Weight and 8 month old baby.

[FlyingStart]

Another mother has asked me for some advice. Before I do, I would like to post some questions to obtain a wider view. Apologies in advance if I have posted this in the wrong place.

Bakground information: The family in question (family A) are comfortable financially, have own home etc, typical mum + dad + DS1 (7) and DS2 (8 months). Family A have never had issues before. Family A live in a different part of the county and therefore myself and mother A don't have the same health visitor. Family A's current health visitor for DS2 is different to their health visitor to DS1, who has sinced moved on.

Mother of family A claims that their current health visitor took an immediate disliking to her upon their first meeting, when DS2 was aprox. 14 days old. Since then, the health visitor has been 'active' with the family, which, initially mother A did not mind. Mother A had a c-section and issues that go with that. Mother A also decided to bottlefeed.

No one in family A has any weight issues. They are all slim and healthy. A couple of weeks ago, mother A went to the GP surgery and her DS2 was weighed. He weighed in on the 99.6th percentile, with his height on the 91st percentile. No comments about his weight were made during the appointment.

However, over the weekend the parents received a rather strongly (and IMO unfairly) worded letter basically saying:

1. DS2 has a weight problem
2. The insinuation was the mother A was the cause or causing this weight problem
3. The health visitor expects full co-operation otherwise a referal would be made to a paediatrician and children's services (read child protection)

The family have never before had problems of this kind. My youngest is > 2 years old and the last time I saw a health visitor was for my youngest's immunisations. So you can imagine the scene - hello Ms Health Visitor, everything alright, yes, jab, thank you goodbye. I have a good relationship with my health visitor, hence why I need a wider view. I can't imagine my health visitor sending me such a letter, but then again, my children hover on the 50th percentile!

What I would like to know is:

1. Is there a percentile whereby a baby is considered to have a weight problem?
2. Is the height percentile not taken into consideration?
3. The letter reads a little bit like a standard letter. Is their such a standard letter? And if so, why can it not be worded in a more gentle and sensitive manner? (I could re-write the letter to be worded more sensitively and making the same points).
4. The paragraph relating to the 'if you don't co-operate will will do this' reads like a threat and, IMO, assumes in advance that the parent(s) will not co-operate.
5. Is this NHS standard? I mean, is this how it's done throughout the country?

Perhaps a HCP could reply. So far, I intend to recommend to the mother that she demands a change of health visitor since it is clear that the mother and current health visitor do not get on. But what else should I say to her? Has anyone experienced something similar and can tell me what to expect?

Many thanks in advance for any replies!

(BTW, babe looks fine to me!)

I have just had this with my DS. He (like ally other babies) is a little Chunky monkey. He was 7lb15oz at birth (50th centile) and at 6 months weighed in at over 21lb and on the 99th centile.

Health visitor said I needed to take him to the GP and was quite rude to me. I didn't take him and went to see another health visitor who took the time to explain to me that it was procedure to refer ANY baby to the gP for further checks if that child goes up or down three percentiles. Apparently they are concerned about genetic conditions and thyroid problems and it's just precautionary!

Thank you for your prompt reply. I am in a way, pleased that it is standard proceedure. The mum is so embarrassed and deeply upset regarding the implication that she's a 'bad' mum and that she overfeeds her DS. She felt as if she was being picked on by the health visitor.

Perhaps it would be a good idea for the mother to arrange a meeting with the peadiatrician anyway. As I said, she has it in writing that she will be refered to a peadiatrician if she does not "co-operate". If the mother does insist on seeing a peadiatrician anyway, will the notes say that the meeting with the peadiatrician was because she didn't co-operate with the health visitor IYSWIM? As oppose to the mother saying, "OK then, we'd better see a paediatrician."

I'm not sure. I did take my son to the GP in the end because the nice health visitor explained everything properly to me unlike the evil HV!

GP just asked if I had any concerns and checked his heart with the stethoscope and said he didn't have any obvious signs of the various conditions they would be concerned about and basically laughed us out of the surgery.

Can ur friend just take her child to the GP for a Check up

Yes! An update. She said that in order to get a paediatrician appointment, she needed to book an appointment with her GP. She has seen the GP today, who basically said what you have written and that in his opinion, an appointment with a paediatrician is unecessary. The GP was very understanding about her being upset by the letter. It is hard not to take these things personally.

The GP said he'll feedback to the health visitor. The GP does not seem too concerned though. She will wait and see what the health visitor says next.

I think the letter could have been worded a bit better. My DS wasn't even in the percentile range at that age, he jumped off the chart although he started at 94th. the daft thing is that a lot of babies get a bit chunky around that age -once they've learned to eat but not necessarily crawl/walk. Most slim out soon after.