The HV says not to worry but..

[swg1]

I am worried.

Baby was born 19th Feb at 7lb 1oz. He was c-section at 37 weeks (I had gestational diabetes). In the early days he had issues with jaundice and low blood sugar (not unexpected, I had this with my older boy).

He seems to feed well. He pees vast amounts and poos reasonable amounts. But while he's never stopped gaining weight he is dropping through percentiles and I am worried.

It's been a slow drop through percentiles (his curve is just very shallow). At three and a half months he's now at 5410g.

I am breastfeeding all I can during the day, honestly - whenever he seems interested. Occasionally it has to be paused and resumed because I have to go deal with my toddler but I can't help that. He falls asleep about 9PM and then usually sleeps until 5AM - I've tried waking him for a feed before that but he's usually groggy, sleepy and uncooperative until he is ready to wake up. I'm expressing last thing at night and after first feed in the morning for extra milk to supplement. The thing is, I'm not even opposed to extra formula to supplement but he is not all that interested. He'll take maybe 150ml extra milk over the day out of a bottle - he refused bottles entirely until I switched brands. Some days I end up having to chuck out breastmilk I warmed that he never finished even.

He's a very snuffly baby which might be putting him off feeding some - they did briefly mutter about potential relaxed larynx at some point then never mentioned it again. He's also a bit windy/refluxy which means I'm reluctant to try any herbal supplements as they can make reflux worse. Also we had a brief and very exciting stay in hospital for three days a couple of weeks ago after he caught a virus off his brother and got a fever which wouldn't go down. All of these things might be contributing.

He does not seem hungry. He's bright-eyed, smily and chatty. But he DOES seem ridiculously skinny. He's not short - 61cm long - and I literally cannot find clothes that fit his long skinny body. My mother is all "have you tried more formula" and I CHEERFULLY would except this child would stubbornly lose weight rather than take more out of a bottle. The HV says not to worry, she's not too concerned, just try to feed more but I CANNOT feed more than I am doing and meanwhile I am watching him drop percentiles and reading the This Is Bad text in the little red book and wondering when she would be concerned.

[DonkeyOaty]

My very first thought is - has he been checked for a tongue tie?

[Northernlurker]

I am inclined to think a baby who is alert and contented is basically ok. If he isn't obviously unwell I would watch and wait till he's started solids and then see what happens. He is gaining, he may catch up with the percentiles or at least settle on a lower line.

[cookiefiend]

My DD2 was born quite high on the cebtiles chart thing and dropped down (quite fast actually). After three months she was almost in the bottom 0.4 bit in the graph. She has followed a line and now at six months has moved back up to just above the 9th centile line. My understanding is that as long as he is gaining, is contented and alert etc then there is nothing to worry about. Your diabetes maybe made hima bit heavier that he would have been.

Also if it is 150mls of top up on top of breast feeding that is loads. The side of the bottle says how much and exclusively formula fer baby should get- and it says slightly more there than the more precise calculations a feeding specialist would give when basing how much they should get for their exact weight. 150mls on top of breast feeding is quite a lot for a little tummy I'm sure. If he can't eat any more he is likely full. If he is able to drink from the bottle it is unlikely he would starve himself.

Trust your instincts- does he seem well? If you are really worried go to the gp. If the only thing making you worried is that bloody red book- step away from it. With both children it has made me crazy and caused loads of tears, even though in my gut I knew they were well I couldn't ignore the fact they didn't follow the mathematical curve on the graph.

[angelicjen]

I thought it took a few months for them to settle on their percentile.
But if your mother instinct is telling you it's not right can you speak to your gp, maybe get referred to a paed.

[SusanAndBinkyRideForth]

Both mine were born on the 75centile and quickly dropped to just under 25th. They were long and skinny as well - and still are!
I think I just made them bigger than they wanted to. If baby is happy and nappies are fine, then please don't worry.

• They then happily tracked that centile for 2 years plus.

[Jenny70]

I thought babies were born on a centile that reflected their placental food supply, but then "adjusted" over the first few months into their biological percentile. Diabetes makes bigger babies, so maybe in an ideal world your baby should have been smaller at birth, and therefore the slower weight gain not as noticeable.

Sounds like you've had a non-textbook start, with the diabetes, infection landing in hospital and the daily/hourly interruptions that all younger siblings have.

I think the best indicator is their alertness and urine output. Please don't think that formula will help here - it may do the reverse, it's harder to digest and fills baby for longer, but not providing as much goodness as breastmilk.

Also over-expressing can undermine your efforts to fatten up baby. Breastmilk volume varies enormously between women and babies, but the amount of milk fat over a 24hr period is remarkably constant - so by enouraging your supply to produce extra milk every day by expressing and storing, the milk fat in your breastmilk decreases - not immediately or for the odd feed, but as a general trend. So if you are expressing and baby isn't wanting that milk and it gets dumped, feeds will be slightly lower in milk fats as a result.

Certainly be aware of this, but by the sounds it is fine and if anything changes in terms of baby behaviour, then follow it up.

[Curiousmum69]

All of mine were born quite high on the percentile chart ...50-75% and they slowly dropped to 2-9% which is where they all sit now. Even the 15 year old is short.

I don't think birth weight is an acurate representation of where they will be in a few months/years.

As long as baby has good urine output and passing stools regually as well as being bright and alert. He is getting enough milk.

Remember growth lines are just averages that don't take into account feeding methods, race
, or individual changes.

[swg1]

Thanks, guys. I think partly I worry because the pregnancy was SO bad I'm still anxious there were after effects :/ The diabetes hit the point where I was on injected insulin 4 times a day and I know that poorly regulated insulin levels can impact on milk supply. My first little guy did have issues feeding to the point where he had to go onto formula/expressed milk way before this time because he wasn't getting enough milk to poo enough and was starting to look severely ill and I always suspected it was my diabetes that time.

The problem is that once you're not pregnant your consultant signs you off and GPs are not generally that knowledgeable about gestational diabetes (ask me about the fun of GPs arguing about prescriptions written by my consultant because their "regular!" type 2 only need to test once a day).

I also appear to be screwing up my own diet somewhere. Been a bit raggedy since birth - tired, bleeding gums, constipation (sorry, tmi!) which I'd put down to just birth recovery. Except we went on holiday last week, I ate vast amounts - including huge amounts of barbecue meat - and for a week it all cleared up. Seriously, gums stopped bleeding within two days. Which makes me think I'm doing something wrong here.