a list of 'at risk' families due to slow weight gain and that I will continue to be pestered!

Btw my hv is lovely, I'm just no good at confronting those in authority! Sorry it's been a long post but I've even missed out on some details, I've been through a lot! Any advice?

Hi- sorry I have to be quick but I'm sure I read on here a couple of days ago that seeing a HV is not actually compulsory?? Also, if nappies are plentiful, you should maybe trust your instinct? Volunteer to go to baby clinic in a couple of weeks for weigh- in and explain your stress to HV. I'm sure she'll understand?

Thanks. The thing is I think all these things but when I'm actually with the hv I don't have the confidence to say them. Might try suggesting the health clinics though, thanks x

Oh gosh.....:( :( Feel for you, sciencegeek.

As you say, there are sound reasons why your baby is slow to gain - everything ties in.

Your HV is, I think, making the error of thinking that frequent weighing somehow 'makes' a baby gain weight ...that the very act of sticking him on the scales will reveal a sudden rise. Or, that weekly weighing covers her arse and demonstrates her concern.

Frequent weighing - except in cases where babies are ill and losing weight and on some sort of knife edge, as has actually been the case with your baby - is clinically dubious. Weight monitoring is entirely justifiable in your baby's case, with the history you describe. But with a healthy baby - and he sounds to be healthy - weekly weighing is perhaps too often, IMO.

One compromise would be to ask your HV about weighing in two weeks, not one. Or even three. This is not a weird request at all - you'll all get a better picture of the overall trend if you leave it that long, and the pressure will be off you and you can enjoy and relax a bit more easily. My guess you would find it easier to say this to your HV, who you say is supportive, than asking her not to come at all.

My god you have had a rough ride of it. Hats off to persevering and staying positive, at least some of the time! tiktok's suggestion of asking for a week 'off' from weighing is a good one.

You and your baby have had some real issues but it sounds as though you're on the right road now. Trust your instincts about your baby. and congratulations.

Thanks for the support and well wishes. I think I'll try tiktok's suggestion when I see hv on Wednesday. I don't quite know how the hv support is meant to work, whether it's at the patient's requests or if they have to follow procedures. As I said my hv is lovely but it worries me that she seems to think weekly weigh ins are necessary. Hopefully it'll be better news next week anyway.

Well after a weekend of feeling positive I've been knocked back again today. DS went for developmental check and jabs and he's only put on 0.02kg in a week. He's now between the 2nd and 9th percentiles. Doc didn't seem worried, said he's hit all the other milestones and I should trust my instincts, but I'm now really worried about the hv coming on Wednesday. I desperately don't want to increase the formula feeds but feel I will be pressured to do so by DH, parents and hv.

Epic fail. :(

:( sorry you have felt so knocked back, sciencegeek.

However, I don't see the point of a further weight on Weds - the doc is not concerned, why would your baby need to be weighed again in 2 days?

How about saying 'HV, ds was weighed on Monday, and he has not lost weight - he has had a small gain, and the doctor is happy with him and his health and development. Can we perhaps defer the next weighing untill [insert suitable date'?' If she demurs, then perhaps ask her to discuss with doc and get back to you?

Thanks getting back so quickly tiktok. I think I'll try phoning tomorrow and just read out your script!

I think I would just cry down the phone if I tried contacting her today. I seriously don't know what else I can do - I feel like he's latching and feeding well and that I now have plenty of milk, he hasn't even pooped since Thursday so goodness know where it's all going! I should mention that my DH is 6'2" and only 10st so tall and thin is in DS's genes!

sciencegeek, please dont stress, if you are getting wet and dirty nappies, and your baby is otherwise healthy and alert, then he IS getting enough food.

if it is any consolation, my DD spent 10 days in SCBU when she was born, she was 95th centile at birth, by 3 months she was 9th...yes it was a little worrying to see the centiles dropping, but with one exception i was told she was fine...and she is. at 17m she is averaging age 9-12m clothes (but has a couple at 3-6m she still wears)...and she is perfectly in proportion.

sometimes they just need to adjust their birth weight to what was to be their natural weight.

your health visitor should weigh your baby once a month really to get a better picture....if you dont want to talk to her directly about it why not call the office out-of-hours and leave a message to cancel this week, maybe even saying that you will call in to the clinic next week, if you feel up to it, maybe even say that the weekly weighs are making you anxious...

you are doing a FANTASTIC job, be very proud of yourself

That is a brilliant idea about phoning and leaving a message....if you are on a list (one of your worries in your first post), I think I am right in saying that the real worries are about parents who don't 'engage' (as the jargon goes) and/or who disappear off the radar, and you are not in those categories.

So good to hear from someone else who's had the same issues and come out the other side! Will see if I feel up to phoning tonight out of hours...

Oh god just had an awful conversation with my mother, she just stopped short of calling me selfish for continuing to breastfeed, she thinks I should switch to formula so DS will put on weight quickly. The sad thing is that I couldn't disagree with her, maybe she's right and I'm starving him?

:(

Your baby had a developmental check and the doctor was not worried.

Is this a doc you trust, who you'd trust to be honest with you? Who likes babies (I always think that's important in recognising if a baby is not doing well)?

Obviously no one on an internet forum is in a position to say yes or no - but we can say, 'someone who has seen your baby and who has examined your baby and whose job it is to assess his health says he's fine'.

Is your mum qualified to countermand the doc?

If your baby needs more than he is getting direct at the breast (plus the 60 ml) you know you have the option of expressing and giving ebm - not sure how that sounds to you?

And google "fast baby weight gain predicts child obesity".....for an interesting study :)

Thanks tiktok, you are talking a lot of sense and backing up my own instincts!

It was the first time I'd seen this doctor (yet another medical person to add to my list!) but she seemed lovely and has her own 15 month old child.

My mum is definitely not qualified except as a caring and concerned grandmother, the stupid thing is that I am scientifically trained and have read all the relevant studies, but I feel like I have no support for wanting to breastfeed exclusively, apart from the doctor I saw today!

I'm going to try expressing every evening to give extra in the morning.

Thanks for the link on obesity, makes me want to stick to my guns more. I also found this website drjaygordon.com/pediatricks/newborns/scales.html very comforting, As I could answer every question on the checklist positively :-)

from another scientist who has issues with confronting authority and a baby who slipped centiles (at 21 months she's in 9-12 month clothes that are often too big for her) but was otherwise fine

I hope the next few weeks see things stabilise for you and give you the confidence to tell everyone to fuck off that's things are fine. It can be hard when you are 99% confident things are fine but have people including family questioning you.

(DH thinks you should punch your mother in the face, luckily I've managed to stop him carrying out his own advice on his own mother)

good luck :)

penguinarmy - so your DD is still 'low weight'? Do you still have the health professionals on your back or do they accept that you DS is just one of those kids that fall naturally at the left of the bell curve?

You hit the nail on the head with how I feel. And I like your DH very much for his support! But my mum is just concerned for both me and DS - she sees how much the weight issue is affecting me and just wants me to question why I'm perservering with breastfeeding when bottle feeding seems a much easier option and instant solution. She just happened to make me feel like shit really bad about myself.

I guess he can't stay this small forever so as long as he's gaining, even if it's just a little each week...

Just thought I'd update you all...

Hv came round today but did not weigh DS. I essentially told her what tiktok told me to say, she agreed to give us a two week break on the weighings. I feel a sense of relief as I said to her that the doc told me to trust my instincts and that these were that DS is healthy.

In other news, my mum apologised for what she said the other night and told me to forget she ever mentioned it.

Now to relax a bit!

Thanks for all the support

I was just posting when that came up, having a 5 week it apparently takes days to compose a post

not amazingly low (somewhere between 9 and 10kg). Personally I think UK clothes are oversized anyway. I think if you look at the weight limits and compare to centiles...

Thankfully nearly all the HCPs were fine, they were great at assessing her. MIL was the same and you can't be angry as you say it comes from a place of concern. Once she was past 2 months the concern starts to ebb as they start hitting milestones. Months 6-9 she gained 1lb and I cried only for the doctor to point out if she wasn't thriving she wouldn't be walking (she'd starting two weeks before). I think our society almost brags about the size of their baby's if they're big and illogical as it is you feel like you've failed somewhat.

Its great you've found your voice and feeling better with your mum and HV. I hope you have a relatively quiet few weeks, you've been through loads.

"In other news, my mum apologised for what she said the other night and told me to forget she ever mentioned it."

Now that is a REALLY decent thing that she said. Well done mum :)

That must have really made you feel better :)

Good news, sciencegeek :)

So the hv rang just now, she's been thinking overnight and is worried that the weight gain over the last month wasn't enough and that perhaps I should go back to two top ups a day and she can visit next week for another weighing

I stuck to my guns and said I would prefer not to have a weighing next week, but I caved in on saying I would give a second formula top up.

How to make me feel like a wreck again. To be fair she did say she might get some pressure from colleagues who don't know me but she knows I'm sensible and will take him to doc's if there are any concerns in the meantime.

What should I do? I'm giving DS whatever I pumped the night before (35-50ml) and one 60ml top up a day, should I add in another top up? I was really hoping to avoid this, I don't want to spend my days pumping whilst DS gets formula, I'd rather spend all day with him on the boob...

Talk about your ups and downs, I think she only listened to me yesterday as my mil was with me!

:( :(

I don't understand the bit about her feeling pressure from colleagues. Is this about you and your baby or her and her colleagues??? Is she saying that on paper, she should be pressurising you to have your baby weighed more but that as she knows you, she knows she can trust you not to have to insist on this?

Here are your options:

• continue doing what you are doing (but I am guessing that if your baby does not gain at the next weighing, you will be asked about this and you will feel bad that you ignored her advice to give more supplements - so you need to decide if anticipating feeling awkward and judged for not topping up more is making your worries about your baby worse, or if your worries about your baby are not that great and you just have to cope with feeling judged (which is not very nice but you can prob cope!)
• topping up a tiny bit more so you can say 'yes, I topped up more' whatever happens next time...this might mean ensuring a 50 ml ebm top up (might mean another pump session :( ) rather than the 35-50 ml one, plus a 70 ml formula one
• topping up by more direct breastfeeds, day and night - which might indeed feel like he is on the breast all day
• getting someone who really knows what to look for to check he has a nice deep latch and is truly transferring milk (you can have a look at the Jack Newman videos which show this quite well)
• seeing the doctor again or just ringing her for a chat and asking her what to do about the HV's approach, even maybe ask them to talk to each other!

Hope this helps.

I might go for a combination of options two and three. I've already seen the jack Newman videos and had my latch checked countless times!

As for seeing the doc, I'm at the stage where I want to avoid all medical professionals... Not the best attitude to have but that's what this experience has left me with! Of course if I ever thought there was something wrong with DS I would be at the docs ASAP!

Thanks for getting back to me tiktok, it seems that I'm forever moaning, apologies for the depressing thread.

:(

but you're doing GREAT btw don't let them take that away.

I'd be of the opinion that doc trumps GP. Normally they 'threaten' you with a GPor pead referral, so maybe just ask for one and say you'll wait and see what they say? Can you change HV teams or get weighed at the GPs instead.