Baby centiles and not accepting concern

[FourHorsesOfCourses]

I have slow growing babies. I think HCP find it impossible to believe as I'm now 5ft 9 but I wish I had a record of my own growth, smallest at school and puberty at 18 after which I became a tall but lean healthy woman.

DD has just had a 1yr check and the usual fuss was made about weight, with DS1 I had dietician the lot I am a master of fattening babies I swear . It's the same as my others, eats lots, great diet, lots of fat in it, just doesn't translate into actually getting taller or wider.

DD (like DS1 and DS2) started just above the 75th and on her own smooth line curve has wandered just above the 2nd centile steadily over the course of the year. I haven't weighed her at clinics but it's obvious looking at other babies and clothing sizes she is small.

The woman doing the check (I think a NN not a hv, not totally sure) talked referrals to dieticians/ pead, I said thanks but no thanks. I'm confident in feeding her, my other children followed a similarish pattern (though a tad bigger) and I work so it's a nightmare with appointments. I'm really not concerned. Hungry babies cry and get ill, mine is healthy and very very happy with chub. Just little. She in addition has (very mild) hemiplegia and I reckon she burns that bit more energy trying to get mobile, also she's obviously seen a pead recently because of this who made no comment at all on her size.

She will talk to hv about me she says, and tried to make out I don't care. I do. I just see it as a waste of time and NHS resources to get another doctor to look at one of my babies and agree they are small but perfectly healthy. If they think I'm not looking after her they have all the records of my other children to verify what I've said.

AIBU?

No YANBU. If it is a NN not a trained HV she probably has to pass it on to someone else though.

YANBU. I would point out that you're seeing a pedeatrician regularly who has no concerns. What do they expect another referral to achieve other than covering their own arse?

YANBU, keep repeating that she has already seen a paediatrician who expressed no concerns.

thanks, I may be paranoid but I have visions of a file somewhere being marked 'vulnerable' if I don't play ball!

As the parent of two very similar children, I can sympathise. They are both perfectly healthy, although slim adults just like my husband. I suppose we were fortunate in that this was a few years ago now and I don't think that health visitors etc interfered too much beyond keeping a distant eye on them via usual weighing/measuring at school.

If they seem otherwise healthy then you're probably right to trust your instincts on this.

I would also talk to your paediatrician next apt and ask them to have a word! As an experienced mother, I don't think you should worry what they think of you! I am a nanny with 30 years experience and they don't like me at all! I only wanted to weigh baby as maybe needed to move up to next stage car seat...was told they couldn't do it without mums permission...ok...Then they said they would but wanted me to strip him off. V cold hall and not necessary IMO. Any way, when they weren't looking I just weighed him myself with just vest n nappy.(When my kids were small there was a baby scale in the chemist). But honestly I don't give two hoots what some young girl with not my 10th of experience think, nor should you. And am so envious of your 'little' girl as mine was a budha and tho totally bf, always flagged up as bigger than normal. Then the talks about what I was feeding her...Don't give her sweets etc etc etc. She was totally bf and only 4 months old! Shes now a beautiful normal J-LO bummed, large chested 20 year old. Good Luck.

You are both right.
You are from the perspecitive that there is no real cause for concern & have expressed this.
She doesn't know you or your family & so is refering in order to make sure she protects your child.
Whilst she may be annoying, we need people like her to be a suspicious of parents sometime in order to catch abuse...Daniel Pelka only needed 1 person to take this view to save his life...but no-one did.
It's not personal, try to take it on the chin. i think she's trying to do the right thing.

This is what happens when HVs look at the numbers and don't look at the child.

I have this every time: "he is 99.9 on weight, oh dear" he is also 99.9 on height and has Grandfathers who would struggle to get through a doorway without ducking and turning sideways. DH and I are also tall. They acknowledge that he is not fat, but instead is big, but still insist we waste the GPs time.

Every single time. And every time the GP says "Gosh he's massive" and that is that.

It is a ludicrous waste of time and resources but that is the cost of the "where there's blame there's a claim" culture. Very few HCPs are willing to take the risk of not referring anything which is even slightly outside the NICE guidelines for normal. "Guidelines" is a misnomer by the way. What they mean is "do this or we will hang you out to dry". Informed clinical judgement is a thing of the past.

When my kids were little I had a friend who was a health visitor. She told me that unless there were other indicators she would not worry about a child who was steadily at the top or the bottom of the size/weight range - what was likely to cause concern was a child suddenly dropping down or rising up the percentiles. This was part of a chat about my son who was small at birth and small all the way through infancy. Somewhere in his teens he decided to grow and is a strapping 6' 4".

Even if they believe you they will want to go over the top to cover their own arses because in their minds, there could be a problem.

Don't go to an appointment if you don't want to, but don't grumble about the fact that they're doing this. It's the price we all have to pay for having half decent child protection policies and a health service that tries to look after children.

My boys were the same. Lost weight but now travel along the same percentile. With baby 1 they applied lots of pressure about feeding. They tried the same with DS2 but I wouldn't have it but they actually accepted my take on it after I'd explained throughly.

Can you talk to the HV on the phone? I expect the assistant is bound to follow the rules.

She needs to cover her own arse.

Also, she doesn't know you personally to know if you are capable and competent so don't take it personally as it can't be personal for that reason.

With all the recent media attention and CQC reports, they can't be complacent about anything, especially someone who doesn't have the authority to ignore these things. I understand that you may feel "insulted", a midwife muttered safeguarding at me when DS was 2days due to haemorrhaging in his eye caused by birth. I wanted to scream at her, but they are just doing their job so nod and smile is the best corse of action.

My hv was terribly concerned that my ds was so tall. Phoned me up asking if I was worried. What she was going to do about it I don't know. Me and his dad are both 6ft.

Dropping from the 75 to the 2 percentile is natural for your children but they want to check to be on the safe side because in many cases it's not, they need to be sure that there's nothing physically wrong with them and that you're not starving them. It's offensive and I don't think you're unreasonable at all but I can understand their concern.

Hmm. I am divided on this.

I was the mum with that massive 10lb baby (ouch) who became a tiny toddler. Perfectly happy, perfectly "well". Advanced for her age - walked at 10 months. Good appetite, varied diet. No concerns.
Fast forward a couple of years, nothing has changed. She's at nursery, gets colds and tummy bugs....like all kids do. We assume she is destined to be short like me (only 5'3). But by 5yrs her sister is catching her up - is the same shoe size when there is 2 years age difference, is a few lb heavier. The HV flagged it up as area for possible concern, and I am forever grateful to her for that because although it was not a growth hormone deficiency as she had suspected, DD was diagnosed very shortly afterwards with coeliac disease. Out of the blue, also so anaemic she needed a course of iron and a blood transfusion before they would even do the biopsy to confirm the CD. This was not evident! yes she was pale, but not weak, lethargic, not ill. She was just quiet and sedate, preferred colouring to running around, and we were used to that being normal for her.

HVs cant win, they suggest investigating to rule things out/check all is well.......and they are interfering busybodies who don't realise 'mum knows best'. They miss a horrific case of abuse/neglect......and they are slagged off again.