Dropping centiles- what to do next?

[ohanami]

I know this has been asked before but I guess I'm looking for some reassurance. Dd is 8 weeks and has dropped from bang on 75th centile to just below 25th. She's a long thin baby, just like I was, only difference being that I was born 2lb lighter on about the 25th centile.

She didn't regain birthweight for a while, probably due to thrush, which in turn caused fussiness which shredded my nipples. Alongside that she was latching badly on one side (I'd been told all was fine) and it turned out I had retained products which made themselves known about a month after birth, which we think all impacted on milk supply. All these issues are resolved now, and there's plenty of milk.

Im breastfeeding, and to give her a boost I've been expressing and she's had 4 to 8 oz expressed milk top ups daily for the last month.

Even with this, she's still putting on weight slowly (has dropped from just above to just below 25th centile line now). She's still 75th centile for length.

Hv said she has no concerns as dd is alert, smiley and sleeping well (slept 8 - 5 last night as I slept through my "force feed the baby" alarm in the middle of the night). Gp said similar at our 6 week check. Despite this, hv has said that if she continues to gain slowly, they'd advise to supplement with formula which I'm keen to avoid.

So (and thank you for reading this far through my long post) I think I have a few questions that I'd appreciate any advice or ideas about:

• is there anything I could do to boost the calorie content of my milk?
  
• if I don't give formula, is there anything the hv's can/will do to us?!
  
• is this a sign of any health issues for dd or is it just her growing in a different way from "average"?

[AmberEars]

My DS1 was born on the 75th centile for weight and dropped to the 25th. His height was well above the 75th. I was stressed about it, but he seemed perfectly healthy in every other way so I carried on EBF. The HV did not try to make me give him formula.

DS1 is now a healthy, active 10yo. He's still tall and lean for his age!

[Jackiebrambles]

Sounds like you are both doing brilliantly despite some massive difficulties!

I'd just keep feeding, on demand, whenever she wants.

If she's gaining, all is good I think.

The HV can advise all she wants, you are free to ignore her advice and continue to EBF.

[ohanami]

Thanks for the reassurance. I don't know if it's just my hv or a local policy but this is the second time she's brought it up. When she realised that weight gain wasn't right she suggested it, but as the problem at that point was supply I politely told her that thought offering fewer breastfeeds would possibly be counterproductive I'm just a little worried that if I continue to ignore the advice they'll put a big red mark on our file or something...

[MaverickSnoopy]

It's so hard isn't it. The worry about what the HV's might "do" whilst also trying to figure out what is going on with your LO.

No one can force you to move to formula. If you receive criticism just point out that she is gaining weight; abeilt not at the same speed as "some" other babies, but that all babies are different. My unqualified feeling is that there is probably only cause for concern if she is losing weight. It's hard to trust that though and I sat that as someone who's LO has just dropped a centile and is eating less than expected (and mixed fed on the advice of HVs). Formula is not a magic answer. Babies will eat what they want to eat and not a drop more.

[tiktok]

If you think she might benefit from the opportunity to have more milk, then just offer more BF, by either offering feeds more often and/or increasing the number of breasts you give i.e. Two or three 'sides' and not just one.

No, nothing you can do can increase the calorie content of your milk - this is governed by the degree of emptiness of the breast.

[Diamondsandpears]

Sounds like you are doing great to overcome the issues you've had and boost your supply. I was in a similar situation and offered more regularly than standard feed intervals that people generally do. It did the the job. No more expressing or bottles.

[buzzbobboo]

All 3 of mine did this. By number 3, I learned that so long as the baby is gaining some weight (this important - loss is bad, holding steady is not great but any gain however small us good), alert, eating well, wearing and pooing and meeting all milestones they are probably fine.

With my 1st, I introduced some formula. It made no difference to his weight gain. So I didn't bother with the other 2. They all hit a centile around 6-9 months that they have stick to pretty much ever since (now 8, 6 and 2)

Ask HV why the baby needs to gain faster. If it's "because they're dropping down the charts" that is not a good enough reason to change what you're doing. They need to show the baby isn't thriving, and weight gain less than the average baby is not the best measure of that!

Good luck!

[buzzbobboo]

For all 3, they started over 75th. 1 is on 9th at age 8, though tall. Other 2 are on 25th, so they were big drops.

[DulliDulli]

My DS started on the 91st and dropped to below the bottom line. The HV was not worried by this but my gut told me something was off. By 16 weeks his nails had never needed trimming, he looked like a skeleton and he was just not right. At the last weigh in he had gained just 7g in two weeks. I switched to formula and it was the right decision.