5 mo plummeting off the charts

[ScrimshawTheSecond]

Hello, my wee girl seems to not be gaining weight. She's otherwise happy, healthy, active, smily and meeting all the milestones, etc. She was on the 50th roughly at birth, dropped a bit and recently seems she just isn't gaining at all (half an ounce in two weeks). Now hitting the lowest line on the charts. She's 21 weeks - my hv says that's over 5 months and that 24 weeks = 6 months, I think her maths is off, but anyway ...

She had bronchiolitis over Xmas, but I thought that recently she's fine and seems totally healthy.

The health visitor is making me feel like a heel and that I'm doing it wrong - any advice anyone? She's fed on demand, co sleeps and feeds once or twice a night, sleeps well - should I really try to fatten her up if there's nothing else wrong? Could it be a problem with my milk? I feed her whenever she wants it and if my boobs are full - do I really need to start pumping and feeding her from a bottle?

All advice appreciated!

Her big brother was always skinny, fwiw, very active and never still.

Thanks

Scrim x

That sound really difficult. I wish I could advise, but I too don't know! Fwiw, I am in similar position and have decided to see a lactation consultant for advice. I feel they will be pro bf, knowledgeable and have the time (because I am paying them) to really consider the options. I hope you get some good mn advice too.

If you weren't having her weighed regularly (as is perfectly acceptable, particularly with a second child!), would you be at all worried?

Did you ebf your first?

It doesn't make any difference what "month" she is, we plot all weights against weeks+days. She shouldn't be plotting against months until over 1. Disclaimer: I'm a HV, don't hunt me down and kill me :)

There are several variables we don't know - like what is your lo's length, how quickly did she drop through centiles, etc. - that would affect advice.

However, there are plenty of ways to try to increase weight in an ebf baby before trying topups with expressed milk (which is a right pain, so not usually the first recourse), including more frequent feeding, breast compressions and switch feeding. Kellymom has good info on these techniques.

A drop from 50th to 0.4th centile is usually a flag to check baby is feeding okay and otherwise well. Perhaps try some of the above ways to increase her weight and see how it goes? 6 months is 26 weeks, btw, not 24 - the growth charts in the red book mark it pretty clearly.

Hi all

thanks so much for all your responses.

My first was bf, with one bottle of formula a day. And no, I went along to weigh her today thinking she's so bouncy and happy and chubby cheeked, she must have gained plenty, really shocked she hadn't. It was a different hv and different scale than we've used before, I wonder if that might be a factor?

Her lenght is 62 cm, roughly the 50 th centile, and steady. I hadn't weighed her much previously so I'm not hugely sure when she started dropping, it looks pretty gradual on the graph. Thanks for suggestions for feeding, that's my instinctive course of action: feed more, rest more, eat more! ta for kellymom link, I hadn't seen that one. Great stuff.

(And thanks for confirming 6 weeks is 26 weeks - I couldn't believe I was arguing about it with a grown woman!)

You guys are great, I really appreciate it.

Sx

helloitsme - this is a really interesting link, via geekaMaxima's Kellymom page:

www.nbci.ca/index.php?option=com_content&view=article&id=47:slow-weight-gain-following-early-good-weight-gain&catid=5:information&Itemid=17

I'm not an expert and do know that crossing two centile lines is often seen as a cause for concern ... But ... I'd hold fire on the worry until this is a sustained pattern.

If she's otherwise well, I'd feed feed feed for a couple of weeks (or a month) and then get her weighed again.

It could be an issue with a different scales, it could be that she's just done a huge poo, it could just be that she grows in fits and stats and this is one of her slow patches.

As I say, I'm not an expert, and you must follow your instincts, but I wouldn't be scared into a solution I wasn't happy with after one possibly concerning weigh in.

My DD is the same, ebf baby dropped from 50th to 0.4th.

We were referred to a paediatrician who after lots of questions and poking and prodding suggested I fast track weaning. I had already started slowly introducing solids from 20 weeks and the paediatrician suggested I cram as much solid food down her as she would eat as well as BFing. Doing this has sent her weight back up to the 2nd percentile line so just waiting to see the paediatrician again to see if they are happy with this gain or if they need to do further tests.

I imagine your HV will suggest you see you're GP who will then refer on to paediatrics, it's fairly standard if they drop more than a couple of lines on the chart as they need to rule out problems like heart conditions which can cause poor weight gain.

Oh and like you my child is bright as a button and seems to be the picture of health, don't let the HV scare you unnecessarily but maybe get it checked out just for peace if mind. FWIW both me and the paediatrician think mine is so skinny because she never bloody sits still but I feel reassured knowing she's been checked over.

Thanks scrim, that was really interesting. Amazing that such thoughtful and thorough information seems so difficult to come by!

Hi Purplemonster, sorry to hear your wee one's been the same. the HV offered to refer her to the children's hospital if I was worried, but tbh she's so happy and content it seemed pretty ludicrous to me. She's booked in to be weighed again in a month, if it's not improved then I'll seek further medical advice - for now, I'm just going to feed and feed and try to get a bit more rest.

Yeah I know what you mean, my HV was pretty hysterical about it but I couldn't get too worked up about a happy child who was hitting all of her developmental milestones. She looks fine to me, just little and slender just like I was until I had her

The plus side is she's getting lots of use out of her clothes as she's still in 0-3 months clothes and she's 7 months. I'm getting my money's worth!

Same happened to us, dd dropped from 50th to 9th but meeting milestones, got referred to a paediatrician who took one look at her and told us to go away (though nicely). The gp said that they used to advise early weaning in a 'I can't tell you to early wean but maybe you could give this a go' type way. (This was at 5 months so not majorly early). Anyway more came out than went in with weaning for the first couple of months so that didnt help. Health visitors were similar to yours like nice fat bottle fed babies so made me feel very small, so I resolved this by stopping seeing the health visitors (and anxiously googling everything I could on those $@# weight charts). She's now 17 months still fine, still small, now 2nd centile but stayed there since 9 months.
Moral of the story, some babies are small, the charts are based on averages, babies dont always start on the centile that represents them so do move up or down them, but if you're worried talk to your gp or paediatrician if nothing but for your own peace of mind.

Hi Zeitgei5t, thanks so much for sharing your story. Glad to hear your wee one is doing well. If I'm thinking rationally about it, the past few weeks are when she's been recovering from bronchiolitis/RSV, for a start, which probably is when the weight slowed, and then she's started exercising all her waking hours, and trying to move - it makes sense that she's not piling on lots of weight. Still hard not to worry, though. Am not impressed by the hv's approach - I appreciate it's a hard job but I don't know how they manage to turn the weight into what sounds like an accusation. And my mother now says there must be a problem with my milk. Argh. Anyway, dd is still smily, cheery, happy, bright and full of beans, if tiny. I shall try to stay level headed and remember that - if it wasn't for charts, everything would be peachy!

DD2 was born on the 9th percentile (39+5), fell off the graph completely between 4&5 months, panicked HV, not me or the consultant as she was obviously perfectly healthy.

Since she wouldn't touch a bottle I got the same advice aspurple

"Will she eat off a spoon"
"Yes"
"Then stuff the rules and feed her whatever she will eat"

So from 5.5 months she lived on Bmilk, yoghurt, fromage frais, and small baby friendly purée (I did hold weetabix to 6months).

By 7 months she'd drink dillute juice out of a cup and eat a yoghurt and let DH put her to bed and me go out.

By 12 months she sat on the 50% line, 12 years later she still does (still won't drink milk).