HV said DS should see the GP re his weight...?

[questions2008]

i had DS weighed today at 28 weeks old, and he came in at 11kg, which according to the scale in the red book is right at the top, 99.6th percentile. He was born at 40 weeks weighing 3kg so below average, and at 22 weeks had climbed up to the 75th percentile, weighing 8.2kg. he's gone all the way through the percentiles.

I haven't bothered getting him weighed any more than that tbh, because i could see he was happy and feeding well - exclusively breast fed till we started weaning 3 weeks ago, and still on BM plus veg/fruit puree for lunch and baby rice for dinner.

Now I'm not worried about any part of his development in general, but the lady who plotted his weight today (Nursery Nurse) said I should see the GP regarding him going so over his birth weight percentile and possibly getting referred to a dietician. I was a bit shocked at the dietician part, surely not? he's hardly eating anything apart from BM and he does that on demand too, so not sure what help a dietician could be to him, and what the GP could even suggest?? Is she being over-cautious? Maybe she thinks i'm feeding him french fries mashed in with the baby rice or something??

ok this is quite long, but i just wanted a mumsnet second opinion not really sure if i should take her seriously or what?

I am surprised at the 2 percentile rule. It's such a small change, I would think most of babies go up and down a bit?

ignore, ignore.
rely on your own instincts. What would a dietician say?!!
HV seem to be very hit and miss, some are wonderful, but IME they are useless.

why is your baby not doing what it says in the book? answer: cos baby hasn't read the book

I am a great one for ignoring tick box guidelines if it seems appropriate, but the person who weighs babies at the clinic isn't usually medically qualified, so they HAS to be some baseline for triggering concern so that someone can look with a more qualified eye. I think the 2 percentile marker is quite a good one - it IS unusual to go up or down so much - most babies do trog along the line with occasional minor dips up and down. It is almost certainly 'one of those things" but ther ARE conditions that need monitoring that can be detected by significant weight change. And 2 percentiles is significant. So I would get him checked by the doctor if I were you. Then you can forget about it and carry on with what you're doing! Assuming it's not pureed McDonalds, of course!

My (v good ) HV said that it was perfectly normal for babies to go up and down through the percentiles in their first year.

My hv also said it's quite common for babies to do this. Both dc were born bigish in 90th+ centiles; both went down to 12th. First time round hv applied lots of pressure to ff as top up, different hv second time around who said some babies born big get small & vice versa.
If he seems heathly, happy etc I wouldn't worry.

I have a friend who's baby was big (she was ff though), she was referred to a dietician who just told her not to give puddings & that a portion size is equivalent to the babies fist. Her dd continued to grow at the 98th centile.

For the avoidance of doubt, 2 percentiles doesn't meant a change from, eg, 96th to 98th centile - I think this actually means moving more than 2 lines up or down in the centile chart - so, eg, moving from 50th centile to somewhere above the 91st centile, as the next 2 lines on the chart are the 75th then the 91st, or dropping down from 50th centile to below the 9th. Most babies probably don't have weight or height changes that take them beyond that change of 2 percentile lines, but I think it's highly unlikely that the majority of those that do have weight or height changes more significant than that, but who otherwise seem healthy, actually have anything whatsoever wrong with them.

My DD went from 75th to over the 98th and I was asked to keep an eye on it (i.e. keep getting her weighed every couple of months to check she didn't jump further).
They are happy that she just grew and I measured her (by sticking her on the floor!) and she was also 98th for height.
Anyway I was told that if they jump two lines then it is an automatic referral to the GP, but I think they were happy that she was healthy and I wasn't feeding her crap and they have left us to it.
Knowing that she is tall as well as heavy helped me.
Odd as my DS went from the 50th centile at birth to below the 9th. Again HV was happy that that was just who he was.
Not sure any babies happily follow the lines do they? Mine don't .

Is it really that common for babies to move between percentiles? There is a big difference between percentiles and percentage points.

I don't think it's that uncommon to move one or two centile lines over the first year. My ds1 moved 3 lines up in height (only 1 centile line increase in weight) and at age 6 is four percentile lines higher than at birth for height (just over 91st centile, versus just over 9th). Neither I nor my dh are short, so I would have been extremely surprised if our ds had remained a smaller than average person!!!!!

For most babies it won't be a problem at all, but for some it does indicate a problem. Surely it's best that it gets flagged up so the GP can just check all is ok?

ok measured him and he's 70cm, so on the 75th percentile for height. thanks for your replies, ill be taking him to GP once its safe to walk the pavements

I'm sure the nurse isn't thinking anything about what you feed your son. She probably just has a series of guidelines to work to,
ie, any child gaining or losing weight faster than a certain rate or going off the scale gets a GP check.

So have the GP check him out. If there's nothing wrong you will be reassured and if the GP finds something, like maybe he needs a different kind of food, then it's better to know sooner so you can deal with it.

But don't worry. My DS was born at 50%, dropped off the bottom of the chart for six weeks and then went back to 50% for no reason anyone could find. The HV did exactly the same to me.

My dd was weighted and due to a cold had lost some weght, she wasn't feeding as much. Was told she had to go to GP. He wasn't sure why I was there! As far as I can tell it'll be some guideline that says if xyz tell them to go to gp.

my 2nd baby was big, and by the time he was 3 months old he was more than double his birth weight, so over 20lbs, and he was a tall , round baby.

i could tell, from they way they looked at him that they all thought he was older than he was, and concerned that he was still lying flat on his back , playing with his fingers!
first question when weighing was how much formula did he have, and of course he had none. but i was pretty cross with them, even if he was formula fed, he still would be a healthy baby, and expected to be this size , by his large birth weight.

my next baby was the opposite, and underweight, and gentle hints to give him formula was totally refused by me......turns out he had health problems, and glad that i didnt do the early weaning, which was also suggested.

over the years i used to get fed up of hearing such conflicting advice , all the time, from chipping away a breastfeeding mothers confidance, to making a formula feeding mother feel like she was giving 2nd best.
being a mother is hard enough without all that worthless stress.

my daughter was 50th percentile at birth but now at 10months is 98th!. The HV nearly had a fit when she wieghed her.I feed her a good diet, she eats family foods in reasonable amounts,my older two are perfect weights and have follwed the same basic diet.I have no clue why she is so big but she is very happy very healthy and until that changes I refuse to worry!

They said the same about my dd. She put on up to 2 pound a week at one point. she seemed happy in herself and didnt eat much. the hv refered her and the poor little mite had blood tests etc. they found nothing. shes just a big boned child who once moving, stopped looking like a bowling ball. my gp said to me to trust my instinct and my ds was gonna be tall. she was right.

one of the problems was they only do weight, not height. once this was done they truly got off my back.she was in proportion but she was reading off the centile chart!!

dont listen to hv's their full of s**t. they are there to make you look like bad mothers and them to look smug . when my ds was 6 months he was high on centile line so was told he was overweight and got nagged about overfeeding. i chose to ignore them when he had his 8 month check up they done his height as well which was also high on the centile line. oh the joy when i got to say to them that his height could be the reason for his weight.

Just ignore the idiot HV, and please don't worry about anything they say. They seem to just upset parents with rubbish comments.

I had this when DS2 was a baby. He was exclusively BF, but always on the chubby side. He was 9lb 1oz born and always on the 95th percentile or above.

I also felt under suspicion of secretly giving him formula feeds.

DS2 had an umbilical hernia and the hospital consultant we saw even commented on his weight. He asked: 'Is he bottle fed?.' When I said no, he then exclaimed: 'Well, what are they feeding you, then?!'

DS2 lost all his gorgeous chubbiness when he started walking .

DS2 (2.5yrs) was last weighed by a HV at five months old. I just couldn't face listening to their stupid remarks any longer.

So you all think it would be better if HVs ignored signs which could in a small %age of cases be symptoms of a problem which needed dealing with?

ok just thought i'd update this, I saw our GP today and after asking about what I was feeding him she said she wasn't worried as DS was "probably just fulfilling his genetic potential" ie taking after his dad. and i love every one of his rolls so no complaints here .

Certainly in my case, my DD start out at just under the 50th Centile and at last weigh-in, was just under the 9th. But this was following 12 weeks of Oral Thrush because every time I took her to the GP or spoke to someone about it I got "It's just residual milk!". So by the time it was diagnosed and treated, DD had got used to feeding with a mouth full of vile tasting thrush and so didn't adapt very quickly to the changes in her mouth, the feel the taste etc.

Anyway, the reason that I haven't taken her back to the HV since, is that I was told that if her weight continued to drop, they would need to refer her to a GP. When I asked what the GP would need to know I was told "well, obviously they'll ask about her feeding but will also ask about what sort of home-life she has"!!

I was horrified! DD is our first (and possibly only) baby and is the most precious thing in my world. The thought that someone may query her home-life, when the problem was with their misdiagnosis upset me so much that I started to panic with every bottle that my DD wouldn't take. In the end DH put his foot down (along with my family and his) and told me not to take her to be weighed again.

DD is now 8 months and has always been a happy, healthy baby (other than the two colds that she's had). She is being weaned, still has plenty of milk but loves her food aswell.

But I'm still too scared to take her back in case she is down on the centiles...

HOWEVER, the other thing that was never taken into account was that I was GD when PG, so at birth DD would probably have been heavier than she would be genetically anyway because of the extra sugar that she would have taken in during my PG. They never even thought of that!!

I think the problem these days is that we feel that we're being watched and almost seen as neglecting our children until they prove otherwise and it saddens me.

DD was 9lbs when born and worked her way up to the 98th centile by around 2/3 months. She was exclusively bf and my dad used to say I was obviously feeding her Jersey Gold Top (ha, ha dad!!) The pictures I have of up to about 8 months when she started crawling, she looks like a party balloon!

I knew she was healthy - and after the first few weeks she wasn't even feeding that often - would sleep 6 hours + at night and had 4/5 feeds at the most during the day. I think she was just very effective when she did feed.

Please don't worry. You sound like you are doing exactly the right thing, and how exactly a dietician is going to help when he is only eating pures and fruit I don't know!

I realise we need to target obesity in this country, and that HCP have to do their job, but I really don't think you have anythig to worry about.

Go to your GP.

Make it clear that you personally have no conerns and that you have been refered by your HV.

Your GP will take a look and rule out any problems, will not label you a fussy mummy and will probably roll eyes heavenwards at HV advice.