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?

Tall parents unsurprisingly have tall children. Tall children weigh more.

How mobile is he OP?

I have tall kids, two of them were little lard barrels at about 8-10 months but by three were long and thin. The others were less lardy at this age but were mobile earlier. All are tall thin adults.

My HV used to bleat about eldest's lardiness. My GP rolled her eyes and pointed out that babies do largely self regulate if they are getting healthy food and said it would all drop off when he started walking. It did.

Ignore her unless there are signs of actual problems and just start saving up for school shoes with VAT applied!

Honestly these health visitors some are brilliant but some are just misinformed and quite dangerous.

Keep feeding him healthy food. Babies are not meant to be skinny!!

I mean I tend to do as a nanny milk in morning milk at night and then the rest in yogurts etc but honestly ignore her.

I would ignore her. By eldest was massive haha now he’s a healthy slim 10 years old. 8 months old will soon loose once crawling, walking. Feed him what he wants.

@Covert20

Well ignore her on the milk, he should still be having a pint a day at that age - but 50g of porridge is huge for an 8 month old - and adult portion Is 30-40g of oats

I’ve just checked my packet of porridge and it says one adult portion is 65g dried weight oats.

My 3 yr old was in the born 95th centile and is still there. Sees paediatrician for a separate issue. In her case all the drs are interested in is that the height centile is about the same as the weight centile.

If i was in your position I would ask for a referral to a proper paediatric dietician who as a specialist can assess and give you a proper plan.

I wouldn't be drastically changing his diet without that input - it will be a shock to suddenly change so much - of course he will be unsettled!

I would have thought in general (not an expert) that gradually cutting down amounts would be a the way to go and maybe spread the reduced amount into smaller and more frequently over the day.

That's very strange advice, babies need 500ml of formula for the first year.
Are you sure you saw a HV?
Nursery nurses or support workers are doing the checks in some areas. They don't always make this clear. If they say they're from the HV team people assume they're HVs.

As a slightly overweight grown up, I have 20-25g of porridge most mornings. It's more than enough. 65g of porridge is an enormous amount for a baby.

If he is following his line in his red book then he is fine! Unless he has dramatically shifted and gained alot of weight in a very short amount of time I wouldn't worry too much! I do think health visitors are very useful in alot of ways, but sometimes they get a little fixated on textbook children and so any child who deviates can look like a problem to them (even when they are fine). If you notice anything else, like lower energy levels, any signs of poor health then you can always bring it up with your doctor but I wouldn't make any diet changes otherwise. Formula is still very important at his age. My youngest is on the 0.25 percentile for height and weight and we had some issues from one health visitor even though the doctor and other health visitor we had both agreed that she was absolutely fine.

It’s been a while since I’ve weaned a baby, but if I remember, then it was generally thought a good thing for them to have some fat on them at that age, so that if they got ill there would be less risk of them losing too much. Also, they tend to slim down a lot once they start crawling and walking. I do remember when one of my boys was on cow’s milk at 12+ months the HV suggested moving from full fat to semi skimmed, rather than cutting down the quantity.
I wouldn’t let my baby scream with hunger though, that seems unnecessary and cruel to both you and him.

0.4th percentile I mean not sure where I got 0.25th from

I would definitely ignore them! He is just a big baby. I had this with my eldest who is now 4, the tallest in his class by a way but skinny with it! Babies always get chubby at this age then when he starts moving it will drop off. You know your baby best, feed him what you feel he needs.

My daughter was off the chart, 75th height and past 99 for weight. She was born fat with rolls on her arms and legs and a big podgy face. The HV suggested I put her on a diet/restrict food and I just stopped taking her to be weighed. She slimmed down when she was around 2. She still eats a lot - way more than her skinny sister- but she eats good food so I don’t worry about her and she definitely isn’t fat.

Generally if the baby is on the same centile for both height and weight then I wouldn't worry. If they stray to a higher centile for weight then cut back a little after a month or so; if they fall to a lower centile then see a GP. Those are my rules to live by re babies and weight

I agree with others to ignore the HV on the formula, that seems like risky advice for an 8 month old and it's no wonder he's unsettled.

For the food, I'm also in agreement that 65g seems a lot of porridge for a baby & generally I've been told that while nutritious for an older child and adult, it doesn't have the variety of nutrients & may have too much fibre for a little one to eat in large amounts.

If concerned about his weight or hunger, I'd focus more on finger foods he can eat himself rather than spoon-fed to give him more control while waiting to talk to someone else.

OP I’ve been in your exact position. DD was top of centile consistently and as she wasn’t BF I was told constantly I was over feeding her (my friend who bf and had a child the exact same was congratulated on her ‘gold top milk’- so annoying and unfair!!)

Anyway...I ignore the HV. Continued to give recommended amount of milk and healthy nutritious food until baby was satisfied. I moved more towards BLW as they naturally eat less and self regulate than spoon feeding.

DD is now 3 and slimming down beautifully. No longer obese in the healthy category and has a great relationship and attitude to food and eats so well. I’m glad I had the confidence to go with my gut. some HV are absolutely useless and go off one measurement instead of looking at the bigger picture. Also some assume you’re lying and forcing them to finish bottles or sneaking them chips- it’s bizarre. My granny who’s 90 said they would be congratulated on chunky babies and kids- the bigger the better!

If you know you are not over feeding him and he’s eating healthily have faith he will naturally slim. Read Ellyn Satters Division of responsibility or ‘my child’s eating- helping without harming’. It makes so much sense.

Ignore! He's not crawling yet and once he does, and walks, he'll soon slim down.

DD was similar height / weight (although cruising) and is now a bean pole at 5'10“ at age 13, right in the middle of BMI as always.

My son was 90th centile for weight at that age. He’s now on the 50th as he’s two and never stops moving. Please don’t starve him and his diet sounds great!! You sound lovely like your doing fine.

Some HVs are excellent, others not, in my experience. My first was brilliant- very experienced and supportive. The second was not good. Put the fear of god in me telling me DS2 head measurement at 8 months check was worryingly small which would mean his brain would not develop properly. Told me to get GP to refer. GP said he was fine based on his normal development but agreed to refer. Paediatrician told me he was fine and said most likely And obvious cause was hereditary - and then measured my head with my permission and said that explains it and that the HV should have known that . I never listened to anything she said after that. I would advise checking with GP but do not let a 8 month old go hungry.

Just before my nephew got his wiggle on and starting crawling/toddling he looked ridiculously fat. Big rolls of the stuff everywhere.

He was a very hungry baby and my sister just went with what he needed thankfully because moderating food for a hungry baby is cruel...they have no idea why you're starving them!

Cue crawling and toddling, he grew into all the weight he piled on and has since been cruising through childhood looking distinctly average for his age (although he looks terrifyingly small playing rugby, some of those 14 year old boys are huge!).

If your son is still carrying more than his share once he starts moving, then maybe revisit portion sizes etc then but honestly for now just stick with what you know makes him a happy and settled baby.

I have 4 dc, all really really big babies, all over 95th centile at birth. They were all big until the age of about 12-18 months when they started moving and slowly came down to where they were meant to be. They're all very lean now, dd1 is actually pretty skinny but its obviously how she's meant to be because she regulates her own food intake very well and has a naturally small appetite. I have one formula fed and 3 breastfed and they all seem to have followed this trend. Health visitors are not oracles, many of them get it wrong and thats why they have such a bad rep.
Ignore her. Feed your baby nutritious foods when he is hungry and let him grow the way he is meant to.

I think that HV was unbelievably unprofessional, and even if there is an issue then her manner made it much harder for you to engage. Worth a complaint.

However, it worries me seeing all the posts saying that it's fine as long as he's also long, it's impossible for a baby to be fat, etc. There's loads of research now that overfeeding can go into children's height development as well as weight, so that 99% line for height and weight may not actually mean he's nicely matched, but that overfeeding is driving both height and weight gain (see, eg, www.ncbi.nlm.nih.gov/pmc/articles/PMC2818981/).

And as a society in the UK, we are surrounded by overweight kids, so it's no good relying on us online telling you all our kids are fine: from the ONS - 2018/19 school year, about 25% of reception kids were overweight or obese. And about 30%of year 6 kids were overweight or obese.

I'm not at all saying there's definitely a problem for your lovely boy, but I also wouldn't rule it out just because he's also tall, or because the HV is a right rude cow. If I were you, I'd ask the GP for a referral for specialist paediatric dietetic advice, and see what they say. You definitely don't want to be working with that HV.

Meant to say, don't start cutting back or depriving him of milk without expert advice.

@JeanMichelBisquiat that link doesn't work. However how is being tall a problem? What health conditions will that cause? I'm 5ft 9 and my husband is 6ft. My son was 10lbs 10oz when he was born. He's a tall and big baby. Underfeeding to stunt growth hardly sounds healthy.

@Sertchgi123

Follow the advice, a fat baby will grow into a fat adult.

What absolute waffle.