So, the paediatrician said...

[verylittlecarrot]

"Oh, her motor development seems normal now"
"She's sitting up well. She's only holding on very lightly, really. Quite a straight back."
"Standing well"
"No we don't use the WHO bf charts. Oh is she on the line on those? Can I see? What's a Z score? Well, of course the population would be more world-wide rather than UK and US. Oh, right, I suppose she is mixed race."
"That weight gain is trending in the right direction anyway, now"
"What a fat tummy" (to her, not me)
"I didn't intend to upset you with using the phrase FTT, sorry. I didn't mean to imply neglect or anything like that. Faltering growth? OK."
"We don't advise early weaning to everyone, honestly. We do usually say to wait till 6 months. Risks of early weaning research paper - oh, thanks for that"
"About this - what did you call it? - BLW then. How does she eat? No, I must admit, I didn't look up the reference you gave me, sorry"
"I agree, her birth weight must have been wrong. She wouldn't have lost that much in two days. Interesting"
"Keep on doing what you're doing"

And.....breathe out.

Thanks everybody - you are all making me smile . We feel sooooooo much happier today. Babycarrot has apparently downed several espresso shots while my back was turned and is hyperactive now. Her dad fed her this morning, and she has eaten
half a two egg omelette with spinach, cream and cheese
an entire banana
most of two pieces of toast
and a couple of slices of melon.

Oh and naturally it was sandwiched with an enthusiastic breastfeed before and after.

So that's her own bodyweight consumed today then.

I swear we are not forcefeeding her. And I know our experience can't be extrapolated, but, ILD, Caz and SGK...if I had known that she would rocket off like this with solids, I would have been far less worried about holding my nerve, and waiting till she was ready for food. She has completely taken to it, and hasn't rejected anything. She lets us know when she's had enough (eventually).

Those WHO charts really kick in after a baby is a few months old. And if you read how they chose the babies;
"As a departure, then, from previous growth reference charts used to measure babies and children, the new WHO Child Growth Standards are based on the premise that the breastfed baby is the norm for healthy growth among infants. Until now, existing child growth references were based on infants who were breast and/or artificially fed, but this variable was not controlled for in these early studies.
Because breastfed babies are lean babies, the shape of the curve in the new WHO Child Growth Standards differs from these earlier references, particularly during the first six months of life when growth is rapid.
Additionally, the children selected in the study were fed after the first six months according to guidelines for complementary feeding recommended in the Global Strategy for Infant and Young Child Feeding."

The WHO charts are how children SHOULD BE, not a snapshot of what children were at a certain point regardless of whether they were healthy or not.

Good enough for me.

VLC, your theory is a very respectable one I have heard it raised at conferences by people who are expert in the field, and there are bound to be studies somewhere.

It's probably partly for this reason - naturally small babies being supplemented with formula who then become unnaturally fatter babies - that the WHO breastfed charts start to show a difference from about 4-6 months onwards: before then, breastfed babies on the chart tend to weigh slightly more than the standard charts (which use data from babies whose feeding is not differentiated).

It's why centile charts shouldn't be given as much weight (ha!) as they are, imo. I remember my HV, when I took DS1 to be weighed - she used to come over to me with a worried look on her face and point her pen at where he'd been when he was born (75th centile), then trace the line which fell to somewhere around 9th centile and say concerned things to me.

She barely glanced at him - he was very clearly fine - massively alert, shiny, shiny eyes, huge grin, gurgling away... Very odd.

I think I might email the paed with the discussion documents for the WHO charts, actually. (I gave him the chart.) He was a bit 'yea, bovvered' with them, and made some comment about, well, all charts just represent a snapshot of babies at a particular time, and I missed the opportunity to say that no, these babies were selected as examples of a healthy standard. He was unfamiliar with Z scores and how to compare them to centiles too, so probably needs a bit more time to digest the information. Our printer ran out as we were trying to print off documents for the appointment, so I didn't have the discussion document with me.

i must have been lucky my hv was wonderful. Always praising me for bf. Still littlecarrot is going well now. My mum said she never had those charts when i was a baby and as for baby clinics. There just wasnt any. Hv could just tell apparently!

Hunker, I once handed the HV my babycarrot to hold and said "look at her. Really, LOOK AT HER! Doesn't she look healthy to you?" She had gained 6 ounces in 2 weeks (I was very pleased) and the woman was still twitching about dots and lines. She said "weeeell, yes, but she's a little skinny..."

and the next day she did that emergency paed referral that effectively ended my relationship with her.

I've since met other mums who've told me she did the same to them, but about their babies being too heavy. Sigh.

Your royal hunkerness, you have pinpointed another issue with charts. They do not track individual babies. The data sets come from babies at a whole load of different ages and if you can imagine a massive, floor-sized chart, all the data is shovelled on to it, so you have a study that looked at (say) 1000 babies of different ages, and all their weights go on the chart, and another study of 500 babies aged around 10 months, and all their weights go on it and so on....and then the curves are all smoothed out, in a way they just aren't in real life.

We know from other studies that individual babies will gain weight erratically, and will move up and down - the baby on the 25th centile may scoot up to the 75th, and vice versa. These are healthy babies. But if these 2 babies (the one going from 25 to 75 and the one going from 75 to 25) are plotted on the chart like the way the UK charts are plotted, they will look like two babies who have travelled smoothly i) along the 25th centile and ii) along the 75th centile - each of their erratic journeys has cancelled the other one out.

Hope you know what I mean!

The UK chart tends to reduce these erratic patterns to invisibility, in the favour of smooth curves, which actually do not represent individual babies at all.

This is why properly trained HPs will use the chart as one of many tools, and not the be-all and end-all of growth or health assessment.

shall i come and bitchslap her vlc?!

LOL at me being royalty. I quite like it, actually.

Tiktok, I remember thinking that ages ago. If A.N. Other baby and DS1 both weighed 8lb 10oz when they were born, the chart would have them both as weighing X at 3mo, Y and 6mo and Z at 12mo, without any kind of reference to genetics or diet or any of the other things that can affect a baby's weight gain (tries to think - illness? Teething?).

Not very likely, even with two babies, is it, that they'll hit the same lines at the same age? Centile charts definitely need to be used as part of a whole range of ways to check infant health - first of which ought to be "actually looking at the baby"...! She was as much use as a damp sock puppet, that HV.