Any HV or midwives - 10 week old baby still not regained her birth weight - when would you be concerned?

[XBenedict]

I have a friend with a 10 week old baby that has still not regained her birthweight. The Health Visitor doesn't seem overly concerned at the moment and being a nurse she was asking me for advice - but I don't know as I am an adult nurse.

It doesn't seem right to me but as she is growing and reaching milestones (smiling) maybe it's not a cause for concern yet. She is not loosing weight, just gaining a ounce here, ounce there but generally staying the same week on week. She's been told this often happens. Is this a common occurrence?

this does not happen often with babies born on term (37-42 weeks)!

they shouldn't lose more 10% of birthweight, and should get back to it within 3-10 DAYS! some breast fed babies migt take up to 3 weeks, but anything beyond that is a problem.

I'd be VERY concerned!

First I would get baby checked for tongue-tie (TT) - failure to latch on could be caused by this easily operable problem!

my kids had this problem, DS3 was 9lb 6oz, went down to 2nd centile by 3 months and not only took 4 weeks to get back to birth w, but gained so slowly it was awful... I didn't know he had TT as I never heard of the thing and I only discovered it when he was 8 months old!

DS5 also took over a month, though he was a big lad at 9lb 14 oz. I noticed his TT straightaway, it was sorted at 3 weeks old

DD took 6 weeks, it was a big thing and she had to be checked by hospital pediatrician. she was 8lb 3oz at birth, she too had TT, fixed at 3 weeks

out of our 6 kids only DS2 was a fab feeder, so I suspect that DS1 and DS4 also had it to a certain degree - never checked....

if tongue-tie is not a problem ther has to be something else that causes "failure to thrive".

get that baby checked out asap!

I think this is unusual and merits further investigation - I am a GP and would be referring this baby to paediatrics.

DD was EBF and lost 10% of her birth weight. It took 3 weeks to regain it and the HV was getting quite concerned, but on week 4 she put on 8 oz and then continued to put on 7 oz a week on average. How can the baby be growing and not gaining weight? Is it possible that the scales are faulty?

When DD was a baby (12) years ago babies were expected to put on an average of 7 oz a week. If a 10 week old baby hadn't regained birth weight I would take it to the GP if the HV isn't being very helpful.

DD lost over 10% of her birthweight in the first 3 days & then didn't regain birth weight after 3 weeks HV at that point referred us to the hospital for checking out. At 10 weeks definitely ask GP for a referral to paediatrician - we saw one later on for failure to thrive and in comparison to the HV (who wasn't very good) paedritics were very good (& found DD didn't have failure to thrive but was in danger of not fulfilling height potential!) we were under them for a year and it was very reassuring.

not normal at all! I would go via GP and get it checked out. really shocked by the HVs reaction

Agree that you should get referred ASAP. This is not normal.

Not normal at all, I agree. I would be looking for a paeds refrral too.

3 or 4 weeks for all my boys. Under a lot of pressure to FF but thankfully managed to BF really well in the end.

I do think that often babies are born on a lower/higher percentile due to their mothers eating habbits during pregnancy. The babies often find a more natural percentile slowly over a course of months. It is rare for a baby to stay on one percentile line all the time but I still would be concerned with the situation you mention.

kaz I agree, I can't believe HV thought it was normal!

I recently worked with a baby who took four weeks who was under birthweight at 4 weeks. They came to A and E and were immediately admitted after HV had ignored their concerns. So if GP or HV won't act go via A and E for paediatric review.

It is not normal to be under birth weight at ten weeks. It should trigger assessment at 14 days although some babies do take longer especially if they lost a lot and as long as they are gaining it doesn't mean you need to do anything. The sad thing with the babies I have worked with where nobody intervened early with appropriate feeding support was that by the time they were seen, formula became the only option because the mother's milk supply was shot and they rarely managed to develop a full supply despite feeding and pumping, whereas almost everyone I've seen at 10-14 days has gone onto breastfeed exclusively if that was what they wanted to to.

Ds was 8lb 15 at birth and lost over a pound initially. He took c.7 weeks to regain birthweight but he was referred to the paediatrician at about 3 or 4 weeks (saw the Registrar straight away as I was in the hospital anyway at the breastfeeding support group) but it was another 2 or 3 weeks before I saw the consultant who really wasn't that interested in the healthy baby in front of him and was more interested in what my dad, a former colleague, was doing.

However, ds was a classic case of a "non-failure to thrive baby who didn't follow the growth curve".

He was fully breast fed - and even though the breastfeeding counsellor midwives (I avoided HVs) didn't think there was anything to be concerned about they still referred him just in case.

DD lost over 15% of her birth-weight in the first week (despite being in hospital the whole time with hourly checks it was missed).

She took nearly 8 weeks to regain her birth-weight - she was EBF. She was always ahead of the curve on milestones and a very alert, happy, healthy baby. We saw the paediatrician at 9 weeks, he was totally happy and discharged her.

It's not normal and should be investigated ASAP.

However, I'd hate to think your friend would end up in a state of panic while waiting to see someone.

Please reassure your friend that, although she definitely should get her baby checked out, there may not be any problems and this could just be a baby who is slow to put on weight naturally.

I'm a bit at the HV!

She was tongue tied very slightly and because she hasn't been gaining weight it was snipped a few weeks ago but there hasn't been any significant improvement in weight gain.

Thanks for the advice.