DS on 9th centile and "may need topping up" - help, confused

[Moorhen]

Just been to see consultant with 6-week-old DS to follow up blood tests (I'm rhesus neg). All fine, but junior doctor we saw disappeared for half an hour to check w/ consultant, and then came back to say we'd need to come back in 2 months as she was concerned for DS's weight.

He's gaining 4ozs a week and is 8lbs 6, I said. Have been told this is normal.

Yes, she said, but is not fantastic and he's on the 9th centile.

She did not explain what this meant. She also said I should feed him every 3 hours (I am) and wake him up during the night (he's starting sleeping 5hrs between 11pm and 4am, only reason I am compos mentis enough to care for him!) to feed.

If I do this, she said, we won't need to talk about formula just yet.

I don't want to talk about it at all, tbh!

DS looks perfectly healthy and everyone says how alert and bright he seems.

Should I be worried? At the moment I am feeling very stressed.

Think someone who knows more will be on in a sec but as far as I know being on the 9th centile is fine! By the very fact 50th is average means some babies are bigger and some smaller - exactly as not all adults are the same weight! He's gaining weight, and alert and happy, don't see the problem. I wonder whether they'd be as concerned if he was on the 91st line?!

Bollocks!!!!

These are the points to bear in mind re a baby and feeding - is he alert and happy when awake, is he producing plenty of wet/dirty nappies, and is he gaining weight.

So bloody what if he is on the 9th centile? The charts show normal development - therefore the 9th centile is normal (bottom end of, but still NORMAL fgs!). I'm assuming he wasn't on the 90th centile when he was born? Unless he has dropped through more than two centiles, there afaik there is nothing to worry about!

You are doing all the right things re. feeding, re the 3 hourly when awake - and five hours at night is perfectly fine.

Out of interest, how big are you and your dh?

she is talking rubbish the 9th centile is fine he is just smaller than average carry on as you are and even if it wasn't she shouldn't be encouraging you to use formula aagh
you are doing a fab job keep at it

also remember the centile charts are based on ff babies who tend to be heavier

if he were to stop gaining or drop below the centiles that would be different but you just have a smaller than average baby

"also remember the centile charts are based on ff babies who tend to be heavier" - no sorry, that's not true! They are based on a mixture of ff and bf babies. Search for posts by tiktok - she debunks this myth at least once a week

But otherwise andiem I agree with you!

God this rubbish advice just goes on and on. Your lO sounds perfectly healthy and you ARE both doing brilliantly. Ignore them.

My little boy was falling off the chart (he still is tbh!!!) As has been mentioned, he's still on the chart, so... And isn't 6 weeks too young to be making presumptions? In the end my health visitor was ok with him because he stayed on the same centile. Don't stress, and stick to your guns !!! Good Luck!

9th centile means that he is within normal parameters. DS2 (5)has been on the 9th centile since the day he was born he has friends bigger and smaller than him - no worries. It just means that out of 100 6 week old baby boys,of normal gestation and in good health - 91 will be heavier and 9 lighter than your DS.

Don't forget he is not being compared to the 1% of children who fall outside of normal range eg children like my DS1 who never reached the 0.4th Centile and has needed medical intervention.

Meant to say - congratulations on your lovely baby boy, enjoy him and you sound like he is doing really well. Let him sleep for his 5 hours and don't stress there is no need!

Thank god for mumsnet!

Miaou, interesting point - I think the concern may be partly because his weight gain is not following the line. Looking at his growth chart, the first weigh-in puts him smack on the 25th centile.

If it helps, his head circ is on a smooth arc between the 75th and 50th centiles. His length is consistently on the 50th centile.

Does that mean there is a problem?

He still feels like such a lovely healthy baby, and can do everything the books say he should.

I am 5ft 7ins and a healthy weight (not big, not small) and DH is 6ft 3ins and big built - although funnily enough drs were concerned when he was a child cos he was so skinny. As he says, he soon showed them...

Shame you have been made to feel worried, moorhen.

Your little boy sounds fine to me....no one who knows anything about infant feeding would be worried, truly.

If they really think - for some ker-azy reason - that he needs more than he is getting, then you can squeeze in another bf in the day.

But why you would do this when everything is ok, I don't know - maybe to shut them up???!

Charts are not based on ff babies (thanks, miaou!!) but babies whose feeding method is not differentiated (though many of them, prob most, would have at least some formula)....but in any case, bf only charts would show him as below the 9th centile, so that would freak out your daft docs even more!!

(Excuse a bit of myth busting here: generally speaking, at first, bf only babies grow faster than ff babies, so a small baby on the standard chart will look even smaller on the bf only chart. After the first few months, this is not the case, and by the end of the first year, the average bf baby is smaller than the average ff baby. Charts are not the answer, especially in the hands of ill-trained healthcare professionals!)

you should ask to speak with the consultant. he is the expert here and the HO or SHO has less experience with bfing than u or I (probably). also are they concerned with the weight purely becase they are comparing using the basic ffing weight charts?? and not the bfing ones?

you will know right. if your lo is bright, alert and happy, producing enough wet/dirty nappies and is healthy then there are no concerns. It gets right up my nose these bloody incompetent SHO's when it comes to bfing. both my dd's were on or just below the 9th centile and still are and they are both very active, happy and content girls. it is people like this who need properly trained on bfing. GGGggRRRRR rant over!

determination - didn't you read my post??? or the gazillions of ones I write on the topic of charts???

If they look at the bf only charts, baby moorhen will look smaller!

Charts are not the issue.

My first-born was an average size at birth but then aparently didn't like milk too much (I know that now!) and only put on 2 oz a week - the social workers made me crazy, demanding that I take him to the clinic every 2 weeks to be weighed, and then every week, and after 6 months, when he was going on solids, just said 'oh well he's obviously just going to smaller for his age, there's nothing we or you can do about it, go home and don't worry!' By this stage I was paranoid about his weight and eating and even today (he's nearly 15!!) I feel that he isn't as big as his peers, but surely that's a good thing these days? A fat baby will probably become a fat child, surely?

I didn't think of asking to speak to the consultant. Damn. TBH, was having trouble deciphering dr's accent and thus comprehending the basic info she was giving me, which I think made me less demanding than I would be normally.

I am seeing my health visitor on Monday and my GP on Tues for our 6-week check-ups; will ask plenty of questions then, as I suspect they know more about bfing and just as much about normal babies.

Grrr. I mean, I'm a new first-time mum and thus neurotic to start with. Who needs more things to wonder about?

Why aren't babies allowed to be small any more? I don't get why so much fuss is made over babies who are still within the 'normal' range albeit near the bottom. If you get a baby on the 91st centile no one starts interrogating the mother and suggesting the baby is fed less do they? Yet it's on the same point of normality, just near the top.

It's ludicrous.

Please don't try to stress over this if they were really worried about his feeding/ growth they wouldn't leave a 6 weeker for 2 months before reassessing. I imagine they are being over cautious.

As everyone else says he is feeding well, putting on 4oz a week is alert and bright. Please don't let the junior Dr blight your early weeks with your little chap. There were many weeks when my older two didn't gain any weight. I wouldn't know with DS3 (16months) because I never take him to be weighed.

moorhen sounds like your doing really well. I think 4oz per week sounds reasonable and he is a good weight. I would carry on as you are. By the fact he has a feeding and good sleeping pattern at 6 wks suggests he is very content and settled for the age he is. Well done!

Moorhen, my DD is 11 weeks and on the 9th centile, no-one has ever expressed concern. At 11 weeks she is just over 10lbs, still a tiddler but she is doing fine. try not to worry

These feeding charts with the centiles on were in the news the other week because if serious talk of them being scrapped because they are so, so unfair on BF babies. They are based 100% on white, middle-classed, bottlefed babies.

If your baby is putting on weight, getting through 5 or 6 wet nappied a day, feeding regularly then you are doing FINE. Bad positioning can cause poor weight gain, but you would probably have very sore nipples by now if that was the case.

Don't let poor advice destroy your confidence and especially your breastfeeding relationship. You can't 'see' how much milk your baby is getting with BF and you have to trust the process for it to work. In the early weeks this can be very nerve-wracking so I can see exactly why you feel so upset. BUT, please, please be reassured that your babies gradual weight gain and uncomformity with that unfair chart is sadly as common as the poor advice that you have been given - there are endless thread on mumsnet to prove it and reassure you.

Introducing formula milk top-ups more often than not spells the end for BF. It interferes with the sensitive supply/demand system and reduces milk supply at the same time as artifically stretching the babies tummy so they are less satisfied by BF and so on.

Advising 'topping up', for an otherwise healthy baby is now regarded as outdated and detremental advice by BF trained health officials.

WHy not see if there are local BF groups and places of contact for your local BF network of health officials. They should give you the reassure you need.

Lack of confidence is one of the main reasons why mums give up BF and this is especially sad when those mums have already come so far and are doing so well.

Trust your instincts and the process, get advice from people who have had the proper, uptodate training if you feel you need it and you'll be fine.

x x x x

news.bbc.co.uk/1/hi/health/6943949.stm

My DS and DD2 are on the 9th centile, always have been, since birth, they are still small for their ages (9 and 5) but I was never told to top up. I am never going to have huge children.

pastalady- that isn't right about the charts, please read the thread.

to the OP- please don't expect your GP or HV to have a whole heap of helpful bf info for you. they aren't bf experts. your best bet for factual info are the likes of tiktok on here (NCT bf counsellor), also kellymom.com and the the bf helplines.

I stand corrected ruddynorah - I was told that about the charts by my HV when I was a concerned new mum who was worried by them. Will read up on this.

grrr...uninformed junior doctor...sigh....
if you child is gaining 4 oz and doing well..there is NO problem....and certianly no need to top up!
When they loose longterm, then you have a problem...
you do say you feed 3 hourly, i assume this is on demand...if not, do feed on demand, but if your little one goes past 3 hours then offer the feed actively....
but tbh, your little one is gaining and obviously behaving settled, so, I really don't think you have to worry or top up!

also, weren't the charts actually created in a time where ff was predominatn, however, breastfeeding Babies were also included...
to be honest...those charts are rubbish anyway....just as the whole BMI crap, etc......I mean honestly...what are they actually looking at...lol