Underweight 20 week old - what to do?

[Morebounceperounce]

DD is 20 weeks on Thursday and has been bumping along on or just underneath the 25th centile since birth. BFing fine after tongue tie sorted at 10 days, although single FF per day introduced at 4.5 weeks to save my sanity.

She is BF on demand and I offer at least once every two hours from 5.30 am to 6.00pm, with bottle of up to 8oz at 7pm (sometimes chugs the lot, sometimes leaves upto half), then sleeps through. I tried a dreamfeed at 10pm last night but she seemed too sleepy to take much.

When weighed at baby clinic today, the HV said that, while she looks fine and seems happy and healthy, she suggests that I start weaning to try and get some weight on her, as DD is now well below the 25th centile line. but not yet crossed the 9th. Having thought about this, I am not sure I feel comfortable doing this before 26 weeks, having heard the message that before 6 months is Bad so much.

So do I start weaning, offer an extra bottle of formula mid-morning (bearing in mind that I want to continue BFing for some months yet) or carry on with my current feeding routine, accepting that this is how DD is? Any comments or ideas gratefully received!

So she hasn't even crossed a centile line? Crossing two lines is normal, it's only when they cross 3 that any concerns are raise. I'd continue as you are.

If your baby "looks fine and seems happy and healthy" then why is there any need to make her fatter?

By the way, my ds was born on the 75th and dropped gently down through the centiles to below the 25th by 5 months, but always looked happy and healthy and never once was I told to make him fatter.

Agree with Rita - also, if the HV thinks your baby needs more calories, the ones sitting in your breasts are best for your baby at this age :)

Simply increasing the no. of times your baby comes to the breast, or the no. of breasts she has at a time, is a lot easier than messin' with solid food - yes? :)

Thanks Rita, I did wonder about the line crossing and suspect that, as DD is about to cross the 9th centile line, the HV was suggesting pre-emptive action? Or she was a bit old school, as she's not seen my DD before and the others have been much less concerned.

Can I ask when you introduced solids and if your DS chubbed up at that point or continued as he was?

I'm finding this tricky as the ability to nourish your child is such an emotive issue and you assume the professionals know what they're on about. Plus weight gain has never been an issue for DH and I, so it's a bit disconcerting dealing with the opposite end of the scale!

Those charts are for FF fed babies as far as I'm aware, so unrealistic for a BF baby.

[OMG tiktok's on my thread, am a bit starstruck!]

Defo agree about the solid food, have only just bought a highchair and have yet to invest in a tarpaulin! I do offer both breasts at each feed but DD seems to get very easily distracted when feeding so do you think it's worth my trying retreating to bed for as many feeds as possible?

Is that true TheVisitor? Well that just makes the whole thing seem farcical then.

I introduced solids at around 5 months, not sure if he's chubbed up as I haven't had him weighed for months He's still fairly slim/light compared to friend's babies though but is a very healthy and active 8 month old, crawling and cruising already.

I was weaned at 4 months and weighed 18lbs at a year, so I don't think early weaning will necessarily make babies gain weight anyway. Some are big and some are small regardless - for every baby on the 91st centile there has to be one on the 9th!

I would double check though, it's a fair few years since I had a baby! I'm fairly sure. If your littlie isn't showing interest in solids, isn't waking more etc, then take her lead, she knows what she needs. She's gaining weight, she's having wet and dirty nappies, she's alert and happy. That sounds like a healthy baby.

Most women who are bfing have bfing specific charts in their red books now. The old charts weren't based on ff babies either, they were based on all babies, ff, bb and mixed fed.

I'd continue demand feeding, watch out for signs of readiness for solids (sitting up, no tongue thrust reflex, reaching, picking up and putting things in mouth) and start then.

The charts in my red book have been updated to breastfed one, yours might be too.

FWIW none of my friends' babies have stayed as close to their birth centile as yours, everyone (whether ff or bf) has gone up or down one. A friend of mine was told by her HV to wean at 16 weeks because her baby went from the 91st to the 75th

check this link BF baby charts Down the bottom of the page.

Thanks all, this is really reassuring! I really struggle to understand why you are given different and contradictory advice, it doesn't make this parenting malarky any easier.

Just checked my red book and the charts are based on BF babies and the crossing two centile lines is stated in there so I'll carry on as is. DD is not yet quite sitting up on her own so I'll wait until I feel confident that she's ready and then take it from there.

DD didn't chub up between 6 and 9months, she only put on a 1lb, but she did learn to walk in that time. She's chubbed up a bit since, but she is just a skinny bean.

I'm glad you're not getting stressed about the HV. DD went from just above 25 to just below 0.4th but she was clearly fine.

I was told to wean my LO at 4months... and i was a scared new first time mummy so did (to try and chubber baby up as i was told) he was on the 9th centile (50th at birth) and has been following the 9th to this very day (9months today) He was ebf till 4 months as i was also told to ff to let him gain weight!! I really wish i had the confidence and knowledge to trust my instincts... He is a happy, healthy baby :) but i will know for the future not to trust HV all the time!

HVs seem to be obsessed with making babies gain weight, and getting them onto solids (and dropping milk feeds) as soon as possible.

More my dts have gone from under the 50th centile to near the 9th (at 26 weeks). they're not "underweight", in 100 healthy babies, you would expect 9 to be on or under the 9th centile, our babies are just at the lower end of normal :)

I did have a wobble in my confidence after the last weigh in (also prompted by hv comments on weaning), but I've looked at them with fresh eyes today and they're fine. both starting to propel themselves across the floor in a determined commando crawl, so developing normally. if your baby seems fine, trust that she is.

btw I have started solids as they are now 6 months. dt1 taken to it right away, dt2 upset by every bit of food and clearly just not ready yet. so low weight is no guarantee that they're ready for food!