what to expect from paed referral

[ApuskiDusky]

Hi,

I've posted before about my slow to gain ds (8 weeks old, dropped from 50th to just above 0.4 centile) - at the clinic yesterday, the HV recommended supplementing feeds with either ebm or formula, and asked me to see the GP. I am just back from the GP and he can't see any cause for concern, but is going to refer us to paediatrics, as he says there's a limit to what they can test for within the practice.

Does anyone have any knowledge / experience of what to expect next?

I'm trying not to worry but it isn't really working (and trying not to google...).

DS2 was referred for this sort of reason at the same sort of age. He was very skinny though - could see his bones. He had an umbilical infection. They collected urine, took some blood, asked if he tasted salty- usual stuff. I think they decided it was probably an infection pretty quickly, I can't really remember.

When are you being seen?

Not sure yet, GP is calling them tomorrow morning (apparently 4.15pm is too late to get hold of them!), then he's calling me.

I've had my ds go from 75th to 2nd, had paed appt today. She wasn't too concerned to be honest as he's alert and happy, I'm not concerned either. If it's his only problem it might be a quick in and out meeting! I have been referred to a dietician though to sort out his milk as he seems to have a problem with normal formula. He's 13 week today by the way. If he looks happy and healthy don't worry too much, if there's an other issues (e.g. distress when feeding) write them down so remember to ask.

How does your ds look/ act?

Oh and solution two is to avoid the weighing clinic. I'm giving it up! Paed agreed this was fine if he was happy and alert as the stress from hv and daft advice doesn't help him. IT's obvious in most cases if a baby's ill, they look it or act it.

Thanks strawberrycake - no, there don't seem to be any other issues, he's alert, smiling and seems well. I think the main issue is that he hasn't stayed at a centile line yet, just keeps falling through them. The GP said he wouldn't have referred if ds was tracking at the centile he's now at, and doesn't want to wait to see if he falls even further.

Luckily all the HCPs have been good so far, emphasising that things are probably fine, and that they just need to double check there's nothing more to it.

Doesn't stop me worrying about it though! Did the paed just talk to you and look at your ds, or did they do any tests?

DS was referred for 'failure to thrive' - pretty much crawled along below 2nd centile for 5 months. Paed was v reassuring, just asked questions and looked at DS, no tests, one follow up and that was it. Was nice to have it though - meant I could stop worrying. I didn't want to top up, we were given reflux meds but DS didn't take them for long. Like you I had a happy, alert but skinny baby!

My DS hasn't found his centile yet, he's pretty much gone in a straight line across from 5 to 13 weeks! I'm had flappy HV who are obsessed with this being an issue. He's obviously thinner than other babies of his age, his length is above 75th and his weight is just above 2nd but he's a strong little boy. He's gained 1lb since he was 4/5 weeks old but he was nice and big to start with, lost his chubbiness but still clearly healthy.

Basically spoke to pead briefly, asked if I concerned, said no and explained he was happy and healthy looking. She stripped him off, rolled him over and felt his belly and agreed with me! Referred me to dietician as seems to be intolerant to dairy though as a side issue. Was in and out in 10 min. Discharged him straight away, no tests or follow up. Same as cleanandclothed, it was nice to have reassurance, particulrly after hv fuss, but pead if any seemed surprised to be confronted with a healthy baby when notes said he wasn't thriving! Said she looks at the child rather than the chart! Said it's very common for babies to take a while to find their centile to track and can yo-yo all over the charts. We talked about reflux meds but as he seems to be no longer that bothered about it (seems to have learnt to be sick rather than keep it painfully down) we agreed its best not to use meds.

Thanks strawberrycake, that gives me some idea of what might happen, I am a bit less anxious about it. Hopefuuly they'll just agree that he's just small!

I hope so too. Being small is fine in my opinion, he's very cute. This morning he stood up holding my hands from a sitting position so being small doesn't seem to harm him! (He's 13 weeks)

Out of interest though does he have any problems feeding? I've been through the mill with feeding issues.

Not serious ones; we got off to a slow start because he had jaundice for the first 3-4 weeks, but I thought things were then going well with feeding until the weigh-ins. Latch has been checked and it's ok rather than always optimal but my efforts to improve it haven't really made a difference and the BFC I saw plus two on the helplines have not been able to make more suggestions.

DH is more worried than me - a combination of not spending time on MN to hear of others having the same experience, and a black-and-white wish to 'solve the problem'. I need to make sure he comes to the paed appointment so he can hear things first hand.

It's good to talk about it on here!

Definately take him. My DH was worried and wanted to 'fix' but calmed right down. My DS simply went on hunger strike. Refused breast from the word go then at 6 weeks refused bottle too! This week he just changed his mind though and gained 8oz, after gained 1oz every week or two for ages. I think he's simply a contrary sod!

If your DS wasn't getting enough you'd know about it, when my ds wasn't he was either screaming or listless. It was bloody obvious all was not well.

We had the 6 month check-up and despite LO not having doubled her birth weight (born 6lb 12, now 12lb 12), the doc (USA) was very happy with her. Took us to about 4 months, before she tracked a percentile (which was 2nd in the end), so 8 weeks is very early to be worrying about that. As others have said, you know if your LO seems fine (even when they stubbornly only put on an 1oz in two weeks), but mum guilt will still plague you here and there (especially when everyone's "oooh how much do they weigh now" and you whisper under your breath to fuck off and shut up but then the question is followed by a sleep one grrrr)

sorry thread hijack but strawberry wow, 8oz in a week (we've just had 7oz in a month). Hope things continue to go well for you.

Sorry to hijack too-but 8oz! That is what he'd but on between 5 and 12 weeks in total. He changed his mind last week and is stuffing milk down. Went from 2oz feeds 5 times a day to 5 feeds of 7oz and a night 3.5oz in a matter of days. Little fuitcake.

same here. when my ds (dc3) was born he was a good size...he grew in length, but his weight gain was slow, and on his chart he was going down, down, down.....

anyway. was referred, saw lovely paed who said it was a pleasure to see a nice slim baby who was doing all he was supposed to, that his weight chart was a perfect example of a bf baby (charts are based on formula fed babies) and if the only thing worrying me was his weight, then to stop getting him weighed!

try not to worry and obsess about it...as long as he is well, feeding ok and producing plenty of wet and poopy nappies, i'm sure all is fine.....

hopefully your appt will come through soon and you can officially stop worrying!

Just out of interest...in my red book the chart claims to be based or bf.

lick him. does he taste salty. the pead will ask you this so worth knowing before you go.
they will ccheck him over and ask if you are worried.
should be quick and straight forward.

strawberry...my ds is 4 now, so bf charts may well have been introduced.