Going to be referred for failure to thrive

[Turquoisetamborine]

My son is now 9 weeks and 6 days and has just been weighed by the HV. He is 8lb 11.
He was born at 36+6 by c section and was 5lb 14 born. He lost 12% of his birth weight by 10 days old but regained his birthweight by 3 weeks old.
I had him weighed exactly two weeks ago and he was 8lb 2. Had him weighed exactly two weeks later and he's gained 9oz since then.
The HV says I must come back next week to the weigh in or they'll be chasing me.
He feeds at least every two hours during the day and at least every three hours at night. I offer both breasts at each feed. He's been checked for tongue tie. He was having a bottle of formula every night about 10pm until last week when we stopped it as it was making him uncomfortable and constipated.
He had his 6 weeks check at the GP last Friday and she was very happy with him and said he was a prem baby acting like a full term baby. He has held his head up from birth, started rolling over at 6 weeks and smiles all the time. He rarely cries unless he's hungry. I feed him totally on demand.
What am I doing wrong? My other totally breastfed son thrived on my milk and reached 23lb at 12 months from a 6.15 birth weight.

[Nolim]

What does it mean to be refered op? That they will call you if you dont go to the hv?

[sharonthewaspandthewineywall]

HV can be rather sexist

Can we? Gosh I learn something new about myself daily on MN

[Turquoisetamborine]

I'll keep asking about tongue tie then. The HV said that I shoukd be there and she would expect me to be there next week as well as h.
She's observed me feeding him before in my own home.
I don't know what the referral involves Nolim. I suppose I'll find out next week.

[squizita]

Sharon I said can be not are all. One of mine also plotted my dd's weight 500g out on the graph - that can happen, but it doesn't mean most/all do that.

[UpUpAndAway123]

You've had some good advice op. Sounds like you are doing everything right.
As pp has said, maybe see a specialist to check for posterior tongue tie? If you're anywhere near Halifax-the baby cafe is supposed to be fab.
As someone else has said, seeing paed may be helpful-you may be reassured that everything is ok. They won't continue to see a baby who they believe is thriving as their clinics are usually so busy-too busy to see well babies!
Sorry you're having a stressful time and hope you come out the other end soon x

[Oly4]

Babies are supposed to put on weight. There's nothing wrong with HVs or peads keeping an eye on slow gainers or premature babies. Keep feeding loads and do what you are doing... But it would be silly and selfish in my opinion to just turn your back on professional guidance. I think a bf support group is a wonderful idea too

[Hairylegs007]

My small children are genetic too.

[kitty1989]

Just wanted to say you are doing a great job, your baby is putting on weight within their guidelines. Sounds like the HV is being a bit of a cow over cautious. We could have very easily ended up in the same situation. DD born at 36+6 weighing 6lb 13, lost 9% body weight by day 3, admitted to hospital for jaundice - 24h under lights on day 5. Regained bw by day 15. Readmitted to hosp again for another 24h under lights for jaundice. She then had weekly weigh ins until 10w as only putting on lower end of expected weight gain. Dropped from 9th to 2nd percentile at wk 4 (1oz gain that week - hosp again for gastroenteritis) she's now 16w, in the 25th percentile weighing 12lb 11. My DD is ebf.

It does get better trust me x

[ipswichwitch]

The thing is babies don't gain weight in a linear fashion - it's never 4oz (or whatever) per week each and every week. Some weeks it'll be half that, the next double. DS1 (ebf) was prem and had some medical issues that affected his weight gain, but his paediatrician advised against weighing too often because it causes a lot of angst if one week they don't gain. His weight graph is a zig zag line with the overall trend of a weight increase over time.

If they feed well, there are no tongue tie issues and come off satisfied with plenty of wet/ dirty nappies then they are feeding enough and the weight gain should sort itself out (barring any medical issues)

[squizita]

Yes, exactly. And I was advised expected growth varies from 3 1/2 oz to 8 oz per week - then tails off.
My dd's growth is clearly a zig zag.

I have not been referred "up" as though it's slow it's clearly growth and she is in good health.

I don't think a paediatrician would be impressed at being presented with a healthy baby at the slow end of normal ... In any case the hv usually refer to a gp first.

[Hairylegs007]

You said you were small when little so the baby takes after you

[TheCowThatLaughs]

The "HV" was probably more likely to be a nursery nurse I think. HVs are too busy doing child protection stuff now, or at least they are in my area, so they don't run the weighing clinics anymore

[pocketsized]

I think some HVs can get a but over enthusiastic with small babies. My DD was 5lb 3oz at birth, and at about 6 or 7 weeks I got an awful but of mastitis and the antibiotics upset her tummy. At weigh in she had "only" put on 3oz that week, and they started panicking me about her weight gain and referrals and formula. The GP however said small babies only have small stomachs, and it's not unusual for their weight gain to be slower until they get bigger and can eat more. He said often their growth lines are less steep than bigger babies. If you and the GP are happy that your baby is bright and we'll in themselves I wouldn't be overly worried. Extra support from the peads is a positive thing though, even if it has been worded as a "threat"

[sharonthewaspandthewineywall]

I do weighing clinics as do most of my colleagues

[TheCowThatLaughs]

Ah right, so my area is probably unusual then sharon

[squizita]

In our area an assistant/nursery nurse does the weigh in and only sends you through to the hv if you ask or they feel there is an issue.

There have been incidents with them not explaining this fully and using poor wording, which the HV has had to pull them up on.

Examples from my DD:

• Your daughter has not gained any weight (she had, the assistant meant her growth had slowed - the hv was very busy and this error meant I didn't need to see her).
• Plotting my dd's weight 200 g too light on the graph
• Plotting her weight 500 g too heavy!
• Telling me she was on a different percentile.

I've had to show assistants the graph and explain it to them. I also had t
one try to give (bad) advice and I asked them if they were the hv, they said no they worked in the nursery office!

So that set up seems to be in more than one place ... worth checking you're talking to an actual hcp.

[squizita]

Also to add to MrsDeVere I have phoned for clarification before. They are very helpful.
I got told they'd "chase" me once. I realised I couldn't make the clinic that hv wanted me to go to but could make the next day. I called and the duty hv was a bit shocked, especially as I have anxiety and they know this.

[ThatsNotEvenAWord]

Jaundice slowed my DS's weight gain. The midwife explained that my milk was being using to flush out rather than gain weight (or something like that, I hadn't slept for weeks). Stay strong it sounds like your milk is doing a great job

[LostMyBaubles]

Nrft but my ds is ftt.
Hes nearly 5 and has lots of health problems. Im not saying its the same for your dc but do follow the advice given, dont stand for being fobbed off and well done for do so much to help your dc gain weight.
My ds case is uncommon and even his specialists are baffled

[UpUpAndAway123]

Sorry op misunderstood the post. As pp has stated, growth and weight need to be viewed as a trend and looking at a couple of weights in isolation is unhelpful. Unless really required e.g. baby clearly not thriving and medical intervention required then frequent weigh ins are usually not required and just increase anxiety rather than alleviate it. Guidelines suggest once per month. I had a friend who was obsessed with weighing her boy and she had to go to different clinics in the area as the HVs would 'tell her off' for going so often :-)
If you're confident that she is feeding well (wet nappies, good latch etc) and it sounds like you are then I am sure his weight will even out soon x x