Panicked and VERY annoyed about the Health Visitor - long...

[Moomma]

I've posted here before about my DS, now 20 weeks (17 adjusted as he was born just over three weeks before due date). He's EBF but only weighs 11 pounds 6, as of today's weigh-in. I feed on demand, currently 7-8 times a day, have had his latch checked by an NCT breastfeeding counsellor, have been to various GPs and talked to them about him, and generally watch him like a hawk to see if I'm doing anything I shouldn't or if there's anything I can do to feed him up. (Last time I was writing about him, the general consensus was that I was being over-anxious!) He's brilliant - very smiley and happy, very energetic, developing at a great rate and keen to get on with life. He is long and has massive feet which will have him out of 3-6 month clothes soon, even though he is swimming in them around the waist. He looks more like a 12/13 week-old baby, physically - just hasn't put on any chub.

Today I took him for a weigh-in, twelve days after being sent packing by the lovely GP who told me he was just slender, and perfectly well otherwise. The HV who was marking up his loathsome red book got very huffy about it, marked his weight in the wrong place, and told me that six ounces in two weeks wasn't enough and she thought I should be referred to a paediatric dietician. It WASN'T two weeks; anyway I told her he'd been sick with a tummy bug and its aftermath for most of January and was just picking up now. But he's never put on weight quickly in any case. She didn't actually look at him at all - just asked me lots of accusing questions about whether I was following a system or feeding on demand (like I would leave him hungry!) and whether he'd been checked out before. She was so upsetting, I burst into tears as soon as I left the clinic - God knows what people thought as I trailed home with the pram, sobbing.

I just don't know what to do. She wouldn't recommend formula to top him up because HVs never do; he feeds three times during the night and every 2 1/2 to 3 hours during the day, so there isn't much scope for feeding him more, even if he would stop playing to take it. I am so tired of people thinking that I'm doing something wrong, when I'm doing my best - and so is he. I just don't know why he won't get any fatter. People are always shocked to hear how old he is, and when I look at pictures of him from a couple of months ago, he looks so thin. I just don't think I'm enough for him, and that breaks my heart.

Oh well. Just wanted to have a moan about insensitive, stupid, non-child-looking-at HVs, and a little bit of a panic about my poor lovely boy.

I have no actual advice to offer but couldn't not post.

You are doing your best, you are doing a brilliant job, you feed him whenever he needs it and you clearly love him very much.

Babies gain weight at different rates and your DS sounds just fine to me. I'm sorry the HV upset you

Silly old trout.
Your baby sounds lovely.

They are full of shit.

Fact

would you be worried about him if the hv hadn't said anything or were you satisfied before this morning?

it is particularly irritating that she has upset you, undermined your confidence and offered no practical solutions whatsoever.

i suppose you could try feeding more, maybe a babymoon? then at least you would be satisfied you have tried.

How stressful!! I have a neighbour who has four healthy, normal sized children who were all very slow at putting on weight, has been under a paediatrition with two of them and officially diagnosed as "failing to thrive". Even on number 4, she still feels under pressure when the health visitor calls!! Anyway - result: 4 healthy kids. Hang in there.

If the weigh ins are upsetting to you, maybe you could stop having him weighed? If he's happy, healthy and growing (even slowly), surely it doesn't matter how much he weighs exactly.

I see some some twins at a toddler group who are tiny - when I first saw them guessed they were 4 or 5 months old, when they were actually almost a year! Perfectly healthy, active, charming babies just not destined to be fatties.

HV were always on at me about the size of my DC's

'aren't you worried they are small?'

'have you been making a note of how much he/she is taking? ' ( yeah I'm drawing fl oz markings on my boob and watching what the milk drops down to!)

if it makes you feel andy better DS was 17lbs on his first birthday. They are still all small.
I never took DC4 to see a HV, he was off the bottom of the centile chart anyway so noone could mark his weight in!

Enjoy your baby and try not to worry.

Follow your instincts. As you say he is smiley happy energetic and developing at a great rate. Stop taking him to be weighed.

If you are curious weigh him at home. (Weigh yourself first and then both of you and deduct).

The doctor is right and in this case the HV seems to be getting it wrong. They can be great and provide a much needed service but.....

I never took mine to be weighed after the first couple of months with DC1. All that undressing and dressing.

have you tried the WHO charts? bet he doesn't look as bad on those

*any not andy

Bet she didn't tell you how common it is for weight to plateau in a bf baby at this age, did she?

You are lucky to have a sensible GP.

I will NEVER ever take a baby to an HV weighing clinic ever again. I have my own scales. If you find that her advice is entirely useless to you, then perhaps it's time to rethink why you are visiting her?

Ya don't have to, ya know!

If you are still worried, then you can shoehorn in a couple of extra bfs here and there, but it doesn't sound strictly necessary. Try offering and see what happens.

Stop panicking - you're doing great.

P.S. My 3 week early baby was skinnier than yours.

The one piece of advice I feel I can give after having 3DC is... do what is right for you and your family. It really doesn't matter what other people think, especially HV who have an agenda of there own and seem to regularly make mothers feel useless and inadequate.

• you say you feed on demand.
• the GP has said your DC is fine.
• he is developing well in all other areas. I'm no expert but I would imagine a baby that was not thriving would not be so energetic, happy etc. BF babes tend to be on the slimmer side anyway. If you are worried then you do something... there is nothing at all wrong with mixed feeding if you want to do that. A friend of mine EBF through fear of what her HV would say. I mixed fed my 1st, EBF my 2nd and mixed fed my 3rd (he EBF all day and night until I gave him a bottle at 10pm and one at 3am, then he BF with longer and more regular intervals throughout the day). This worked for me and my DC are happy and healthy. A stressed out anxious mum is no good for anyone. I also think you are justified in making a complaint about your HV, no-one should be leaving a clinic in tears HTH x

how much did he weigh when he was born?

Sorry she made you cry.

My DD was similar, is he dropping down the centile charts at all? DD was born on the 25th and gradually dropped down to just under the 2nd.

We were refered to a paeditrician and a dietician, I went along with it all, fairly confident that DD was just a small build (some babies have to be for the whole centile chart to work), she is very long and thin still at 23 months, I have given up getting her weighed now.

Not all babies are chubby, what is yours and his dad's build like...not that this is a definate indicator.

Thanks, everyone, for the support.

He weighed 6 pounds 5 at birth, but dropped down to 5 10 in the first week and from then on has jogged along between the second-last and bottom centile. He hasn't dipped below it yet, but I think it's only a matter of time. GP weighed him two weeks running and had a good look at him each time. HV just looked at the chart - literally didn't look at him once as he was dressed and going back in his pram when she came up out of the ground. The only reason I took him to be weighed was because the GP said to come back to him if he went below the 0.4 line.

I think I was mainly upset because she seemed to think I hadn't noticed/didn't care and was very accusatory in her questioning. It has been such a huge issue and worry for me that it was absolutely the wrong thing for her to say. But I do understand that it's their job to catch problems and refer them up the chain. She also said that GP wouldn't know anything about feeding/baby nutrition. He is the head of practice in a massive clinic in the area of London with the second highest birth rate in Europe, so I think he's seen a few babies in his time.

I do try not to worry and let him develop in his own time, but today really got to me.

actually one thing you say that gets me - its obvious your baby is growing - and growing too long for his clothes.

my dd had a few weeks where she just seemed to get longer and thinner, (feeding lots) - i just think they direct their growing efforts up sometimes rather than out. That kind of growth takes energy - as does all the activity yours is engaging in. Also, your baby being 3 weeks premature does mean that they have to catch up - and that catching up will take more than 3 weeks - think how much a foetus grows in that last bit of pregnancy! It's really not suprising if yours is taking time to get to grips with life outside (he sounds like he's doing very well though)

My brother was 3 weeks early, skinny throughout babyhood and childhood..and now 6'1 and overweight. c'est la vie. All those people telling mother she wasn't feeding him enough.....wrong!

cheer up - those charts are stupid - someone (one in ten) is always going to be in the bottom percentile - even if everyone's baby was overweight!

Although possibly with all that feeding you need to make sure you are getting plenty of food & fluids yourself! Biscuits are very good for the mood as well...

moomma i had problems with bf going and ds was properly thin for a while. i mean like really skinny, not a bit less than chubby. he was getting enough to grow but not to be fat as babies should be.

he was off the bottom of centiles but after a few weeks he gradually caught up and has been an entirely 'normal' size ever since.

i really hope the same is in the process of happening for you but i do think it is worth you trying to get more milk in just to see whether it makes a difference. stay in bed as much as possible, feed and feed.

Moonma- he has therefore almost doubled his birthweight in less than 6 months? sounds perfectly healthy to me! You'll probably find by the time he's a toddler there won't be an ounce of fat on him and all he'll do is stuff his face!

Health visitors are renowned for being as subtle as a brick in the face and if yoru gp tells you she's talking rot, then she's talking rot.

I'll try to persuade him to sneak in another feed or two. Ironically, since we got back he's had one mega-feed for about an hour and a half and two more shorter ones with about an hour's gap between them. I swear, sometimes I think he understands what I'm snuffling about...

We will overcome. BF counsellor told me he would catch up by six months. He's got six weeks! The boobs are ready!

I sympathise. DD was born bang on average on the 50th, and dropped down to the less than 1% by the time she was 6mths... Was also ebf, so also didn't have a clue how much she was getting... She is still slender now she's at school - rest assured she never starved and is bright and very pretty and perfectly healthy!

My advice for a happy life is:

• forget the red book... "oophs HV, have I forgotten it again? Silly me!!"
• Enjoy all the x-tra wear you're getting out of the clothes and shoes...

Try not to worry. If you are eb-feeding on demand, you are doing just perfect. Some babies are just small

Is there any other clinic you could go to?

Sounds like you are doing really well and if GP is happy there is no need for any additional advice from HV.

Exceptionally poor practice for her to be advising without even looking at him.

Following the 0.4th-2nd centile is fine. I expect he is not yet in proprtion with his length, but he will get there, and the GP is happy. Very appropriate advice from GP to keep an eye in case he drops away from 0.4th.

I think he's done well to follow centiles at all, given his tummy bug. Would prob only weigh him every month at the max (current guidelines say once a month when over birthweight).

My mum says 'double in 6 months, treble in a year' - so your DS is on course according to old mums' wisdom! My DS really didn't gain for 7 weeks. In hindsight it was awful. He looks so undernourished and ill in photos I'm sure you know whether your DS is ill and malnourished, or just slender.

On another note though - 37 weeks is full term, so I'm pretty sure you don't need to adjust your DS's age. Unless it makes you more happy to do so. It doesn't really matter.

DS was born chubby and within a couple of weeks was long and thin, GP was unconcerned as he (DS) was busy busy. DS is now almost 6 and is still long and thin, he just is. Some kids are chubbly and some are skinny and some are short and some are tall and and and, the charts are just a general guide not a rule.

If your GP has checked him out and think she is fine, then there is unlikely to be a problem. And we all know HV's can be utter twits!

DS3 has Downs and was very slow to gain weight. He had had his heart checked at birth with an echo and although I was referred to a specialist Paediatric Cardiologist, was told he had a small hole in his heart but not to worry at all. HV insisted on visiting me once a week and insisted DS was failing to thrive and constatly questioned me about what he was eating. (He was weaned prior to six months, you did that then). I could tell she thought I was lying and she kept wittering on at me about PND as I had had it with DS1.

When we went for his 'routine' appointment with the Paed Cardilogist, which was on a Monday, I was told DS3 needed open heart surgery and he was operated on that Thursday. Oddly, I never saw the HV again...

This is my first post (I lurk a lot, so many thanks to all for sterling advice I've gleaned on the sly!) but I just had to post having read, because your son sounds so similar to my DD, who was also born 3 weeks early and is a little 'un.

I have her red book here, and at 17 weeks she was 11.11 and at 22 weeks she was 13.7. So practically the same as your boy. She's also skinny, no chub on her, but very happy, healthy, alert and now she's on solids (EBF to 26 wks) she eats like a horse, so sometimes it doesn't matter what you put in, they are just destined to be littler than the average. She's also long top size clothes lag behind her age, and bottoms are always a size above! so I do think that has something to do with it too.

I got told off by a HV the other day for not having been in since the 3 day check. I pointed out that I had been in to have DD weighed, but as she was always fine I had never stopped for a chat, hence the lack of notes in the book. So I have escaped any ridiculous advice, and have been happy for it. Trust your instinct. Hope you're feeling better now.