Going to be referred for failure to thrive

[Turquoisetamborine]

My son is now 9 weeks and 6 days and has just been weighed by the HV. He is 8lb 11.
He was born at 36+6 by c section and was 5lb 14 born. He lost 12% of his birth weight by 10 days old but regained his birthweight by 3 weeks old.
I had him weighed exactly two weeks ago and he was 8lb 2. Had him weighed exactly two weeks later and he's gained 9oz since then.
The HV says I must come back next week to the weigh in or they'll be chasing me.
He feeds at least every two hours during the day and at least every three hours at night. I offer both breasts at each feed. He's been checked for tongue tie. He was having a bottle of formula every night about 10pm until last week when we stopped it as it was making him uncomfortable and constipated.
He had his 6 weeks check at the GP last Friday and she was very happy with him and said he was a prem baby acting like a full term baby. He has held his head up from birth, started rolling over at 6 weeks and smiles all the time. He rarely cries unless he's hungry. I feed him totally on demand.
What am I doing wrong? My other totally breastfed son thrived on my milk and reached 23lb at 12 months from a 6.15 birth weight.

[Turquoisetamborine]

Oh forgot to say he was jaundiced at birth. We were readmitted because of this and he was treated on a bili lamp for two days then sent home. His jaundice only totally disappeared from his eyes about two weeks ago.

[TwoLittleBlooms]

Hi Turquoise, it sounds to me like you are not doing anything wrong! I'm not HCP but I can give you my experience with my little girl (24 weeks now), we have had a referral to a paediatrition for faltering growth which apparently is the same as FTT.

Firstly, 9oz in two weeks sounds good. I was advised that anything between 4oz and 7oz a week was good. So on that information it sounds like your baby is doing OK.

My baby was born on the 98th centile and lost 5% of body weight but took almost 3 weeks to gain it back. Her weight gain has been really slow, she dropped from 98th to just above the 25th centile and had to be weighed weekly and was referred to a paediatrition. On a bad week she has gained nothing and usually a really good week was 5oz but this was few and far between until two weeks ago. Her weight whilst slow has been tracking along the 25th and because of that and the fact she is hitting milestones - smiling at 6 weeks etc, then the doctors are not too concerned - just a case of monitoring. She is now at two weekly weigh ins and two weeks ago had gained 15oz and at yesterday's weigh in had only gained 2oz for the fortnight. Yet as her weight has not drifted and she is tracking then again there is no real concern.

Is your baby's weight tracking along on a centile (or between two?)

[PotteringAlong]

You're not doing anything wrong! The gp says your baby is healthy, he's putting on weight, just slowly. My second DS was exactly the same. Just keep doing what you're doing

[WinterOfOurDiscountTents15]

Far to early to refer for FTT. My DC was over a year when that happened (whole host of issues, some resolved, some not, but lovely healthy child now nearly a decade on).

You don't have to see the HV or go to their clinics if you'd rather not.

[Micah]

You're not doing anything wrong!

I found the paed referral really useful actually. It went something like;

Paeds: So, who's worried, you or the hv?
Me: the hv.
Paed: rolleyes. Ok, quick look.
Paed. Well they look absolutely fine to me. Meeting targets, strong, in proportion, no dehydration. Come back if you get worried.

I then had proper paed back up and never saw the hv again. Took all the pressure off and gave me confidence to listen to my instincts and not the hv scales and obsession with numbers.

I never got my 2nd child weighed at all, and funnily enough had no issues with ftt whatsoever :). Despite her following roughly the same progression as the first.

[Theas18]

OP winter is giving some advice that whilst true, isn't maybe wise.

You son't " have " to see a HV but if you op our of their care now with a baby who maybe isn't growing s fast as they like, you risk a safeguarding case against you.

My 2p. Continue as you are doing, feed often, look at breast compression to aid hind milk flow for extra calories and have faith in yourself. See a paed if that's what they suggest but don't for instance believe for a minute things will be better on formula- plenty of FF babies grow slowly too!

[MummySparkle]

Sounds like you're doing great :) I would keep getting him weighed frequently, but take the health visitor with a pinch of salt xx

[WinterOfOurDiscountTents15]

You son't " have " to see a HV but if you op our of their care now with a baby who maybe isn't growing s fast as they like, you risk a safeguarding case against you

Bollocks. Safeguarding case? OP can see her dr if she has concerns, she doesn't need either her HV or you scaring her that there will be any kind of a case against her because her baby isn't growing quite as fast as one HV would prefer. Such nonsense.

[paxtecum]

Drinking fennel tea through out the day can dramatically increase breast milk production.

Fennel tea bags are available in most supermarkets and health shops.

Might be worth a try.

[Christelle2207]

Im no expert but sounds to me like you're doing great as is your baby. i would trust the gp over the hv.
If you are worried about supply, consider taking fenugreek- has helped me loads.

[Turquoisetamborine]

I'll order some fennel tea and fenugreek. Thanks for the tips.
He was on the 0.2 percentile but now has dropped below. I can understand their concern but in order to continue tracking the line he would have had to gone up to 9.12 this week! He was never going to do that.
My mam is going to come with me next week as I find the HV scary and if they want to refer us to the paed then that's fine. I'm doing my best for my baby and I have nothing to hide. I'll try breast compressions.
He actually is just catching up from his slow early weight gain in my opinion. The hospital said the jaundice affected his gain in the early days and he was sleepy with being early.

[MrsDumbledore]

Obviously his weight gain was an issue in first 3 weeks, but if I understand you correctly he has put on about 3 pounds in 6 weeks since then which is about normal I think: I was told 4-8oZ a week. So not sure why they are still worried, but agree just go along with seeing HV and paed if she refers you, and don't stress about it.

[Rosieliveson]

Not seeing a HV does absolutely not open you up to safeguarding concerns. They are there as a support mechanism. Not an obligatory service.
I understand that you're keen to track your baby's weight. You are doing the right thing.

[sharonthewaspandthewineywall]

I'm sorry but rolling over at 6 weeks?

[Turquoisetamborine]

Mrsdumbledore yes he was slow to gain weight early on but it's been on average 4-5oz a week since then. The NHS website says he should double his birthweight by 4 months so he's on course to do that.
Yes sharonthewasp he did start rolling from his front to his back at 6 weeks. In fact he did it at a Surestart group and they couldn't believe it. I said there has to be some advantages to being small. He is still very strong even though he's tiny.

[thatsshallot]

Dd was like this and paed referral went similarly to pp above.

For last DS I didn't bother with HV and just went to GP, when challenged said GP was doing checks and would ever if appropriate and was left alone.

IME paeds are so overstretched they would only take on cases with genuine clinical need, slow gain but otherwise meeting all milestones and no other concerns would be batted straight back to primary care.

Sorry for pressure on you though

[Hairylegs007]

How big are you and your relatives?

It could be that he is thriving but just small and has found his more natural percentile line.

[Hairylegs007]

I think if he's meeting all his milestones, he's totally fine

[Turquoisetamborine]

Hairy, I'm 5ft 6 and was only weighing 18pounds at the age of one. I'm a normal size now. I was referred for failure to thrive but as I was totally breastfed they let it go.
H is 5ft 8 and 12 stones so not massive.

[MummySparkle]

sharon my DS rolled over really early - frightened the life out of us!! He hated tummy time so much he kept rolling over to avoid it! Then he got too tubby to roll over and rolled again around the time they usually do :)

OP you sound like you're doing fine. How much did he weigh on his actual due date? And have a look at his weight on the line for his corrected age. Sounds like he is doing great :)

[tiktok]

Turquoise, sorry you have had all these worries.

No one on here is in a position to advise you not to see the HV or to ignore what she says....or to say with any certainty there is nothing to worry about. For what it's worth, on what you say here, it's not at all clear what the concern about FTT is (have they actually said you are going to be referred?)....though it is perfectly reasonable to offer to keep an eye on a baby who was born a little prem, and a little small, and who has jaundice, and whose weight gain is a little slow. I don't think that's heavy handed at all (but I think mention of 'chasing you' is a bit off).

If you or the HV think he might benefit from more calories ie more milk, easiest thing to do is to feed more often,using more than 2 sides per feed :)

[squizita]

I had a similar slow grower. All that sounds like is happening is they are keeping an eye not failure to thrive territory. With me they just saw my dd slightly more frequently. She gains slowly but like yours is developmentally normal so it's never gone any further.

My hv also spoke about "chasing" - I think they get in trouble if people disengage.

My hv explained many kids are like this and there's a fair distance between extra hv visits and a medical concern, especially if a gp has oked her.

I also found bf helplines good for support.

My dd is still very small but in good health.

[Turquoisetamborine]

I wasn't there at the weigh in yesterday, H took him but he said the words were we will be chasing you. And that they would be referring for failure to thrive if he hadn't caught up by next week.
He's been feeding non stop since so maybe he heard her!
I won't disengage with the HV but it doesn't fill me with joy to go and see her.
I'm going to a bf support group tomorrow for some real life support. Thanks.

[squizita]

Might be cause dh took her? HV can be a rather sexist (though I don't know, maybe if the mum wasn't doing so well not coming outside might be a clue) and also with a bf baby, like to see the baby feed (or did with me, they could see her feeding well which reassured them). Not fair but I've seen it happen at my clinic.

[BoutrosBoutros]

I would also not rule out tongue tie. Sounds like you've been doing a great job feeding but posterior tongue tie can be really hard to pick up. I was told DS didn't have tongue tie by midwives and breastfeeding counsellors but finally a very experienced HV (former ent nurse) picked up posterior tongue tie and cutting it made a huge difference. I'd say don't rule it out and keep asking everyone you meet to check and check again just in case!!