B/F baby dropped a centile - should I worry

[Davette]

BDNo3 is 10 wks old and solely breast fed. She has dropped from the 50th centile to the 25th over the last 4 weeks in both weight and height - am I not feeding her enough and stunting her growth! I should know not to get neurotic after three children but I can't help it! Is there any way I can get more food into her? She is happy and content and sleeps at night from 8 pm to around 4 pm so reluctant to wake her but struggling to get her to feed more in day

Davette - standard guidelines are that it is normal for babies to drop up to two centile lines, and even then, the majority of babies who drop more than this are fine - just they prob need a little closer check.

If your baby is happy and healthy and fed responsively, there would usually be no need to worry about a drop from 50th to 25th, which is only one centile line.

What does HV say?

It would be shame for you to worry, and to try and get more into her when she does not need it!

My DS2 did exactly the same, 50th centile at 4 weeks and 25th centile at 8 weeks.

HV not worried at all. Said totally normal in breastfed babies who grow at different rates and does not mean he is hungry.

Who said you are not feeding her enough - are these your words or the HV's???

No need to "try and get more food" into her. You say she is happy and content - why are you worrying?

The charts are based on formula fed babies and breast fed babies often gain weight more slowly. DS3's weight gain slowed down for a bit and he was only putting on 2oz a week. I was so worried! I went crazy, eating, especially oats, drinking gallons of milk, I left oregano out of the cooking, I took fenugreek, I tried to rest (not easy with three kids under five!) pumped, fed DS3 every 2 hours, the only thing I didn't do was strip off (it was too cold!). In the end I stopped getting him weighed. He was happy, pooing, weeing, sleeping, in age appropriate clothes. He was fine. And I was happier because it was only causing me worry.

tabbycat , this is incorrect, sorry. No one in the uk will be using older charts now, but even if they were, they are not based on formula fed babies. They came from data from babies whose feeding was not differentiated. Current charts are very similar to the older ones, but the data comes from babies who were predominantly bf for 4-6 mths. They show that on the whole breastfed babies do not grow more slowly - they grow very slightly more quickly than formula fed babies in the first months. Then growth slows down and by the time the 'average' bf baby is a year, he is lighter than the 'average' ff baby.

OP's baby is aged 10 weeks. It does not matter what chart is being used - he has dropped one centile line, and it probably doesn't matter at all because that is within normal for all babies, bf or ff.

I was told by HV that the whole growth chart is based on formula feed babies so doesn't really tell you much if your baby is breastfeed. I was pretty angry when I was told actually because surely the scales should be the other way around? In my case my dd not gaining weight as much as the chart suggested she should resulted in a lot of pressure to formulate feed my dd and a lot of worry for me. The HV later admitted to the scale thing and said it was going to be changed in a few years... so if your baby is growing and seems happy (reaching milestones) I wouldn't worry. Just keep an eye on her.

snuppeline - the old 'UK 1990' chart was discontinued in May 2009. It was based on data from several sets of babies, some will have been bf, some ff, some mixed, some early solids. Because most babies in the UK are ff at some point, the data was skewed towards ff, but it was not 'based' on ff babies.

In May 2009, the new UK-WHO-UNICEF chart was issued, based solely on data taken from a recent world-wide study of babies who were predominantly bf for the first 4-6 mths.

Both charts are equally useful, if used properly, for the first few months as there is very little difference (except that bf babies grow very slightly faster than ff babies).

Relying on the charts - whichever chart - is poor practice. Weight is only one aspect of a baby's well-being. Slow gainers can be perfectly healthy. Fast gainers can be perfectly healthy. Any weight should be judged in the context of the whole baby.

Tiktok i just want to say I love your posts . You communicate very clearly - I knew everything you posted here (probably from reading your other posts on MN!) but I would never be able to set it out so clearly and non-judgementally. You've really contributed to my breastfeeding education - so a big thanks to you

Ooh, ta

That's very interesting about the 'UK 1990' charts being discontinued in May 2009. My son was born in June 2009 in a hospital out of our borough and given a 'new chart' in his red book. When I was seen by midwives/HVs in our borough, they always commented 'oooh, we haven't had training in these new charts'. I saw the HV in March of this year and she said that they're still using 'old charts'.

There is quite a significant difference, isn't there? Both of my (ebf) children are on the 2nd centile in the old charts and 9th in the new ones. Though my ds has followed the 9th centile since birth, whilst his sister jumped all over the lower centiles in her 'old book'.

rosebud some PCTs have been told to use up their copies of the older charts - but they should not have had more than a few months' supply to use up. Babies who started on the old charts should continue with them, though. No new baby should be plotted on old charts now, unless there has been some very incompetent supply ordering somewhere in the PCT

The difference between the charts only starts to be significant after about 6 mths - a baby jumping all over the centiles on one chart will do the same on the other one. Yes, a baby on the 2nd centile on the old charts may well appear to be on the 9th centile on the new ones as time goes on.

Either way, a happy contented baby sleeping all night and dropping one centile at 10 weeks is not anything to worry about.

Thank you, I feel a bit reassured now - had nightmare trying to feed first two boys and there is an outside chance I'll do the 6 months who knows, maybe even the year with this one so didn't want to muck it up but think you are all right, she's a bright little button and I'll keep going with her demands - will probably be the case for the next 18 yrs anyway

What made you worried in the first place, Davette? There's no need to have her weighed anyway now - good practice is to weigh healthy babies no more often than monthly in the first six months, so that means not for at least another month

Worry is my middle name, first two babies not particularly happy babies, this one is Miss contented, don't want that to stop if I can help it. Obviously worried that if she's not gaining weight at the so say '5 oz a week'I'm doing something wrong and it will all go down hill! Last time everyone nagged to go to a top up bottle, didn't click he was just being a baby until it was too late and milk supply knackered.

Had a much better day today, back to Miss contented probably because I'd relaxed about the whole thing over night, just paid a bit more attention to the latching on today and gone really well - she slept from 7 pm till 5 am last night so I guess she can't be hungry. I sometimes put so much pressure on myself for it to be perfect I set my self up for a fall - but I think that's what being a mum is about isn't it, wanting the best for your children.

Davette, my bf baby has done almost exactly the same, she was on 50th centile when discharged by MW at 20odd days, and on about the 30th when weighed by HV at 9 wks. HV didn't even mention it, but commented on how healthy baby looked and GP was the same. I have had the odd moment of privately worrying about it (friend's ff baby who was a couple of oz lighter than mine at birth, now weighs the same as her and is five weeks younger!) but I haven't really got any concerns about her, she is an enthusiastic feeder, does lots of nappies of both varieties, sleeps well, smiles loads, has lovely fat cheeks and legs and is growing out of her clothes at an alarming rate, so I reckon she must be just fine, just like your baby