4mth old dropping curves

[digsydel]

Hi ladies

My DS tracked along the 50th percentile for a couple of months before dropping quickly to the 25th. He started slowly coming down off that before he was diagnosed as tongue tie at just over 3 months and we had that fixed 3 weeks ago hoping it would improve a variety of feeding/digestive issues (bad wind, reflux and vomiting after feeds, loose nappies, green nappies etc) as well as help him gain more weight. the theory was that his tongue tie meant he could get to the fattier hind milk.
The other issues have since improved but I took him to be weighed again today and while the HV initially measured him as still sitting just under 25% and expressed no concern, I've checked it myself both visually on the graph as well as using a couple of weight tracking apps and it says he's now at 15%
Naturally I'm starting to worry as he's clearly not keeping up his weight gain.

He's EBF, roughly every 3 hours (sometimes 4-5 hours overnight) for 20-45 mins at a time, and is otherwise a very happy, healthy little boy who is very engaging and seems to be developing fine otherwise.

Am I right to be worried? Should I take him to see someone? Is it possibly a milk thing? He's my second child and I had no trouble feeding my daughter who sat at 91% on the chart until she started to walk. At the same age she weighed a whopping 700g more than him!
His feeds seem to have just been troublesome from start to finish between the reflux and the dodgy nappies and now the weight issues.
I love feeding him, and I know it's meant to be best but I'm beginning to wonder if I'm doing him a disservice by sticking to my boob guns and if maybe he'd be better off with formula.

Any thought please?

[FSVC]

how often are you having him weighed? If he's happy, feeding and having wet and dirty nappies in appropriate quantities I would back off the weighing for 4-6 weeks and DELETE THE APPS! - it can make you understandably anxious if he looks to be 'going backwards', especially as he's smaller than your first was at this age, but all babies are different and go through phases, plus when you only weigh a few pounds to start with any slight deviation - just had a big poo, weighed at a different time of day, etc - can look fairly significant.
He sounds lovely btw

[digsydel]

Thanks FSVC

He was being weighed once every 4, then first drop from 50-25 happened, I got him weighed 2 weeks later and again 2 after that when we had his tongue tie done so we would have a reference. It's been 3weeks since then. Even if you only take his readings every 6 weeks though it means he's gone 50-25-15 percentile which to me seems significant. He was born at a healthy 80% too.

the app is just a normal chart growth tracker / plots for you instead of you peering at the little lines and guessing yourself.

PS He is lovely 😊

[FSVC]

Aww! I could fancy a 4 month old snuggle myself today.

I would honestly wait a good six weeks and just try to relax as much as possible about it. Sounds like it's been a rocky road with feeding and I totally get why you feel anxious about it, but I noticed a big improvement in reflux in both of mine at the 12-16 week point and hopefully you will too, particularly since his tongue has been fixed.
IIRC he would still be classed as 'below the 25th' unless he dropped below the 9th centile - there are about 8 thick lines on the chart and generally its crossing two of those that MIGHT be a cause for concern, rather than the individual 100ths, if you see what I mean. Birth centiles are rarely followed I think, it's the trend that's important rather than the absolutes, he may just be finding his level as a smallish/slimmish chap!

[FSVC]

Of course contact HV/GP sooner with any specific worries but regular weighing can really get you keyed up. You'll see him growing, babygros getting smaller etc. Try not to get drawn into baby olympics with other mums too, that never helps when someone tells you about their baby who takes x ounces at regular times. Is there a breastfeeding cafe group near you? That might be nice. Take care, don't feel downhearted about feeding, you've done well to deal with reflux etc. My friend's baby had terrible silent reflux and CMPI, it was very stressful for her. Good luck!

[SpeakNoWords]

I think it's too soon to see any difference after the tongue tie was cut. It may take a while to head up the centile curves.

It's worth remembering that any point on the centile lines is "healthy". 80th is not healthier than 9th, just bigger. My DS1 was off the top centile line at birth and stayed above or on that line pretty much until I stopped getting him weighed. He is a very tall child and so weighs more than other children his age. My DS2 is much smaller, he was 25th centile when born, went down to well below the 9th centile and is now just ahead of that. He is small for his age, currently on the 0.4th centile for length, and is just a smaller baby. He's perfectly healthy though, even though he's miles behind what DS2 weighed at the same age. No surprise really as DS1 weighed nearly 3lbs more at birth than DS2!

As long as your baby is well in himself, is meeting developmental milestones, producing wet/dirty nappies then I wouldn't be worried. Try and leave it at least 4 weeks between weigh ins, anything more frequent isn't necessary and can cause undue worry.

[digsydel]

Hi ladies

I only Got him weighed that frequently because I was asked to for various reasons.

If we look at his monthly weigh ins though there's still a downward curve
1 months 50%
2 months 50%
3 months 26%
4 months 15%

They say if he's happy, feeling well and with wet/dirty nappies then I shouldn't worry but none of those are 100% either even after got tongue tie sorted

He fusses on the breast and has taken to pulling off and crying during feeds (not all but at least half) and his dirty nappies are more often than not very loose and can be green or luminous orange a lot of the time. He also very windy (both directions) and still vomits up regularly after feeding where it's often clear, almost like water.

We had an improvement with feeding and nappies after the tongue tie was sorted but it's not sustained and feels like we've gone a little backwards again.
There are feeding clinics near me but on both occasions I've felt a little fobbed off, possibly because of his age. The first clinic he was pulling off and roaring but she just kept on saying "I guess he's not hungry" (he hadn't eaten in 4 hours so was hungry!) and the second one I took him to after tongue tie to make sure he was adjusting his latch to his new tongue were friendly but seemed to think I was there unnecessarily and don't accept babies past 16 weeks now anyway.

I dunno, I guess the combination of all of the things above, as opposed to just the weight gain on its own, are what's worrying we. I can't shake the feeling that there's something going wrong with his feeding somewhere along the line, I just don't know what.

[MiniMaxi]

Sorry to hear you're having a hard time. Our LO is the same age pretty much and has fallen off his centile curve - we were told as long as he's still gaining weight and seems well then not to worry.

Has he been treated for the reflux? We have found ranitidine very helpful.

[digsydel]

Ranitidine wasn't much help for us, nor gaviscon unfortunately.
We hoped the tongue tie would help and it did seem to initially but he's been very bad the past few days again.

[FSVC]

Could it be CMPI or similar? I don't know anything about it but it could be worth reading up on? There are a few threads if you search.

Has he ever had expressed milk in a bottle or a cup? One of mine was really colicky (crappy latch, with hindsight) and seemed to be less windy on bottles of ebm.

As you're finding, feeding support is a bit patchy hope you turn a corner with it soon.