Bf Baby 18 weeks dropping centiles

[RottenRow]

title says it all really. I have a happy, healthy dd who has dropped from 75th centile at 2 weeks to almost on 25th.

She feeds on demand every 2.5 to 3 hours. Usually wakes once or twice in the night for a feed. She consistently gains weight but obviously not in line with the chart in the red book. The hv told me today I have to go back in 2 weeks to make sure she hasn't dropped any more. I can't help wondering what course of action they will suggest if she is not meeting their milestones.

I really cannot stress how ok I think she is doing. She has chubby legs, never stops smiling and I hate the fact that I am being made to feel like something is wrong.

At the moment that kind of drop is ok - she's gaining weight - she's feeding ok and you feel she's well.

You don't HAVE to go back - it's up to you - but the key thing is if you go back what you'll do about it if she's dropped further down the chart. Obviously the first thing you'll do is come back here to talk it through .

Bear in mind that babies don't grow linearly so she may well be reversing things in a fortnight. Or she may not - she may just want to track the 25th now.

It won't do her any harm to squeeze in the offer of a few more feeds if you want to. But don't force it at this point.

You're doing nothing wrong. They're being cautious which is a reasonable approach but it's not like she's a newborn. Your milk will be settled and things are well to date, so I'm sure it's either a blip, or just the way she is.

Thanks from the reply. I can try an squeeze extras in but even as a newborn she would not eat when she wasn't hungry. She tries to sit up when she's had enough or isn't interested. Just have to hope she maintains on the chart like you say and if not I'll be back!

Hi RottenRow,

I don't have any particular advice, but just wanted to add my support as we're going through something similar. DD has dropped from 50th centile at birth to 2nd, but like yours is smiley and healthy (although mine doesn't have chubby legs!). My health visitor has been very relaxed about her weight. I think the general policy is to suggest a medical check up if a baby drops more than two centile spaces - the health visitor sent us to the GP at this point, so you might get something similar if your DD drops below the 25th centile line. The GP suggested supplementing with a bottle of EBM or formula after each feed - I'm just mentioning that as an example of the type of action they might suggest if she drops further, but at the moment it sounds like your DD is doing fine. Good luck with the next weigh in.

If she is happy, healthy, plenty of nappies, then really wouldn't worry. Some children are just smaller than others by nature. And you certainly don't have to go back if you don't want to. Its not a legal requirement to see a health visitor at all, and you certainly don't have to comply with their suggestions.

Would also suggest clarifying whether the charts are based on bf or ff babies. That being said, the charts are an avarage. Dunno about you, but my child is distinctly more than avarage ;-)

Seriously though, don't worry.

Thanks for the reassurance Hefner and sirboobalot. I am hoping she will gain enough weight for them to be satisfied in 2 weeks time but think I will avoid weigh clinic from then on. They always seem to be negative about something.

I haven't had DS weighed since about 8 months, because it just made me panic. He is now 2years old and some of his 9-12 month clothes are still too big! He eats like a horse, and still breastfeeds several times a day. I couldn't get more into him if I tried. He is healthy, happy, active - and just small. Don't let a chart worry you. X

sirboob UK charts are now neither "BF" nor "FF" as such. :)

hefner mentions the normal reaction of a GP which can be very frustrating. Saying that, if she continues to drop it may be worth checking out that there isn't an underlying health problem (very, very unlikely) but it does need the GP to do this.

If they say there's nothing wrong, but add in formula, your choice is to do this if you wish, or you can see someone who actually knows about infant feeding and take their advice instead.

I think we're being held up to the 3 week old weigh in which put her on the 75th. She had been feeding exceptionally frequently in the days before and was obviously undergoing a massive growth spurt. And now this is the yardstick which we'll never achieve as hovering above the 25th is where she is meant to be (IMO).
Anyway we'll go the gp if we have to. I can't see the point of formula just to make her gain in line with their charts.
I do have another question though. They measured her length which put her on the 50th which kind of makes sense as both dp and i are
tall and slight. Was wondering if this was a point in her favour as it means she is growing or is it 'bad' that she has a higher centile for height than for weight?

My son was born in the 50th percentile, he has dropped down since birth. He's now 19 months and in the 5th percentile.

He even tailed off the growth chart when I was pregnant, from 32 weeks onwards, and I had extra scans.

Some people who are born to grow into petite-ish or athletic type bodies just naturally do that I think.

As long as you and the healthvisitor agree your baby looks healthy I think it's fine.

Organicarrotcake, but why is the normal reaction of a GP (presume you mean the suggestion of a top up feed of EBM or formula), frustrating?

It seems sensible to me that if a baby is thin or not putting on weight and needs to catch up, it makes perfect sense to have extra feeds?
You say "If they say there's nothing wrong, but add in formula, your choice is to do this if you wish, or you can see someone who actually knows about infant feeding and take their advice instead." Who is this person who actually knows about infant feeding, and what else are they going to suggest other than "give extra feeds"?

Not trying to start a fight with you, honestly, but genuinely I can't see how it's helpful to pre-empt that a GP suggesting extra feeds is somehow wrong! It's common sense! Unless I have totally misread your post in which case I apologise.

sleepspaniel perfectly reasonable question :)

IF a baby is not growing well enough then this may be because s/he's not getting enough milk, or it may be that there's an underlying health problem.

If there is a health problem the GP is well placed to deal with this.

If the baby isn't getting enough milk, and it's a breastfed baby, the first answer is not to give formula, but to work on improving the breastfeeding. GPs don't get trained in breastfeeding in any way that is any use as part of their standard training, so they are unable to help with this (unless they have had separate training of course). What you ideally need is a breastfeeding-trained person, ie a breastfeeding counsellor trained with the NCT, ABM, LLL or BfN (3 year diploma or equivalent) or IBCLC.

Unfortunately, rather than recognising or accepting that they can't help with improving breastmilk transfer, GPs VERY OFTEN (of course not always) will simply suggest all they do understand - ie offer formula top ups.

I didn't mean the use of top up EBM - however while this can be a useful tool it's also not the ideal option in many cases as it's a PITA and often improving direct BFing milk transfer is a vastly superior solution. It is, of course, an option to be looked at in many cases though.

Of course, sometimes formula IS required. But it should be the last, not first option. Simply topping up with formula can seriously undermine breastfeeding, and has its own significant health risks (which have to be countered by the risk of not topping up where it is genuinely indicated).

So, to try to answer your question, you are absolutely right that the parent of a slow-growing baby would be well advised to see if they can get the baby to take more milk (which you'll notice I suggested in my original reply) but my personal gripe is with GPs who simply immediately suggest formula top ups.

Saying all that, rottenrow, I still see nothing in your OP at all that would cause me concern - however always be aware that here online we simply can't see the full picture so do not hesitate to seek RL medical advice if you feel at all concerned.

Ah thanks Organic. I can see that a "baby a bit thin = formula" as a knee-jerk reaction is frustrating, but Hefner's post referred to GP's answer as being EBM or formula.

I do appreciate your POV but I worry that sometimes the most obvious solution IS to give extra milk but that some women will be put off doing this/feel pressured into spending too long trying to improve BF without success whilst the baby drops even more weight.

Obviously it wouldn't get to critical level, however surely a baby who has dropped many centiles for weight whilst still retaining their original centile for height (and having ruled out medical reason) does need extra calories, simple as that.

I understand that organiccarrotcake I'd be the first to go the gp if I thought there was a problem. I do appreciate everyone taking the time on here to reply. She gained 13 oz in 7 weeks so she is gaining. Am kicking myself as she was due a feed when I weighed her and perhaps those extra few ounces would have tipped the scales in her favour.

Sleepyspaniel could it not just be that she is going to be tall and slight like her mum and dad?
Today she has wanted a feed every 2 hours so this is a probably another growth spurt. And then and some point she'll level off again and feed less. The fact that she is gaining weight and does tell me when she is hungry makes me think we are doing just fine.

sleepy yes, it's a very valid concern and it's SO hard to get the balance. What we really need is joined up care services with GPs, MWs and HVs getting good BFing training so that they can give a balanced approach to a problem -or indeed work out if there IS a problem.

Add to that the fact that there is way too scarce access to BFCs and qualified LCs (made worse that anyone can call themselves an LC without being an IBCLC), so too many mums simply can't get qualified support. Then they feel pressure from people who don't have sufficient knowledge (but seriously want to help) to do one thing or another. It's dreadful.

Do you think that the OP's baby has dropped too many centiles? Is that your concern? I don't think I've ever said that a baby who is losing weight (which the OP's isn't) or who has dropped "too many" centiles (which the OP's hasn't) DOESN'T need extra calories (in fact I suggested that she might try to offer more feeds if she felt it was possible, just to cover all bases).

If I thought for a moment that the OP's baby was in a situation where she was at any risk at all then there is no way that I would just be reasuring her that I thought she was ok. I'm NOT a BFC or IBCLC (I'm a peer supporter and trainee BFC) but that's why I've pointed out that my and other posts shouldn't be taken as gospel. But rottenrow clearly knows that :)

I'm sorry, rottenrow we're rather hijacking your thread here.

I totally agree with you. Are you feeling happier about things now?

"Ah thanks Organic. I can see that a "baby a bit thin = formula" as a knee-jerk reaction is frustrating, but Hefner's post referred to GP's answer as being EBM or formula."

To clarify - I'm not sure I'd be happy with saying baby a bit thin DOESN'T = formula, either.

I am all for formula in the right place. It's just too quickly turned to when there isn't enough knowledge in how to resolve BFing issues.

Mums who struggle on for "too long" are also mums who don't have the right care or support. Neither of these situations are acceptable.

To answer your question I am and I'm not alright. My gut instinct tells me she's fine but being one of life's worriers I will not be at ease until she is weighed again and has remained on same centile. Fingers crossed.

Had she dropped at all at this weigh in? I know she's gained weight (which is the critical thing) but how did it track on the chart?

It was roughly the same as the last weigh in. Possibly slightly lower but the last weight was taken at 11 weeks and 6 days which was recorded as being 11 weeks. If it had been put down as 12 weeks (being one day off) then it would have been level rather than dropping.
Not sure if that makes any sense.
2 weeks ago she had hand foot and mouth and she is now cutting her first teeth so I feel these things may have had an impact. Plus she has just learned to roll which she is practicing endlessly. She is really strong and trying to pull herself up to sitting position. I know I'm rambling but I just hope these things mean she is healthy. Am feeling bit tired and emotional so am off to bed. Think maybe going over it so much is making me feel worse when all I need to do is feed feed feed and hope for the best in a fortnight

Hang on - she's had hand, foot and mouth AND cutting teeth?

Poor bub - and poor you - must have been really tough. BUT I'm guessing her milk intake wasn't optimal with a sore mouth on two fronts? That will be very, very likely to have an impact.

Practising rolling = lots of energy used and sounds like an energetic and happy baby!

I think you're right to stop thinking about it and just feed and feed, and see how things are in a couple of weeks. Hope you feel more settled tomorrow.

Rottonrow I'm sure she could well be tall and slender as a natural body shape. I am just querying whether (and I really don't mean Organic here because Organic's replies are clearly balanced and open to all options whilst respecfully retaining a certain preference) some people doggedly won't consider formula or even EBM until things start getting critical because they have been channelled into feeling that anything other than feeding by actual breast, even EBM, is not right or is lacking. whereas to me, if a baby could do with increasing their weight, there is NOTHING wrong with extra feeds be it EBM, formula or a combination of both.

I had my 16 week old weighed today and he has dropped into the 2 nd percentile from 25 th, so I have to go back too in 2 weeks. He looks really well has little chubby arms and legs and is super bright eyed.
I am breast feeding exclusively and I have noticed he doesn't feed as much as before. But I thought that was normal.
Don't know what to do to get him to feed more or what to expect if no increase in a fortnight. And what does this drop in weight mean? Is it So terrible. Neither myself or dad are big. Tall but slim.

Oh and my baby never stops moving

Hi inlovewithbaby. On one hand you want your baby soaring up the charts but on the other you think they are well and happy and meeting their milestones so do they have to grow to the tune of a line in a book?
I think dd is now having a growth spurt, as I said above she has fed two hourly today and we have been up twice already tonight rather than once. I think her weight had plateaued and is about to spike up so if weigh in had been at the end of this week things might look very different. Perhaps your son will be the same.
Dd is definitely becoming more and more interested in the world
around her so one thing I am planning to do is to try and feed in private where possible in case she is being too distracted. I don't have to worry about extra feeds as she is handling that herself for now.
I hope all is well with your boy too.