Should I ignore the HV?

[marvellousmaplesyrup]

Health Visitor came round to visit DS (8mths) this week for a general check up.

She said (in her own words) how "horrified" she was to see the size of DS. He's always been on 99.6th centile in both length (now 78cm) and weight, but since being weaned he's tipped slightly off the charts in weight to just over 25lbs. She me feel about 2 inches tall and gave me a proper rollicking for "over feeding" DS.

He used to have around 500mls of formula three times a day, porridge (65g) for breakfast and home cooked dinners with veg (around 100g) for lunch and dinner. No snacks, apart from some chopped up fruit when he was a bit grumpy.

Her advice is I need to cut all of this in half. Two bottles (150ml each) only on waking and bedtime, 32g of porridge, 50g of food for lunch and dinner. What's worse, is that she wants us to go from lunchtime at 11.45am until dinner at 5pm with nothing in between?

Because she made me feel so small and being a FTM, we followed her advice for a few days, but DS is understandably inconsolable and is sobbing with hunger most of the day. He is waking up in the night (despite sleeping through) and takes ages to get back to sleep.

My gut tells me I should probably cut down a bit, but not to the extent she wants us too. Surely there has to be a happy medium? AIBU to ignore her?

Someone has to be at the top of the charts? Hence there being a chart to begin with.

Sounds like he has a healthy balanced diet. Unless you have concerns keep going as you were. Putting a healthy baby on a calorie controlled diet is absurd, which is essentially what she's recommending you do.

I had a lovely HV who was very knowledgeable but most importantly very kind and diplomatic - yours is clearly lacking in the social skills vital to the role.

My eldest DD was the chubbiest baby. We look back on photos and laugh at how roly poly she was. We laugh because it's so hard to imagine now - she's four and a skinny little whippet of a thing. Babies are designed to self-regulate. They stop when they're full. If you mess with that process by restricting him you could be signing up for a whole lot of issues in the future.

Gosh she sounds completely mad. In my experience ignore her...you are doing a great job

[quote Iminaglasscaseofemotion]See@marvellousmaplesyrup, the hatred for HVs. You really don’t get good advice or a balanced view on this forum, if you mention those words, Health Visitor.

Thats because so often they talk absolute shite.[/quote]
I rest my case.

All the pyramid shaped babies I know are now tall and skinny as adults - once they started crawling or walking (one wasn't interested in crawling and went straight to standing) they slimmed down.

Babies don't generally overeat as long as they're only offered real food. So don't give anything processed, stick to basics, and don't buy clothes too far in advance because he'll probably be a completely different shape in 6 months.

I know an 11 month old of that weight and she is a bit tubby, but still reasonably healthy. And she's much shorter.

Hmm I think you need to go with your gut tbh. Definitely reduce but perhaps not as much as she suggested.

My health visitor is lovely. DS is how 9 months, at his 8 month check she just asked me how weaning was going, how many bottles he had but not the quantities. She weighed and measured him, he's similar in size to your DS. He still has 4 bottles a day although I do want to cut this down. Doing it all at once would not go down well with me or DS.

OP, my DS had similar proportions at the same age except that it was me who was worried about his weight whilst my HV was telling me not to worry and feed him what he asked for.

Then around 10 months and at nursery, he started with the constant bugs that affected his appetite and by the age of 16 months, after walking 14 months, he was still in the high 90s height wise but it about 70% weight. He was a very slim toddler and kid.

He is now a young adult and does need to watch his weight but is within the healthy BMI range.

Don't worry right now, just go with your gut instinct, just watch how it goes after he stsrts walking and around 2yo, then 4yo. He still has plenty of time to settle in his regular growth.

My mum received a proper bollocking from her HV because I was off the charts. I had rolls and rolls of podge everywhere. I most definitely did not turn into a fat adult. My BMI has always been well below 25. As long as what you’re feeding him is healthy, I’d ignore the HV for the minute, especially if he’s also tall. Just make sure his diet stays balanced and he’s active.

My baby is 8months and due to Coronavirus I haven't seen the HV since February which has made it much easier to ignore her.

Mine has 800ml of milk over a day and 3 meals but seems like smaller portions compared to what you're giving. At this age they change all the time so I would t worry about it too much. See where you are with him in 2 months.

Could you not just cut the calorie content of the meals down? Like more veg? I think you're actually very lucky and done well to have an 8m old who will eat veg and good meals. Mine doesn't and we're a good year older!!
My personal opinion is not to follow her advice, he is 8m old and doesn't understand, crying for hunger seems unbelievably mean at that age. Weight can be sorted in later life and if he's eating good healthy meals that's great and like others said once he's on the move the issue might resolve itself

Have you got an example of what you've fed him last few days?

No child at 8 months needs to be on a diet. You just need to properly finish weening and adjust the balance in his diet for him.

I would reduce portion sizes but not by as much as she is talking and stick to lots of veg and protein with a bit of carb. At 8 months they are building up for walking shortly and if he is not yet fully crawling mobile also that.

I would cut back on the milk - it sounds like fundamentally he is weened and so doesn't need alot - I would go for an evening feed for a bit longer as part of his overall calorie intake but would reduce the others.

At that age kids will grow out of being "fat" in the eyes of a HV in a flash once they get moving

I'd ignore the health visitor and ask for a gp's appointment.

Health visitors are not all good. My HV was hopeless. Your GP is the one with 7 years of medical training.

Quite honestly, I would ignore her and if she brings it again, ask to be referred to a paediatrician.

DS was a heavy baby and also tall. The HV tutted at his weight and told me to cut down how much formula I gave him until I told her he was EBF and hadn't had an oz of formula in his life. Then she decided he was probably fine.
I now have a policy of politely ignoring HV advice after one told me I had to do CIO instead of 'pandering' to him, and if he screamed so much he vomited I should still ignore it as babies do that to manipulate their parents. He was 14 months old.
Follow your instincts about the right amount and type of food to give, make sure he gets plenty of opportunity to exercise (ie. isn't strapped into a pushchair, jumperoo or high chair all day) and I'm sure he'll be fine.

@BabyLlamaZen

Have you got an example of what you've fed him last few days?

The past few days he has had:

150ml milk on waking (7am)
35g of porridge with around 20ml of whole cows milk (around 8.15)
65g of left over chicken dinner mashed - chicken, sweet potato, carrots, peas, cauliflower (11.45)
Same amount of the same meal at 5pm
180ml of milk at bedtime (7pm)

Never having formula fed, I don't know about the formula quantities, but I can't imagine cutting it in half is warranted, quite apart from the distress to your poor baby. They still need milk (bf or ff) at this age, not to mention fluids. I think in your situation I'd BLW ad lib alongside that - so little pieces of whatever you're eating (healthy/baby-suitable - lean meat, potatoes, veg?), as much as he wants. I certainly wouldn't be restricting him to 50g.

I've had the opposite issue with 3 short children, two of whom were (and are) also very light, and honestly, there is a lot of collective emotion around small children's weight and eating which certainly isn't always kept out of professionals' responses to it. Your baby will soon be heading for a phase of increased physical mobility which should - as long as you are feeding him healthily - sort out any 'over'weight at this stage. Keeping him hungry will only lead to unhealthy emotional associations with food and cause him distress.

(I should say 'never having formula fed long term'. My first was topped up with formula for his first couple of weeks)

If he's the same centile for his height and weight then he's not fat, he's the right weight for his length.

IMO, what you're feeding him is about right. I hate HV trying to make mums feel bad. Babies come in all different shapes and sizes!

And considering how small their stomachs are, 12 to 5 is a very long time for such a small baby to go without food. I don't know why your HV recommended that in particular, but it doesn't seem to make any obvious sense to me, tbh.

Are you sure he's not a cuckoo?

That sounds a perfectly reasonable amount of formula for an 8 month old, and the formula fulfils most of the nutritional needs at that age. I think it's dangerous advice to cut that down. And babies don't need skimmed milk, full fat is fine. I would ask for a different HV.

Height and weight centiles are in balance so I wouldn't really worry to be honest.

Well I used to follow ‘on-demand’ feeding with both my 2 and little and often.

I never felt comfortable with the idea they need fed at 1pm, 5pm etc..... I would offer it and if they were hungry they would take it. If they weren’t hungry the wouldn’t.

A baby can’t just eat continuously because they want to. They will be sick.

My two have grown up to be ideal weights and are both great eaters, and enjoy veg and salad etc...

If he's crying in hunger then feed him, honestly the reason a lot of people think HVs are crap is because of experiences they have had with them. To use the word 'horrified' is pretty disgusting to be honest, fair enough if she had concerns she should communicate them and advise (beyond cut the intake in half and don't feed him for over 5 hours which is crap advice), but why are a lot of people in these roles seemingly so short on people skills.

My youngest is 8 and oldest 12