0.4th Centile

[Laureatus]

Hi all,

I'm sorry this is a bit long! I think I'm looking for a bit of encouragement - our son is 14 weeks and has been trailing below the 0.4th centile for weight since about 8 weeks. He has high muscle tone so we think he uses up extra calories, being so tense. He also has bad reflux so he doesn't keep down all his milk and we regularly get trapped in a feed-sick-feed cycle that can last hours! Initially I had to use nipple shields but no-one told me they're known to affect weight gain. Since getting rid of them his weekly weight gain has gone up from 50g to 100g, which is some progress!

We were prescribed high-calorie formula to bring his weight up, but after starting well on it he's started refusing a bottle and won't take any - he was horribly sick after taking it and I think he's got an aversion to it as a result.

He's now been put on Omeprazole for reflux - first as a tablet we had to dissolve then as the custom-made liquid suspension. It was impossible to keep either versions down until we started to mix it with his Helliborange vitamin liquid, but he's still very sick at times. He's also just started Clonazepam for his muscle tone.

It's difficult because it's in my mind all the time and he doesn't settle easily or have regular nap/sleep patterns, which everyone else seems to have (the reflux wakes him up so his sleep is all over the place).

I'm particularly down now because when I told the health visitor the consultant measured his length at 53cms this week. she said I must be wrong because that is a birth length. I've checked and they did say that; we measured him with a tape tonight and made it 55cms, but that's still below the 0.4th centile for height. So now I'm a bit anxious about all his measurements.

I'm focussing on the fact he is gaining weight, if not as much as they'd like, and he's a very happy chap otherwise who appears healthy in all other respects, but my husband and I feel sad that everything we try isn't getting anywhere.

Anyone with similar experiences or some words of comfort? Thanks!

[BillHadersNewWife]

Are you or your partner short?

[Laureatus]

Not tall, but not really short - I'm 5'3" and he's about 5'9". All our family are under 6' but not tiny. I have a brother who's 5'11" - and my mum's family are all tall: she's 5'8" and her dad and uncles were all about 6' and in the army - Scots Guards etc.

[JiltedJohnsJulie]

If he has trapped wind and reflux like symptoms, has he been checked by a tongue tie practitioner OP? Have a read of this article and see what you think.

Have you plotted his length on a growth chart yourself? I must be reading it wrong because I can't see that 55 cm is on the 0.4 centile, or do you mean he's on that centile for weight?

At this age, it's also very difficult to tell the difference between reflux, tongue tie and Cow's Milk Protein Allergy (CMPA).

I've linked the tongue tie details above and her is some information on dairy and other allergens in BM and some information from Allergy UK.

If it's his weight that is the 0.4 centile, has he always been in this centile? Is he tracking it? Some babies are on the lower centiles, just like some babies are on the highest. If you are concerned about his weight gain though, have a read of How might I increase my baby's weight gain? from Kellymom.

It might be worth talking all of this through with a BFC too. Have you got the BFing helpline numbers?

Do you go to a BFing Support group too? F not, do you know where your local ones are?

[Laureatus]

Thanks @JiltedJohnsJulie that's really helpful, I'll have more of a read.

His weight has dropped below 0.4th centile; the height chart at 3 months says 0.4th centile is 56cms, so he's close but seems below it. He was born between the 9th &25th centiles at 48cms, at 6wks 50cms and now at 14wks they measured him at 52.9cms, but we measured him at 55cms at home last night. He's nearly grown out of 0-3 clothes (but they still fit even with his cloth nappies on!). My ultrasounds always showed short leg measurements but they said it's unreliable.

We're following the MESH program with the health visitor so she comes and weighs him weekly. We had a midwife trained in tongue-tie diagnosis (she said there was no problem) and the head of our breastfeeding support group come round (while I was still on nipple shields). Lo was admitted to the hospital (with me) for 3 nights in December so they could observe his feeding and they got him off the nipple shields (they were not for pain but because my nipples weren't drawn out enough).

We have been concentrating on his weight issues as they are probably connected to the high muscle tone from his neurological condition. It was only when I mentioned his length that the health visitor seemed to think I must be wrong, like it was ridiculous. She said he looks longer than that - she's going to measure and weigh him when she comes on Tuesday.

We've asked the HV and the consultant paediatrician about allergies but they haven't pursued it so they must think the symptoms aren't there and no family history of it (eg no mucus in nappies).

So he's being seen consistently and we're getting loads of support, but I just feel like we might be missing something fundamental and wondered if anyone else had any ideas!

[BillHadersNewWife]

Great post from Julie there. Did you check his tongue OP? Also, 5.3 and 5.9 IS indeed on the shorter side for parents. My DH is 5.9 and I'm 5.5. Our older DD is the shortest in her class...she was always short. She's just 5.feet at fifteen and most of her friends are 5.8 plus.

[JiltedJohnsJulie]

Did you read the link on tongue tie OP? If I had a pound for every MNetter who’d been told their LO definitely didn’t have tt, only to find out that they had, well, I’d have a very big pile of pound coins