Dropping centiles

[Trooperslane]

My DD was a small one, weighing 5lb 4oz when born at 40+0. She's now 23 weeks.

She has been mix fed from the start and is a great feeder.

Weight gain was good and she's bright as a button, sleeps through 7 to 7, usually and has done from about 12 weeks (I know how lucky we are).

Out of curiosity rather than concern I had her weighed this week. She has totally dropped off the chart - was between 2nd and 0.4 centile.

HV has gone semi crazy and says we need to feed her 'several' additional feeds per day.

To do this we'll be feeding her every 2 hours in order to achieve this - she'll already empty both breasts/drain a 210ml bottle.

My question is two fold

1. Do I need to be overly concerned about this drop?

1. Should we lift her during the night? I'm really reluctant to do this because I feel sleep is as important as food and do really think that she'd shout if she was hungry. She's very vocal in general.

We haven't weaned as yet - HV suggested I start but I am not convinced a few swallows of purée/ mash is going to do anything and would prefer to wait til she's 6 months, albeit that's only 2 weeks.



She's hitting all milestones and as I say, sleeping well and is generally very smily and happy.

[Trooperslane]

Bump

[TheGreatHunt]

If she drains a bottle is this at her or your instigation? Have you tried offering any more afterwards?

How often does she feed in the day? Did you or her set the routine?

It might be that she's just a small one - what are your family like?

[Trooperslane]

Hi Great

It's totally baby led - and she drains the bottle and screams when it's finished (in an angry sort of fashion!)

I'm 5ft 3 and normally a size 10. My family are all mini sized and DH's pretty average.

Might try to do a bottle and a half and see what she makes of it.

[Trooperslane]

Very rough routine

Bf around 7
Bf around 9
Bottle 11
Bottle/bf 3
Bottle 6

[JakeBullet]

Hi OP, I used to be a HV (note the "used to be" )

I would be a little bit concerned (but only a little from your description as she sounds happy and healthy) about why she has dropped like this...and tbh I wouldn't recommend weaning...at this age she will still get the bulk of her calories from milk. If you start to wean she will likely take in very little food but what little she does might stop her taking milk.

Has she dropped much below the 04th centile? Occasionally some babies do this and they are fine....just petite.

You say you are mixed feeding....do you think there is much breast milk being produced now? I only wonder if this is a possibility due to breast milk being produced on a supply/demand basis and if you are not using it exclusively then it is possible the amount of breast milk is reduced.

She drains a 210ml bottle......would she take more after this? I know at one point DS was draining a bottle and a half of milk (where he put this I just do not know....but he was very active).

Lastly has the HV referred her to the GP or for further checks. I suspect this is simply a calorie issue and once that is sorted she will just adjust upwards again.

[TheGreatHunt]

I'd offer more but if she doesn't want it, she doesn't want it.

You sound like me and my DH size wise. My dd is tiny - dropped from 50th centile to the 2nd by the time she was 1. But she didn't start slipping down until she started on solids.

I woul say though, she might start waking up for food in the night - this is normal and passes! It happens when there's a growth spurt (I remember both ds and dd going through huge ones at 6 months...!)

[Trooperslane]

Thanks both.

I think my milk might be fine in quantity - we've pretty much been doing this since birth.

Good advice though - will up the frequency of bf and amount of formula and see how that works.

You've put my mind at rest re weaning and I'm going back in 3 weeks to have her weighed - will also get her length and head circumference checked too and make a gp apt if we need to.

Thanks both

[JiltedJohnsJulie]

Some great advice here already. Might also be worth talking this through with a BFC. Behave you got the helpline numbers or is there a bfing support group near to you?

[Misty9]

Just to add my experience, as it's similar in some ways. Ds was born a big 9lb on 91st centile (that bit's different) and whilst ebf he dropped to 2nd centile by 7mo (somewhere between 4-7mo as didn't have him weighed regularly). To her credit, hv wasn't bothered but I was bit concerned so off to gp we went. Head circumference had also dropped, and he'd actually lost weight - so we ended up referred to paeds. Watch and wait policy then discharged a few months later as all fine. He's slowly climbed back up to 50th centile at 2.5yo now, was a bugger to wean (didn't really eat properly until 15mo) and was just never destined to be a big baby :)

Def get head circum checked as this is more reliable indicator. Has she actually lost weight? Most of all trust your instincts- if she seems happy and healthy to you, chances are she is. No harm in seeing gp if you are worried though.

[EATmum]

Just to add that my eldest DD dropped the 'more than two lines on the graph' that seemed to be a trigger, ending up on the 2nd centile. My HV got me so stressed about it, I'm sure I was approaching every feed with stress - nothing less appetising, even for a baby. I'd strongly suggest that you keep an eye for any signs that something is wrong, but don't ignore your instincts. I knew she was fine (she's 12 now, slim and fabulous) but couldn't trust that knowledge even though she was developing exactly as she should. Eventual referral to hospital who almost laughed us out of there. Which helped!

[Trooperslane]

Thanks guys - all great thoughts and I'll definitely get head circumference dine too.

She hasn't lost weight, but gain has slowed down.

Since we've been consciously upping feeds she's markedly more content during the day, so maybe she ha been hungrier than we'd thought.

[Trooperslane]

And a nice little update - thanks to all for your advice

Got her weighed on Tuesday and she's put on 1lb 11oz in 3 weeks :)

nicer hv reckons since she'd been learning to roll last time she was weighed sheds used up loads of energy and needed the extra milk.

We only started weaning her on Saturday and she's back following the 2nd centile. Glad you guys convinced me to up the milk not start the solids.

Happy trooperslane :)

[Trooperslane]

*she'd

[Fuzzymum1]

My DS1 was similar - 4lb 12oz at 37 weeks, dropped down the chart until he was well off the bottom (well below the 0.4% line). He ate loads and had every test they could think of at the hospital including tests for coeliac and cystic fibrosis. I was even suspected of starving him when they saw how he tucked into a meal at the hospital but thankfully a friend of mine was a nurse on the ward and told them he always ate like that! After about three years of back and forth to the hospital they decided he was just naturally small. He's now 20, 5'10 and closing in on 9 stone - still slim but quite tall and very healthy and thriving at university. Dropping centiles needs to be investigated but isn't always a problem.

[Trooperslane]

Thanks fuzzy. Glad you had good news too.