is this accurate advice from health visitor?(27 Posts)
DS is six weeks old. Steadily gaining 8-9 ounces each week, progressing nicely on the 25th centile line. Lost 4.6% birth weight by day 5 and gaining since then. EBF going very well.
Mentioned to HV that this past fortnight he's stopped waking daily between 11-4 am and she said that's extremely concerning. I should never have let this happen,they need feeding at least three hourly and I should wAke him up at night in that give hour block by setting an alarm clock.
So I mentioned my supply seems fine, he is steadily gaining 8-9 oz each week and I'm full at 4 am but nothing too much. She said if you wake him he would have the chance to hit 50 centiles instead go staying along 25 centiles.
Does this sound tight advice given the context?
This sounds like nonsense to me. My HV told me that my DS (who was also on the 25th centile) just needed to keep following that line and wasn't expected to 'jump' to higher centiles. If anything, jumping up might mean that he was gaining too much weight.
She also told me to feed on demand and that DS would let me know when he was hungry - i.e. there was no need to wake him to feed. That said, my DS was on formula by six weeks so there was no concern about milk supply, but surely you can judge that as you go along and if you feel your supply is ok then carry on as you are?
In my experience there are a lot of mixed messages from HVs.
No it doesn't sound right to me. I can't see what your HV's concern is. Your DS is gaining weight steadily, cruising along on his centile. Sounds to me like all is well. Not every baby is on the 50th centile, I never heard that reaching the 50th centile should be a target or anything.
What do you feel yourself?
Err that sounds crazy advice. He is gaining well and now giving you one five hour chunk of sleep which is about right for his age ime.
Assuming he seems well, has good nappy output and is gaining well then why on earth would you wake a sleeping baby.
Feed on demand.
You would wake an overly sleepy baby who was not gaining well but that is not the case here.
I fed 3 hourly during the day and at night let the baby sleep as long as she wanted, on paediatrician's advice.
I had to wake mine for every feed as she was so sleepy but last feed was at 11pm then I let her snooze. Typically she would wake somewhere between 4 and 6.
Some (most?) HVs are deeply traumatised by any child who doesn't follow the 50th centile. Ignore any HV like this.
Your DS sounds like he's doing everything he should - eating well, gaining well. Given this at 6 weeks he's perfectly capable of going 5 hours if he wants to and should be allowed to. You and he have earned the right to a longer stretch at night now
Health visitors seem to have an issue with babies sleeping long periods. They advised me to wake ds1 every 3 hours but I didn't feel the need. He was putting weight on really well and drinking loads of milk when he was awake. I believe mum knows best. If you think he is doing well (which it sounds like he is) then don't change what you are doing. I take health visitor advice with a pinch of salt
Thanks all. It sounded completely off to me. I'd done plenty of research around BF while pregnant and knew the signs of feeding going well and DS has all those. A completely chilled out blissful baby, loads of wet nappies, nice bf poo, attentive, alert, sleeps well, never lost much birth weight and has been gaining spot on his centile line since Day 5. We've never once been told he has lost weight. But the idea that cursing along on his centile is not enough had never struck me. That I should actually be aiming for the next centile with his feeding seems a lot of pressure....
Another vote for absolute nonsense! The 25th centile sounds like the natural place for your baby at the moment. 8-9oz gain per week is great- at the high side of average.
Ignore this complete nonsense. If you're in doubt fix an appt with your GP and watch them roll their eyes at the
It sounds like you're doing absolutely text book perfect baby feeding- congrats! The sleep sounds very average too which is great.
Be prepared for appetite and sleep to roller coaster lots over the next few months. This is all normal too and does not mean your milk isn't enough or you need to introduce solids or anything else against normal guidelines. Any significant deviation from normal guidelines should be checked with a GP IMO. I'm sure there are some excellent hvs but I've yet to meet one- they just seem to give out of date, conflicting and plain wrong advice IME.
IME of 3 babies and many HVs, they don't understand statistics. They don't get that a range of weights are perfectly acceptable. Nor do they understand that babies are people not pre-programmes robots who stick to the pre-programmed lines on a chart. It drives me utterly bonkers!
Your DS sounds lovely. Listen to him not to them.
So what you think is right, follow your gut .
Sounds like nonsense to me too. Babies make it clear when they need something. Feeding is no different. If he was hungry he would wake to be fed.
It's quite normal for babies to drop a feed at around this age, if all the signs are that he's getting enough milk then he's getting enough milk.
There's nothing wrong with being anywhere on the centiles. Someone has to be at the bottom and someone has to be at the top, and some have to be in the middle. 50th is average, not a goal
I wish they'd make sure each and every health visitor understood how to use the percentile graphs.
In my life and profession I've come across great health visitors. Highly knowledgeable, insightful and progressive. I've actually interviewed the pioneering guy who created the percentiles graph and improved public health as a consequence. So interesting and an honor. Didn't want to talk about hv misinterpretation though! And last week I interviewed a brilliant independent hv in the east of England, who was great, really inspiring and the end of the call devolved into a discussion about my sons up and coming (routine) op and how young children heal...
But in my personal life and role as a mother, I've not been lucky enough to have the same experiences. Sigh.
It seems that any baby not on the 50 percentile is in terrible danger which the mother must avert immediately, even if they're tracking the same line steadily...
I had experience of bonkers advice - for gaining and reducing weight, all with the same baby!
DS was born massive and it was suspected undiagnosed gestational diabetes. Rest of family all tall & very slim so the consultant said we should expect a plunging line until he found his natural weight not artifially boosted by the extra sugars. So we were discharged after DS blood sugars had stabilized, with instructions to keep an eye out, extra doctors checks, but not to panic if he lost weight but was feeding well and otherwise thriving.
I get that movement across percentiles is worth looking at, but not just one but two hv ignored the consultants diagnosis and advice, for no discernible reason they preferred their own random interpretations. What other profession would be able to disagree with a diagnosis completely with no evidence or rationale for it? Then tried to persuade me that he didn't need doc monitoring, just... A diet! Or force feeding, depending on the hv.
First one said I must limit my 5 week olds milk and refuse to feed on demand, as my baby was 'too fat' and I must be feeding him too much! Breast feeding was met with pursed lips as it was more important to measure & control his milk intake
Avoided her for the next appointment and got the polar opposite advice, that he was falling through percentiles and though it was healthy when he was falling to 50%, but when he broke through the 50th line - to 48%, it was suddenly a sign he was terribly unwell. So the reasoning was that I must be starving him, my supply must be drying up and not good enough quality, and so I must wake him up hourly to force feed him, again bottle considered better...
Both hv refused to believe in the gestational diabetes, and preferred their own made up stories of what might be happening. Grrrr. Very confusingly neither thought that DS needed to see a doctor (GP or paed), in spite of the doomsday predictions.
At this point I stopped with hv appointments, and by 12 weeks he was gliding happily along the 25% and continued to do so.
Thought that was it, but at his 2.5yr check the hv did try and restart the panic as he was too underweight...
Apparently the height & weight percentiles should mirror each other and if not, there's something horribly wrong.
So 98% height, 25% weight steady for the last 2 years is cause for alarm for some reason! I did break at this point and explain that this wasn't the case at all, otherwise every single person would have the same height to weight ratio and there would only be one body type... Which clearly isn't the case! She wasn't convinced.
Thank goodness I've not had to go again.
She's wrong - and clearly misunderstanding the stats. Those centiles represent the spectrum of normality, and where you are on them is less important that the pattern of growth the child follows.
A child who had been on the 80th c dropping consistently over weeks would be a cause for concern. A child happily following their growth curve on whatever centiles is likely to be fine.
She's thinking that the closer to average the better but that's erroneous!
You lucky bugger, sleeping between 11/4!
My HV has always said that they should be moving along a centile not going up. Its normal for some babies to move centiles if they're at the very top/bottom but if they move up too much it can be as bad as if they're moving down. BF should be done on demand not by the clock. You're doing the right thing, ignore this nonsense
Sounds ridiculous. When I took DS to his 2 month appointment here in the US, the pediatrician asked how long did he sleep at night. His average at that point was 6 hours and they said that was great. As long as he is gaining weight consistently, there should be no need to wake him at night.
DS lost a lot of weight post birth and we were told to feed every 3 hours (set alarm and all that) until he passed his birth weight. After that, let him sleep as much as he wants at night
I really hope your Hv Never meets my DS. He is 6 weeks and does very long stretches over night without feeding and these have got steadily longer since 10 days. He's my third so a bit more relaxed this time but my feeling is if they are content and putting on weight, leave them to sleep! Thankfully my HV agrees!
You are doing brilliantly-keep doing what you're doing
Let's be generous here and consider that the Hv may not have communicated well, or that you OP mAy have misunderstood. It would be good to discuss again with your Hv what she said and see if the message comes across differently. On what you have said here all appears to be fine with your baby and the feeding of course.
Babies let you know when they are hungry by that age. Be led by your little one and don't stress about it. You're getting sleep - yey! I'm pretty sure my LO was doing something similar by that stage and he is absolutely fine.
No tiktok. This was the conversation.
Weighing just completed. Red book filled. Very happy health visitor. Gaining 9 oz a week and cursing along his centile line from birth.
Me : oh just a question. He sometimes sleeps 4-5 hours at night. Is that a problem? He feeds loads all day and before and after those hours and my supply seems fine.
HV: NO. babies cannot go for more than 3 hours between feeds. You need to wake him up.
Me: oh. But he's doing very well in terms of weight though and I have no discomfort or supply issues. So would you..
HV: set an alarm. Those alarm clocks on iPads? Or on your phone. This should not have happened at all. Maybe that's what is getting in the way of him getting to the 50th centile.
Me: oh he should be on the 50th?
HV: maybe he will get there if you wake him up to feed.
This is the conversation as it happened in front of me and my husband. Both of us aren't misunderstanding or misremembering.
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