Dropping centiles - should I switch to formula?

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My ds is 7 weeks old and had a birth weight of 9lb 3oz he initially lost just over 10% of birth weight due to a poor latch which we had help with and he now latches fine.

He was weighed by hv at 4 weeks at 10lb 2oz and weighed yesterday at 11lb 5oz which puts him on the 50th centile when he was 91st at birth and 75th at 4 weeks, the hv didn't seem too concerned as he has lots of wet and dirty nappies (usually one dirty per feed) however I am now worried he is not getting enough milk and will have dropped even further on the next weigh in. I am not sure whether to continue or introduce a ff or an expressed bottle feed to help with weight gain however I am not sure if this would help as he doesn't seem to be hungry when he comes off the breast. It's now reached a point where I am dreading getting him weighed by the hv to be told he hasn't gained 'enough'

Did the health visitor advise you to switch to formula?

Sorry you are worried :( breastmilk is incredibly calorific and in most cases is the best for your baby. If he doesn't seem hungry it doesn't sound like he's not getting enough milk from you so there is little point I changing to formula in my opinion. I know it can be really hard when the hv's put pressure on. It might be worth seeking support from a breast feeding counsellor or La Leche League who can advise you. They don't have to only be used for the newborn days and latch etc, they can be really helpful with all sorts of breastfeeding issues.

Hi no they didn't seem overly concerned she just said to offer more however he is feeding at least 10 times a day and I tend to offer every time he shows any sign at all. I think my worry is I will take him for his next check when he has his injections and he won't have gained enough again and may have dropped even further - he is a very long baby 55cm at birth and 62cm now so I have wondered if he is just meant to be tall and slim! However this does not come into the dreaded charts

I know it's hard not to worry but if they aren't showing concern then you need to try not to be concerned either. You'll soon know about it if they're worried!

Ten times a day sounds normal to me. I was feeding my baby every two hours until he was about 4/5 months old. He just wouldn't leave me alone!!

Don't forget the charts most HV use are tailored for formula feeding, there's a different chart for breastfeeding because the weight gain is slower - check out kellymom.com/health/growth/growthcharts/ for some information.

If he's having plenty of wet and dirty nappies and your HV wasn't concerned then I would try not to worry. I'd second the La Leche League suggestion, they have a helpline you could phone if you want to talk it though with one of their lactation consultants.

I had feeding issues with one of my daughters. She went from the 50th centile to the 0.2 centile.
The paediatrician explained that a baby's birth weight is dictated by the placenta - how efficiently it has been working throughout pregnancy. Over the first 12 weeks a baby finds its 'natural' weight, therefore dropping / going up centiles isn't in itself something to be concerned about.
I was also advised that so long as they are putting weight on (even if it's only an ounce a week) then so long as all the other indications are fine (like you said - happy, sleeping for decent periods, wet and dirty nappies etc etc) then not to worry.
If your baby is happy and you know milk is going in (because it's coming out the other end) then I'd really try not to worry.

And only weigh him every 3 weeks or so!!!

Thanks for the replies yes definitely plenty coming out of the other end! He does seem happy he's recently started going 4-5 hours at night so I'm assuming he wouldn't sleep this long if he was hungry!
The chart in his red book is for a breastfed baby however I still didn't think 19oz gain in 3 weeks was too bad!?
I realise I am probably worrying about nothing I think it is the attitude of the hv's that has bothered me, using language such as 'poor' weight gain and 'he's not getting enough'. They have watched me feed him twice and couldn't see any issues so I am probably just being a typical ftm!

I wouldn't worry, my DS dropped and dropped and dropped, but the HV said as long as he was steadily gaining weight, not to pay too much attention to the curve. Also, the wet nappies are the important ones in terms of frequency. DS had 1 dirty one a week and I was told that was normal for a breastfed baby.

19oz in 3 weeks is great! I don't think you've anything to worry about. You're right to keep an eye on weight gain, but the gain is good and baby is over wise well.

I suspect he's just finding his curve. Not all 9lb+ babies stay on that 91st centile.

Carry on as you are, keep offering at every squeak (and formula is no more a solution than extra breast milk), and weigh no more often than 3-4 weekly.

The charts aren't FF anymore.

Having said that as PP have said many babies "find their line" - so go up or down in their first few months then track another line.
HV tend to be ultra cautious so if they're not worried all good!

Look up "compressions" on Kelly mom or LA Leche League website if you're worried: these help make feeds more efficient and calorific.

I had a similar issue which turned out a non issue iyswim. My baby is just short but perfectly healthy/normal development wise. I did compressions and worried a lot but I reckon had I just let it be she'd have been the same. .. just needed to fund her line.
I ebf till solids at 6 month and now predominantly bf with the odd bottle of follow on milk if she's hungry when I'm out and I've not pumped.

Glad to know I am not the only one!

Feel much better knowing lots of people have been in the same position think I have been feeling a bit vulnerable after the weigh ins as although they have never been concerned as such I'm always left feeling a bit like I've been told off

Will keep up the feeds and try to remain positive next weigh in is at 11 weeks so a little while off yet

If you think your baby is not getting sufficient to eat, OP, then feed him more, by all means....but why formula??! He can have more breastmilk, by extra feeds, or extra 'sides' per feed. Just offer another breast and see if he takes it :)

However his weight pattern is within normal.

It's correct, as squizita says, that all charts used in the UK are based on breastfed babies, and this has been the case for several years. Funny how this myth persists....:( :(

Totally up to you but there is no need to. My DS was on 50th centile at birth and at 12 months is on 19th. He eats like a horse. I checked with the health visitor and they had no concerns at all. Babies who are big at birth often drop centiles as they get older. Remember size is often genetic as this becomes more obvious as they get older .

If you are worried why not chat to the health visitor again.

My DS was nearly the same birthweight as yours, lost 11%, and settled just above the 50th centile which seems to be his natural spot. I was told bigger babies can often drop down a few, it's natural.

DS was also a frequent feeder - every 2 hours during the day as a minimum.

Eats like a bloody bird now...

As long as all the other indicators like wet nappies alert etc and is putting in some weight then some babies just need to catch up or down on their birth weight. But if you think they need more milk just offer the breast more or more sides or compressions.

Dd1 was 8.14 so 91st percentile dropped to 50th by 4 months and at nearly 3 is still there. She is still 98th percentile for height.

Dd2 total opposite born 7.2 in 50th and has climbed up to 90th! Also on 98th for height.

Fennel tea is almost guaranteed to substantially increase your milk supply.
The tea bags are available in most supermarkets and health shops.

Drink it through the day as you would tea, but don't put milk in it.

Oh, sorry for the misinformation OP and tiktok! I read it on here about the charts and assumed it was true.

Sometimes a baby's birth centile can be artificially too high due to undiagnosed gestational diabetes. I had this - Ds was on the 91st for weight and 98th for height but he dropped gently but continuously since then, at five he's nearer 50th and 75th.

I think my thinking with a formula feed was a bit of a knee jerk reaction to again being told he had not put 'enough' on after seeing lots of chubby formula fed babies at weigh in. I could express if need be but think I will carry on as I am as it seems lots of people have been in the same position, I don't think I need any supplements as if anything I seem to have oversupply issues.

One thing that has been mentioned is wet nappies this again is hard to judge as he has so many dirty nappies he doesn't have them on long enough to be soaked as the guidelines say but surely dirty nappies indicate plenty is going in?

What's the biggest health issue facing our kids right now, malnutrition or obesity? Please don't fret x x

Do not switch to formula!!

You're giving your child the best start in life and there is no danger in a little weight loss before gain.

Please don't replace your perfect bm with manufactured substitute!

The last thing a worried mum needs is imperatives and exclamation marks. Plus no actual practical advice.

Quite agree, squizita. Enough with the bossy-boots high-handed tone, MrsNT - please!

OP - nappies are not a great guide after the newborn period, but of course, normal weeing and pooing is reassuring.

The main thing is your baby's weight pattern is within normal - plenty of larger babies have a period of 'catch down' growth. But if you are still uncomfortable or worried, then the easiest response is to offer more breastfeeding....no need to increase you supply, just increase the opportunity to have more breastmilk. Your baby may not need it, but you do no harm by offering :)

I don't know why your HV has got you so worried. Perhaps when you see her again you can tell her that she has made you so nervous, you have sought advice on the internet.

I am sure every baby does not follow a particular line on the chart. My DS went from 7lb12 to 10lb3 in the first month, then put on only an oz in the next week, dropped a few centiles, then sort of carried on that way until adulthood. He is now a 6ft beanpole. I used to feel very vulnerable at the weigh-ins and ended up rushing him on the solids to 3 meals a day because of one of my health visitors, after which he refused food. Even now, I feel I got things 'wrong' in my anxiety.

My DH was always the smallest in school photos and is a skinny short-arse, so I was surprised to find he had been a 9lb baby - a fact his mother managed to withhold until I had had all my babies

It sounds like you are doing very well to me.

Apologies if I'm stating the obvious, but don't forget that your baby has gained weight, not lost it. I think in conversations with health visitors etc it can be easy to confuse dropping centiles with losing weight, which would be much more of a concern.

Mine was born on the 9th centile, and he is now at 12 months on the 75th but is slim (and tall) so although in the opposite direction, he was clearly not meant to stay at his birth centile.

Thanks everyone, I've been offering extra feeds and he has taken some I've also noticed I think sometimes I have been letting him get overtired so when I am offering feeds he is screaming and I've been thinking he doesn't want to feed whereas with a bit of calming and a rock he has fed to sleep a couple of times.

I've tried offering ebm in a bottle after a feed just to see if he is still hungry and he will perhaps have half an oz before refusing the bottle too so I am confident he is getting as much as he needs, he's also been feeding and sleeping more the last few days so wondering if he's hit the growth spurt late as I didn't notice any big difference at 6w.
His next set of checks will be done by a gp rather than hv so will be interesting to see what their take on the situation is if Centiles have dropped again