OK who can answer this question for me - what does it REALLY matter if your baby doesn't "follow the centiles" or put on weight according to the averages....

[harpsichordcarrier]

because it seems we are obsessed with it and I don't really understand why.
If your baby doesn't follow the centiles in the first few months, then what effect would this have on development?
how can you know this isn't normal for your baby?
will s/he catch up later?
even if s/he doesn't, who cares? why does it matter? and why do we all get so uptight about weight gain?

Weight gain is a totally unimportant factor in isolation of all the other factors. Mothers trail to the clinic because they think they should and like to plot the weightgain on a card (I did the same).

It has been recommended for a long time that weighing of babies regularly is unnecessary yet it still goes on. It is one of the most worry inducing things that is done with newborns. Mums should be guided to assess the total well being of their baby. If baby feeds well, is happy pees and poos then weight matters not a jot IMO.

Don't know the answers harpsi.

My dd didn't follow her centile and it was the first sign that she had a serious problem. But it wasn't the only indication and I don't think that HV get that across - that weight gain is just one tiny part of a much bigger picture.

I get my son weighed occasionally because it makes my grandmother (94!) happy. She is obsessed by his weight.

She also thinks that he should not have left the house during his first six weeks - I ignored this advice but am happy to humour her on the weight issue.

I've met lots of nice people at the baby clinic and it's somewhere to go on days when I can't think of anywhere more interesting.

i'd love to know the answer as every so often it crosses my mind that i don't have a clue what centile dd is on as she hasn't been weighed since she was a fortnight old.

DS was born dead on the 50th centile & folowed it exactly to 3 months, then dropped right off and was below the 3rd by 6 months. HV recommended growth hormone, which I didn't like the sound of - luckily, as this was a couple of months before all the scare stories about it emerged. He's always been short and skinny, but has also been extremely healthy - I would say that he's had less than 3 weeks off school in his entire time (he's now 19 btw)
He does tend to be sensitive about being short - but that's mainly because of other people's attitudes - (why is it apparently OK to tease someone about their height?)

aitchtwooh wish i hadn't taken mine back after the first couple of weeks. I took him last week to find out his weight and height are at the 25th centile and his head is in the 80th...

Don't know what that means for the future but before hv i saw him as a perfect little one and now i am wondering every time he falls over if he is unbalanced because his head is soooo big!!

Thanks for this post! As mother of one stubbornly slow weight gaining child, I did a bit of research to find out...

I'm sure you know that slow weight gain can indicate neglect, heart diease and malabsorption disorders like cystic fibrosis. BUT these really are pretty rare, compared with slow weight gain, which is pretty common. One review says that about a quarter of all children shift more than 25 points across the centiles in the first two years - here

There is a very reassuring literature review here
It concluded:
"The IQ difference (equivalent to approximately 3 IQ points) is of questionable clinical significance. The height and weight differences are larger, but few children were below the 3rd centile at follow up. It is unclear to what extent observed differences reflect causal relations or confounding due to other variables. In the light of these results the aggressive approach to identification and management of failure to thrive needs reassessing."

Cheered me up!

I never ever understood those charts. I used to show an interest with dd1, but showing an interest just meant nodding and umming and ahhing when the HV was talking about it.

By the time dt's appeared I didn't even take them to be weighed. They looked fine, they were fine. If they were ill we went to the doctor. I just couldn't be faffing about with weights and charts and undressing them for no reason.

Plus the baby clinic was through 5 sets of double swing doors and it was a nightmare to get to with a double buggy and a 3 yr old in tow.

with dd1 I used to go and get her weighed and the hv used to get all in a tizz because she was dropping through the centiles.
guess what? she's just little like the rest of her family.
I have never had dd2 weighed ever since she came out of hospital. the gp tried to wrestle her onto the scales at her eight month check but to no avail
I just see it causing so much heartache to new mums and the primary reason for weaning early and a frequent reason for giving formula
but why, I just don't get it

interesting firepile....

aaah, misc, the reason i stopped getting her weighed is that she wasn't putting on weight after her birth and they made me drive her to the hosp every two days to get her weighed. to be fair i think i got her weighed again at 5 or 6 weeks to check she'd (just) regained her birthweight and then i swore i'd never do it again. it was torture for both of us. she's got a flipping enormous head as well, which i did wonder about until i noticed DH's and my enormous heads.

Well, if you're worried about IQ, perhaps i should say that DS went to grammar school, got all A & A* at GCSE, AAB at A level & is now at university (all in the cause of reassuring you, of course, not boasting at all.... )

erm, if you're looking for someone who gave formula to what i now think was a perfectly healthy child because of the scales? and someone who could have done with less weighing and more BF support?

moi.

ooooh, nice stealth boasting rusty.

my experience with this was that it is the hv's that need re-educating. dd1 fell off the bottom of the centiles, I knew she was ok, she was lively, healthy looking, ate and pooed/weed well etc. I had no concerns about her. So why did the hv feel that she was a cause for concern, advise me to feed her chips and threaten referrals left right and centre. I just stopped taking her to the hv. Now she is a perfectly healthy but naturally skinny 6 year old.

Well said Aitch..me too.

My first dd lost weight whilst I was feeding her. I was already very shaky on the BF front (no MN in those days) and they banged on so much about the weight and the chart that I gave up bf because I felt I was starving her.

yes I thought that was probably the case aitch
and I see and hear it all the time
I just can't see that the "risks" of "slow" weight gain (if it is slow, which I doubt it is most of the time) justify putting bf at risk with all the health benefits and of course psychological benefits &c
I just don't think these things are put into the balance at all

i haven't read whole thread.... so forgive me if i'm repeating other posts..... the real issue (according to paeds i've encountered in my professional life) is that of "falling through the centiles".... ie it's ok to be v v small and low on the chart, it's not ok to be following the 75th centile and then plummet to the 25th.... if there is a dramatic fall, unexplained by illness or some other cause then this is a matter for concern.....hth

ds is light and little. He was 8.5kg at Christmas, when he was 19 months, and wears 12- or 12-18 month clothes. He's always hung around the lowest centile, occasionally dipping off. But then dh is 5'2 and I'm 5'1, and neither of us are all that big framed. He is bright, alert and healthy. I agree the obsession with weight and centiles can be very worrying and damaging. Surely human development can't always be plotted neatly on a curve.

harpsi (hi, it's FiT ), I think it's all part of the deep anxiety we tend to have as mothers, as to are we doing the right/best thing for our baby. Add in health professionals generally liking things to be neatly plottable, and the tendency to competition and comparison among new mothers (I lurk on a German forum my SIL uses, and so many of the mothers have proud lists of each check and their baby's weight at it underneath their posts - leaving me, usually, spluttering 'blinking hell, that one weighed more at 8 months than ds did at 18'), and I can well see the obsession- and anxiety-causing potential these things have.

dh, btw, is small by anyone's standards, but isn't sensitive about his height at all - he carries it wonderfully well, in fact. I'm glad of that - he'll be a fab role model for ds, who is unlikely to be a giant.

aitch I have most definately not got a big head! dh on the other hand... anyway was so annoyed at myself for going as it was the first time in 17 months and only because i walked past the clinic saw tumbleweed rolling around and felt sorry for them having nothing to do.
they suggested i now go back every week to monitor my strange child....no chance, they won't be seeing me again.

because weight gain has been considered the sign of a healthy baby since time began in most cultures, however, it needs to be looked at in context

a podgy/fat baby is not necessarily a healthy one - i see children in playgroup and playground that are walking age yet can barely walk because they are top heavy - how healthy is that ?

my ds (excl. bf until 6 months and still bf at 2.8 years) who has always followed 9th to 25th centiles walked with ease and follows developmental milestones to the book

someone once said "look at the baby, not the chart" i.e if baby looks healthy, has good skin tone, is happy, alert and meets development milestones don't look at the damned charts !!

hmmmm, yes but it is usual for babies to lose some weight after birth, isn't it?
and why is it a matter for concern? I can understand why it might require investigation (in very dramatic cases, prob few and far between) but why the advice to give chips/biscuits/formula top ups? what benefit is there to simply piling on the weight rather than investigating any underlying issue?

totally agree, harpsi. i actually probably have some health issues too but i'll be better prepared next time.

the first HV who came round actually miscalculated the weight loss (it was 12%, she said it was 19%) and started shouting at DH that 'that child could be dying for all we know', whilst i wept in another room, shouting 'i can hear you, please stop talking about me like i can't hear you.' in the end it was me who had to do the calculation but by that time she'd called the ambulance and i was 'in the system' as it were. it's unbelievable, thinking back. my whole BFing/HV experience has been peer reviewed following my complaint, i only hope no-one else ever has to deal with such unmitigated aresholery.

Dd had only ever been weighed at her development checks but recently had to be taken to A&E. The student nurse made a big deal out of dd's weight slipping down the centiles and referred us to the HV. Fortunately the HV wasn't quite so OTT and said that it was probably the illness that had caused the weight loss. If dd hasn't moved back up the centiles again by the end of next month then dd will have to be referred to the Paed but the HV stressed that it's only because it's standard procedure and that the chances are that it's just the way dd is meant to be.

Sometimes you just get dragged in to the whole weighing and centiles business without wanting it.

aitch what a crappy story