To think Doctor should be more worried about babies weight loss?

[SmallYetMighty]

Ds 11 months is small and always has been but in the last 4 weeks he has lost what I would consider a large amount of weight.

Naturally I rang the GP and queried this and after waiting all day today for a doctors appointment he was seen tonight at half 5 and they are not even remotely concerned. The GP even said his weight wasn't low for his age.

Last month he was - 17lb 2oz
Yesterday exactly 4 weeks later he is now - 15lb 7oz

He has been cruising for over a month and has been crawling for several months and whilst not noticeably much more active, I'd say he is always on the go.

He eats really well, 3 good meals (mixture of blw and spoon fed) and 2 snacks plus he has 2 bottles a day.

I don't think I'd be as worried if he had lots of weight to lose but he wasn't very heavy before losing the weight.

Am I right to think they should be more concerned or is the GP right to say he's fine and the amount of weight he has lost is nothing to worry about?

Thanks all, it's reassuring to know that others would be as concerned. I got the impression from the doctor that he felt I was massively over reacting and just a neurotic first time parent.

Our surgery isn't open at weekends so I think I'll check his weight again over the weekend and call back on Monday to ask for a second opinion.

I thought milk should be the main source of nutrition until 1, would he take another bottle?

@Apples6544

I thought milk should be the main source of nutrition until 1, would he take another bottle?

My thoughts too. When did he drop to 2 bottles?

Aside from food, how many bottles/breastfeeds does he have along side it?

I think you should try and get him seen at hospital. My DD lost 15% of her weight after birth and we were constantly back and forth the the children’s ward and had fortnightly weighs by the hv. We get a telephone appointment from a consultant every 8 weeks. All this through the pandemic. DD weighed 11lb at 3 months, your child is much older but not much heavier.
The hospital will also refer you to dietitians.
If he’s eating well it does sound as if the food isn’t being absorbed, similar happens to dd.
A fast track way is to ring 111 and get an out of hours gp appointment and hopefully they will refer you to a paediatrician, especially if the out of hours appointment is in the hospital.

@Apples6544

I thought milk should be the main source of nutrition until 1, would he take another bottle?

He used to have 3 bottles but he dropped the one during the day at about 9 1/2 months. He simply stopped wanting it so we followed his lead, as we had done throughout with regards to his bottles, he was always fed when hungry as apposed to a schedule.

His 2 bottles are 8oz and he sometimes doesn't finish all of it. However he has plenty of dairy during the day (he's especially fond of cheese).

As far as I know, milk should still be his main source of nutrition until 12 months.

I'd keep on and on with the HV, call and call.

When ds1 slid from the 75th percentile (at birth) to the 9th (1 year) and stopped putting on weight entirely be 9 and 12 months we had a fair bit of intervention, tests and visits to the hospital dietitian. The upshot was as long as he was healthy, growing and energetic, I didnt need to worry. So as your dc is healthy and active I wouldnt worry too much but I would keep an eye on his weight to see that it starts increasing again (although not necessarily at the rate it did before).

Can you Google ‘health visiting team - area’ I just did and got an office number for the team in my area.
They won’t work weekends, but you can give them a call on Monday if still not heard back from your allocated HV.

I know they have an incredibly high amount of children they look after, so they may have been busy / out on appointments etc.

I would seek further advice i.e. health visitor and second GP opinion. It is the loss of weight not just the centile dropping that is concerning. If the baby is dropping down the height centiles they may not be getting enough nutrition to grow. I would also reintroduce additional milk feeds ( bottle).

Can you Google ‘health visiting team - area’ I just did and got an office number for the team in my area.

Thanks for the suggestion but we dont appear to have a central number for our area.

I would also reintroduce additional milk feeds ( bottle).

I will try offering him another bottle today. I can only try but I'm not sure that he will take it as it has been some time since he stopped wanting it.

Use his milk in his meals as well as what he will take himself from the bottle. Give a bottle when he first wakes up & before bed? Doesn’t need to be 8oz. Your hv will be able to reassure you or get him checked by gp again. There will be a discrepancy between scales too. Speak to them on Monday

@Crappyfridays7

Use his milk in his meals as well as what he will take himself from the bottle. Give a bottle when he first wakes up & before bed? Doesn’t need to be 8oz. Your hv will be able to reassure you or get him checked by gp again. There will be a discrepancy between scales too. Speak to them on Monday

He does have his milk in food e.g when making mashed potatoes or scrambled egg and his two bottles are already first thing in the morning and just before bed. I'll try offering one at lunch time again today but if he doesn't want it then I'm at a bit of a loss as to getting more milk into him.

I'll keep trying the health visitors number but unfortunately theres not much she can do if she doesn't answer as theres no way to leave a message and she obviously doesn't know I'm trying to get hold of her.

Another one here who thinks you should get a second opinion. Did the GP even weigh him? Of course your scales may be slightly out, but I wouldn't be happy if they were telling you everything was fine without making basic checks.

I'd definitely push it for another opinion OP, my 11 month old DD is crawling always on the move, she weighs nearly 20lbs still. She hasn't lost weight from crawling, she's just not really putting any on, it's sort of levelling out. I'd go back and ask to be seen again

Hi OP

I can relate to feeling worried over baby weight loss. My DS (who is a bit medically complicated for other reasons) lost a fair bit of weight recently.

It turns out he probably wasn’t eating enough. He’d got super active with crawling and climbing but didn’t eat more than he had been to keep up with the metabolic demand. His consultant advised us to pimp his meals and snacks with cheese, cream, yoghurt, biscuits etc. He’s 20 months old so this advice might not be suitable for your DS but it could be as simple as insufficient calories. They need more than you think and milk is nutritionally dense so less milk means he has to get that carb, protein and fat replaced elsewhere.

We gave diet a bit of focus for three weeks and our DS gained 0.8lb which meant he jumped up a centile and looks much chubbier. He’s actually sleeping better too so that was an added unexpected bonus.

Best of luck- I agree with getting a second opinion but do focus on his diet too. I’m all for BLW but when not enough is going in they need a bit of intervention.

@PitterPatterRaindrop

Another one here who thinks you should get a second opinion. Did the GP even weigh him? Of course your scales may be slightly out, but I wouldn't be happy if they were telling you everything was fine without making basic checks.

No the GP didn't weigh him. I had pictures of him on the scales which showed his weight but you're right thinking about it, it's really poor he didnt actually check on his scales. He checked his stomach and asked about his bowel movements and foet but that was about all. I got the impression he just wanted to makes the appointment as quick as possible so he could get home to be honest.

She hasn't lost weight from crawling, she's just not really putting any on, it's sort of levelling out.

That's sort of what I was expecting to happen. I think if he'd lost a few ounces I wouldn't even have thought twice about it as he wasn't very big to start with but to drop so much goes against everything I've read.

second opinion but do focus on his diet too. I’m all for BLW but when not enough is going in they need a bit of intervention

Thank you for the detailed response. I will definitely ring back on Monday to request another GP takes a look at him and I'll try to up his food intake but if I'm honest he's pretty good at getting most of the food into his mouth these days and his portion sizes are quite generous. Also at least one meal a day is spoon fed, normally porridge for breakfast so I'm as confident as I can be that he's eating well and consuming a good amount.

Hmnn, I suspect they wouldn't refer him as he hasn't crossed two lines yet, but is just above doing so. I have the same issuez with my little one teetering on the edge of a referral for her whole life, but always just a shade over the line, so it's apparently ok.

I'd be definitely wanting a second opinion with him losing weight though. That's a bit odd.

Hmnn, I suspect they wouldn't refer him as he hasn't crossed two lines yet, but is just above doing so. I have the same issuez with my little one teetering on the edge of a referral for her whole life, but always just a shade over the line, so it's apparently ok.

That sounds very frustrating, especially considering it seems like such an arbitrary rule.

Surely they would be more concerned with a loss of weight than whether or not a child had crossed 2 percentiles especially with a child at the lower end of the charts?

No the GP didn't weigh him.

You went for an appointment because you were concerned about your babies weight and they didn't even weigh him. I'm not a GP, so hopefully someone with more knowledge will explain why they might not have do so, because checking his weight seems like the most obvious starting point. Your scales may have been wildly off, and a quick check by the GP could have reassured you that all was actually ok.

Just to say as well that the consultant said to us that the most common cause of infant/toddler weight loss is them just not getting enough calories rather than the more sinister stuff you read on google. And also them just finding their natural centile predisposed by genetics (although this tends to be just not gaining weight rather than actual weight loss).
When you next speak to the GP it might be helpful to have done a food diary with quantities for a few days so you can evidence what he’s eating. Our consultant and dietician work in tablespoons so I’d say for breakfast for example 6 tablespoons of porridge made with whole milk plus a medium banana etc etc.

And yes, they should do a physical examination- listen to heart and lungs, palpate abdomen, check length and head circumference. Ask about recent illness or allergy and ask for your instinct- what do you think has caused the weight loss?

If the GP isn’t doing that basic stuff I’d ask to see someone else.

@PitterPatterRaindrop

No the GP didn't weigh him.

You went for an appointment because you were concerned about your babies weight and they didn't even weigh him. I'm not a GP, so hopefully someone with more knowledge will explain why they might not have do so, because checking his weight seems like the most obvious starting point. Your scales may have been wildly off, and a quick check by the GP could have reassured you that all was actually ok.

Our surgery don't have baby scales. So even if they wanted to weight a child they can't. If they are worried about the baby's weight they are told to get it checked by the health visitor.

Is he more thirsty than normal or wetting through nappies? My son was diagnosed with Type 1 diabetes at 13 months old following rapid weight loss, increased thirst and urination. Don't wish to alarm you but sometimes there is an underlying issue. I too think you should seek a second opinion.

You went for an appointment because you were concerned about your babies weight and they didn't even weigh him.

Yes, in retrospect it's quite bonkers and I should have asked him to check. The only examination he did was feel his stomach.
He did also ask about intolerances and bowel movements but that was pretty much the entire exam. He didn't do any weight or measurement checks or even ask if he had been unwell.

When you next speak to the GP it might be helpful to have done a food diary with quantities for a few days so you can evidence what he’s eating.

Excellent idea! I've made a note of everything he ate today so hopefully they can see he's eating well and it will help them in their investigations.

Is he more thirsty than normal or wetting through nappies?

That's interesting he isn't weeing through nappies but he's definitely drinking more water. I had just put it down to getting a new sippy cup that he finds easier to use but you're right it could be something else to consider.

I wouldn’t worry too much about him drinking more water if he’s dropped a milk feed. They need to replace some of the milk fluids with water and if he had T1 diabetes he’d probably be wanting milk feeds and water- basically anything thirst quenching. But it’s definitely worth getting it checked as part of any investigations.