9mo on 0.4th centile HV stressing me out

[kellestar]

I have been avoiding my HV for a bit as she was stressing me out. DD arrived a week overdue weighing 5lbs 13oz. HV wanted daily weigh in's for 2 weeks and then weekly. DD started on 2nd centile for two weeks then dropped to 0.4th and has consistently followed this, she is now 9 months. I stopped having her weighed every other week as I was stressing my self about her weight. Now choose to go every other month. Her last weigh in was last week 13lbs 8oz.

When I was first pg was picked up the my thyroid levels were slightly elevated so was put on PTU 50mcg a day for a month. My levels have been normal since that small dose with monthly BT through pg and every other month since.

HV called me yesterday in a fluster about DD's weight could I come up for an appt with her and GP. Agreed time for today. Arrived on time, HV was 20 minutes late, no apology, no GP present. She then goes on about DD's weight gain not being up to standard. Asked about diet, which is a mix of homecooked and shop bought, really healthy appetite, BF with a formula bottle overnight. Active baby who crawls, cruises and stands without support.

She seemed persistent that as me and DH are overweight DD shouldn't be so small, but as children we were as small as DD is. She also kept going on about thyroxin stunting growth, but I have never taken it.

She wants to refer her to a paediatrician

Sorry ipod ran out of space in the box. I almost welcome the referral as she just goes on and on about increasing calories to 1000 extra a day plus an inch cube of butter in every meal, recommending me to give full fat products, which I do, but also high sugar. I have been asked to keep a food diary and weigh out how much she eats from now until we see paeds.

She also said to give up BF'ing and instead have a formula on prescription that will help increase her weight.

I have always thought that DH is petite and someone has to be on the bottomline or it wouldn't exist. She is 25th for height and 9th for head. HV says ideally she'd be in the 25th for weight.

I know I should wait and see paeds, but is she right to worry me so, what can I do and really don't want to stop BF'ing but she is really pressuring that it will be best for DD.

But someone has to be on the 0.4th centile. Unless she's under the chart, she is still within normal - and has been growing/gaining consistently, meeting usual milestones.

I would say ok to the paed appt - paed will most likely say - 'what have you brought her for, she is fine' and send you away Sounds like you are happy with DD's progress generally?

my DS was the same when he was born. If they want to refer her then go for it. I have always worried about DS size and the school nurse has now decided he may need a referral at the age of 6. If you are referred early and they find something then the sooner the better. If they find nothing it could save you lots of worry. (have to say think my DS is just wee - someone has to be the smallest) hope this helps.

X posted. I would carry on with the BF, and request a dietitian appt to go with the paeds review- they will be more able to suggest diet tweaks if needed and they often run clinics with both available at the same time.

I think the important bit is "as children we were as small as DD is" - if that's the case, then this is just normal for your sets of genes, and not something to be changed by stuffing butter down her at every meal.

It might still be worth having the referral, then you can shut her up by saying "the expert says she's fine". Not that you have to go to her anyway of course!

The HV is being silly if she thinks being on the 25th centile for weight would be "ideal" just because that would match her weight. Some people are just built slimmer than others, and their centiles for height and weight don't match.

My DS has always been on the 0.4th centile for height and weight. He's otherwise healthy and developing normally, and I've managed to escape the clutches of paediatricians so far (he's 10 now). He wears age 6 or 7 clothes, eats like a horse, and doesn't stop moving all day. I used to worry about his size, but as me and DH are short, he didn't have genetics on his side.
My advice is keep BFing, enjoy your child and unless she's looking ill, avoid HVs, they'll just worry you unnecessarily.

My DD is on the 0.4 centile and has always been small - only 5lb 5 at birth and a month early due to pre-ecampsia. Sounds very similar to your daughter though - as DD very slowly put on weight and now at 21 months weighs 19lb 8. We got referred to paedtician and they were brillant - very reassuring and far better than seeing the HV who just worried me constantly (and whom I avoid too!)

She is developing ahead of her peers, but then she is lighter so crawling is easier :)

I think the referral isn't too bad, like you say they'll let me know if something is wrong and if not at least I can tell her to jog on. I don't think I'll make changes to her diet until I see paeds, don't want to change anything if she is happy and well.

I was just flabbergasted she could make me feel like the worlds worst mum, depriving my DD of a good diet and stunting her growth.

forgot to say we also saw dietician as well as paedtrician who was also very good. We did get prescribed the formula milk but DD was on formula already - and that did help her however if your breastfeeding maybe you could use it in her food?

Does she look especially skinny or okay for her size? If she's growing well, extra calories will surely make her fatter rather than increase overall growth, I'd have thought.

Not sure if it helps, but my ds has always been an odd grower so avoided HVs from early on. Now aged 6 he's still in his 2-3 year old shorts because he's so skinny but he's very tall (99th %ile) and strong, just lean. He's always looked a bit skeletal but he's healthy. It's just the way he is. Both parents were skinny as kids - decidedly less so now.

See the paediatrician to make 100% sure all is well and once the referral is in never see the health visitor again.

DS1 started on the 25th centile and by the time he was 9 months was on the 2nd. He was bf exclusively to 6 months and then bf alongside food.

It did cause me some concern, so I asked the GP to refer me to the paediatrician. She saw him a couple of times and said she couldn't see anything wrong at all. She did refer him for a blood test which showed he was slightly iron deficient so he took a supplement for a while.

I would go along with the referral to the paediatrician. If nothing else it will put your mind at rest. I wouldn't worry too much though, your DD sounds fine to me.

DS1 is still a skinny chap, but right on target for height and very healthy.

And definitely keep on breastfeeding if you like it.

My DD was on the lowest centile but my HV had quite a calm attitude towards it. She said there had be some babies who were the smallest and some who were the biggest, and as long as she kept gaining weight it was all right.

I think you need find out if, overall weight aside, there are any other reasons for concern and get fully clarified what they are. Do they think it's a symptom of something else and if so, what? Why is your lowest percentile baby a cause for concern when others are not?

If anything, the referral will help clear things up for you, so you might as well go through with it.

On a sidenote, I was told by the GP that he would refer DD on to a paedetrician if I was worried about her weight, so it might just be a standard procedure for small babies. I never took her, as neither me, HV or GP felt she was cause for concern, but they did give me the option.