Awful trip to health visitor. Please help.

[fionnthedog]

My ds is 5 months (22 weeks) has always had low weight gain. Was born on 25th centile dropping rapidly to 9th. He's ebf and currently feeds around 5-6 times in the day plus once at night. He has been fairly consistently following 9th centile for the last few months and was finally allowed to only have him weighed monthly. Went today after a month and he's only put on 6oz in a month and I have to go fortnightly again until "he gets back up there".

I'm devastated and don't know what to d to get him back up there. Should I begin weaning early? Or switch to formula? He has had a cold the last two weeks and cut his first two teeth - would this impact weight gain?

You do know that you don't have to take him to the health visitor or have him weighed?

If he's following a centile line fairly consistently and is feeding on demand with plenty of wet and dirty nappies then I wouldn't worry too much.

Babies often drop their weight gain at about 5 months because they suddenly become a lot more active. I wouldn't wean onto solid foods, these are often foods that an adult would eat if they were trying to lose weight. Have you tried breast compressions to get more milk into your baby at each feed. When do you do your evening/ night feed. Is there any chance of getting another feed in? Finally if your baby is happy and has plenty of energy then you don't have to get him weighed.

They should have taken into account that he was ill & teething. I wouldn't necessarily wean early because first solids are quite low in calories, I don't think they would do anything to help weight gain?

I agree with previous post too, you don't have to bring him or have him weighed. I know for me personally, that would totally stress me out, and in turn affect baby.

Is he otherwise well - alert, meeting developmental milestones?

You are doing brilliantly. As Mrs Pnut said as long as ds is feeding well for him, having sufficient wet and dirty nappies, is settled and happy between feeds and meeting his major milestones over the next few months, I wouldn't worry at all. They grow in fits and starts. As you probably know ebf babies often gain weight more slowly and steadily. I wouldn't necessarily recommend my approach, but my ds (dc3) hasn't been weighed since he was about 8 weeks old on the 12th centile. I would say that as mummy, you know best, so if you are not otherwise worried, then carry on as you were x

Sympathies. Dd1 was similar and it was all so stressful. I highly recommend the book "my child won't eat" if you can get your hands on it. The authors name is Gonzales I think. I found it incredibly reassuring and it gave me confidence in what I was doing.

no no no no no don't go and get him weighed like that
allowed?? pah!

is he happy? hitting milestones? yes? then fine, he is fine!

and i am speaking from experience, my DD was born on the 50th... then put on weight slowly, but always putting on weight until at 10w she was on the 9th centile.

guess what? at 2y8m she is STILL on the 9th centile. that is where she belongs.

she was born on the 50th probably because i had Gestational Diabetes and was on a drip during induction...

trust your instincts... if the baby looks happy and not losing weight he is probably fine...

and i refused to go back to the annoying HV to get her weighed... did it something at the place with the nice one...

the only change i did was to maike sure i offered both sides at every feed and when in doubt offered boob so she took whatever much she wanted

Another onehere who last had dc3 weighed at, um, 2 weeks old . If your older baby is alert, healthy and feeding on demand, then forget the tyranny of scales. I once asked my ace HV whether she could tell before weighing whether a baby was going to be OK, and she said 'of course'. At our first HV visit with dc3 she didn't weigh at all, because I said I was happy and dd looked chubby and happy!

Dd is now 7 months, btw!

Fion, it's horrible to feel supervised and surveilled and criticised :( :(

No one here can tell you to ignore the HV, but you can certainly ask questions!You could phone and speak to the HV rather than wait until the next weighing, in fear and trepidation :)

• why are they are concerned about the weight? A drop of up to two centile spaces is within normal (in fact, babies who drop more than this are usually ok, too, but it's just usual to not even raise an eyebrow at two centile spaces, 'cos it is so usual). Your baby has fallen one. What is the worry?

• what difference would more frequent weighing make? Merely putting a baby on the scales does not 'do' anything....!!

• if there is concern about the weight, then why have they not suggested ways to address it? The easiest and best way - given there is no urgency at all about any of this - is to bf more often. This allows the baby to be in control and avoids the risks of over-feeding or solids replacing milk. Discuss doing this - 6-7 feeds in 24 hrs is not all that often, so you can probably fit in an extra one or two offerings at least, or one or two extra 'sides'.

It doesn't sound as if the clinic has been much support to you, but they clearly care about you and your baby....they need to know if you have been left upset and confused, and under-confident.

Hello all. Thank you so much for your reassurance. My instinct is that ds is fine but as a first time mum I get so upset by the HV always seeming to question my abilities ("do you not have any concerns?")

I have tried ever since he was born to offer more feelings but it just ends up in a battle and both of us being upset. After the clinic this morning I forced hi to take the second side and he threw up afterwards.

I'm mostly thinking about switching to formula to reassure myself that he's getting enough but I just can't help like feeling such a failure.

:( :( :(

Please call the clinic.

It is clear from what you say here that your baby is fine, he does not need more milk (you have offered it and he says 'no thanks!' (sort of :) ), and he is healthy and well.

WHY would you give formula? You would know how much he was taking - but what good would that do?

If he needs more milk, you have it there, in your breasts. He doesn't want it.

That's usually a very powerful indication in a baby as 'old' as five months that he doesn't need it :)

And tell the clinic you feel like a failure.

Any clinic that allows a mother to feel that way needs to know, so they can flippin well get their act together

Sounds like DD. 25th centile born, dropped to 9th, where they wanted her weighing weekly so they could decide if she was putting enough on.

I never went back until her 2.5 year check, I carried on breastfeeding her and she was and is bright, happy and filling nappies. She's somewhere between the 9th and 2nd now. Me and her dad aren't world beaters for height and weight.

If you're not worried about him don't go back. Don't let them make you feel like you're doing something wrong if he's hitting his milestones and filling his nappies.

Nothing you've written makes it sound like formula would help. As others have said, your baby is not looking for more milk. Do you think your baby could be a genuine smaller baby, e.g. if his parents and other relatives tend to be smaller? Someone has to be smaller than average, by definition.

Have you tried reading kellymom.com? It's great for evidence-based info about breastfeeding. Unfortunately many people know little about breast feeding, even health visitors, which you have to bear in mind. It's there a breastfeeding cafe or similar where you can speak to someone else? Some have health visitors or breastfeeding peer support available.

My DS also dipped ofc his line around that time. I wasn't worried. He seemed to be feeding when he wanted and always product go wet/dirty nappies. He occasionally dips down but it's just growth spurts.

Although funnily, it was only when he went above his line a bit that I got a silly comment from a HV. She asked if I was forcing him to feed. He was ebf at the time

Outrageous! DS (PFB) was on the 25th centile at birth and was EBF, dropped down to the 9th, but was happy, alert, meeting milestones etc etc. I kept my nerve and kept feeding and he's now a v healthy, sporty, speedy 10year old. Needless to say, when I had DD, I very, very rarely too her to be weighed. Some HV are obsessed with babies being "bouncy" overweight. Ignore, ignore, ignore.

Absolutely don't go back and speak to your doctor - let them know that as far as you are concerned - baby is fine, following a centile, happily feeding, and the only problem is you being harassed - telling you you HAVE TO do anything wrt attending clinic is waaaay out of order - by the HV.

Say that you are happy to make an appointment with the DOCTOR for a couple of weeks' time to check the weight, but when the HV is telling you that you're 'not allowed' to do something - that's the end of the conversation - and the end of the professional relationship. Added to that, her advice is looking less and less correct - far too much emphasis on following charts at the expense of looking at the whole picture.

Your baby seems absolutely fine. HV, not so fine. Drop her.

Gah, this is all wrong!

The centile they are born on is thought to be irrelevant now, because it's much more related to gestation, mum's size, fluid levels and gestational diabetes. They are supposed to take the centile they're on at 2 weeks as a starting point - so it sounds like he was ALWAYS supposed to be on the 9th, he's still on the 9th. There's nothing wrong with that, everyone has to be somewhere on the chart.

The health visitor is using older methods which aren't thought to be accurate any more, and causing you undue stress and worry.

The cold would have impacted weight gain and is totally normal, plus it's normal for weight gain to slow down at around 4, 5 months - you'll see the line flattens out a bit if you look at the book.

Follow your baby's cues. If he's refusing more then he's having enough. It might even be harmful to force him up to the next centile line. I think their advice is dangerous, not to mention upsetting.

Other signs your baby is getting enough milk - if he's alert when he's awake, he's weeing at least 6-7 times a day and his poos are soft like porridge, not hard.

You sound like you're doing fantastically, please don't feel like you should stop or that you've failed.

I think the only thing you need to switch is HVs. Or Clinics. Or both. Or give them up.

They can mean well, but HVs can just say the wrong thing. If you are worried about his weight/weight gain then yes, maybe continue to have him monitored - but tbh he sounds fine.

Sounds just like DD. I ended up phoning the La Leche League helpline on a Sunday in floods of tears and the lady who picked up was so, so kind and had some sort of medical book in which she found the correct range for weight gain and it was nothing like what the HV thought.

If he's feeding well and the output is, ahem, good, and you think he's ok, then he very probably is.

I know what you mean about the 'not having any concerns' thing - I took DD for her 2yo development check and the HV was really patronising about how relaxed I seemed about everything. It pisses me off because motherhood has actually taught me that I do have good instincts and I don't need to question everything to the nth degree and that I just need to roll with it (I slip from time to time of course; just ask DH last week...) but they seem to want me to fret about every tiny thing which for someone who has had a serious anxiety disorder, is really not good.

Do you have a Baby Cafe near you? www.thebabycafe.org/ I can't recommend them (or at least Oxford) highly enough.

Thank you all again. I know rationally that things are probably fine, but tis hard when you feel awful to be rational. Plus he still has a very snotty / bunged up nose which means he's also out of sorts which adds to all my worries.

I will try not to do anything rash. Am sure that tomorrow things will feel a lot better. There's just a lot of day to get through before then xx

Ds1 slid from the 75th percentile to the 9th in his first year. 8 years later he is still on the 9th for weight and is as healthy and active as he has always been. All the worrying and trying to feed him up as a toddler was a total waste of time - nature obviously intended him to be slight.

Sounds like a very hard day op.
Some Health Visitors are sent to try us. One at our centre is famous for crap, outdated advice (told me I should probably give up bf at 8 weeks as I had some period pain). Get in touch with the clinic as tiktok suggests, or don't if you don't want to-you're the mum who knows her baby here after all! If your instinct is that your DS is fine then he probably is, if you're worried call the gp. There is no allowing you to go longer. It's up to you. It sounds like you're doing great and I think that a switch to formula might just result in formula flavoured sick. It is rotten when you're made to feel as if you're doing something wrong and the hv should know this and be more helpful.