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Children's health

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Original poster

Confused by Centile drop - told two different things by 2 different HV's. Help please

22 replies

BT11 · 09/03/2023 13:48

Hi all!

For context - My DS 12 weeks tomorrow is 90% BF and rest formula (if I don't get a chance to express). I response feed and let him take his time. I still wake him during the night as he's a long sleeper at night and likes to be awake more in the day.

He is really chatty, active, smiley, very strong, loves playing and is hitting all milestones with ease.

I went for a weigh in yesterday as we have had the flu and wanted to make sure he's okay as he had a few problems with my hindmilk imbalance for a little while. I have been trying the very best I can with feeding. It's been all I think about and I'm really upset after yesterday's visit.

Previous HV said he's 50th Centile, current HV has said he's 75th and dropped two centiles to 25th. I asked my friend this morning who is a pediatric nurse and he has said he's 50% with a slight dip.

Current HV has said to speak to GP and get him on a feeding plan. I'm very upset and waiting for GP callback.

What do you think?

Confused by Centile drop - told two different things by 2 different HV's. Help please

OP posts:

Are your children’s vaccines up to date?

Set a reminder

Original poster

BT11 · 09/03/2023 13:49

Just to add he is 98th Centile for length and I have been told that his calories may be going towards his length growth over weight.

Just feel a bit deflated!

OP posts:

Unseenentity · 09/03/2023 14:08

From the chart you have posted this looks like completely normal growth.

Original poster

BT11 · 09/03/2023 14:17

Thankyou! @Unseenentity I was honestly shocked and didn't really question them on it to much out of confusion. But I'm hoping GP has a copy of this for our telephone call.

OP posts:

Sleepygrumpyandnothappy · 09/03/2023 14:23

That looks completely normal and healthy, especially if he’s been ill. And he’s factually not dropped from the 75th to the 25th.

Original poster

BT11 · 09/03/2023 14:28

Amazing thanks for the response.

I'll feel better equipped for the call so I can really empathize that they can't be right about that.

Anddddd breathe. 🤣

OP posts:

RoseslnTheHospital · 09/03/2023 14:28

I assume the "drop" from the 75th centile to the 25th is because his birth weight was about 75th centile, and now he's between the 25th and the 50th.

It seems hasty to be talking about a feeding plan based on one instance of a drop. I would think it more reasonable to suggest weighing again in 2 weeks time and see if there is a further drop, a maintaining of the current centile or moving back up to where he was before the recent measurement.

I would just try to feed him a bit more frequently if you can, maybe add in an evening/night feed, and not worry too much about foremilk/hindmilk.

Original poster

BT11 · 09/03/2023 14:34

@RoseslnTheHospital thanks for the advice.

I'm going back in 4 weeks for another weigh.

I'm upping the feeds and I'll add a night feed as well. HV told me to feed every two hours and I was devastated - I have only just started to get sleep again 🤣

But I'll try everything for LO. Just got to crack on with it!

OP posts:

CatOnTheChair · 09/03/2023 14:34

I would keep an eye on it, and get him weighed again in a couple of weeks, but given you've all been ill, I'd say dip due to illness.
I can't see anything near a 75th line - but my screen is quite small.

Hoowhoowho · 09/03/2023 14:35

Looks like totally normal growth. I’d assume the health visitor who has concerns is using the birth weight centile which is completely irrelevant as it’s from a different data set (UK-90) than the rest of the chart (UK-WHO) and so you always calculate from the 2 week centile.

You only need to be concerned if he drops two centile spaces from the 2 week centile.

User0ne · 09/03/2023 14:38

Given that you've both been ill I'd stop worrying. Many people lose a little weight when ill. If your DC is fine in themselves then the weight loss is nothing to worry about and they'll regain it shortly.

For context I have 3dc, born on the 9th, 25th and 90th centiles. My 3rd child was born 2 weeks late, the others were early. Guess which centile the late one was.

Neither me or DH are very big and dc3 dropped from the 90th centile to the 25th over 18m - to join where the other kids (and me and DH as adults) are.

Centiles are a guide - that may or may not be an indicator of a problem. In your situation I would look at the bigger picture before deciding whether to be concerned.

TwistandSprout · 09/03/2023 14:38

it looks like your HV is well off and has shared inaccurate advice after misunderstanding your book. You would not wake for feeds every two hours through the night.
What has been the problem with the feeding and the imbalance?

RoseslnTheHospital · 09/03/2023 14:39

CatOnTheChair · 09/03/2023 14:34

There is a dot marked on 0 weeks at about 4kg which for birth weight is between the 75th and 91st centile as marked on the Y axis of that chart. But as a PP has said, whether or not the baby has dropped 2 centile lines should be taken from the 2 week point, not from 0 weeks.

Twizbe · 09/03/2023 14:40

This looks fine. He's following a centile.

You being both being sick and a growth spurt at around 12 weeks could cause a slight slow in weight gain, but this chart looks fine.

Original poster

BT11 · 09/03/2023 14:43

I'm so glad I posted now as I feel SO much better!

He is outgrowing clothes and is long and lanky - and is fine in everyway!

I am a FTM (and and I was swapping breasts too quickly/pumping too quickly and wasn't fully draining the breast resulting in too much foremilk, slow weight gain and lime green nappies.

I really worked on that and got everything back to normal. So was expecting things to be a little better.

OP posts:

Waitin4snow · 09/03/2023 14:45

My teens have always been 98th centile height and 50th centile weight or sometimes a bit less . If you or your partner are tall and slim it’s likely genetic. You are right to be cautious but please don’t get upset - we are not all average

Original poster

BT11 · 09/03/2023 14:46

User0ne · 09/03/2023 14:38

For context I have 3dc, born on the 9th, 25th and 90th centiles. My 3rd child was born 2 weeks late, the others were early. Guess which centile the late one was.

Neither me or DH are very big and dc3 dropped from the 90th centile to the 25th over 18m - to join where the other kids (and me and DH as adults) are.

Centiles are a guide - that may or may not be an indicator of a problem. In your situation I would look at the bigger picture before deciding whether to be concerned.

That's great advice thankyou!

LO was also 2 weeks late.

I'm just happy that things will level out over time 🙂

OP posts:

Original poster

BT11 · 09/03/2023 17:45

Just a quick update -

Went into GP just now. She was confused as to why I had been asked to go in.

Baby is definitely 50th Centile and only had a slight dip due to the flu. Nothing to worry about at all. It's common for breastfed babies to be long and lean.

GP wrote a note for HV to see on next visit to confirm HV has made an error reading my book and to be more careful giving out information like I was provided.

Thanks again 💐

OP posts:

nocoolnamesleft · 09/03/2023 18:44

I'd only count that as dropped one centile line, and if under the weather would expect it. So yet another person saying they wouldn't be worried.

Original poster

BT11 · 09/03/2023 21:10

@nocoolnamesleft thankyou. I honestly feel so much better.

Panic averted 😂 I also know to question things a little deeper if it doesn't feel right.

OP posts:

BouncingWorms · 09/03/2023 21:17

I see you’re happy with the situation now. But just to add that the referral to the gp is so they can check if an illness/infection is causing the weight loss and treat appropriately, since you know it was flu the appointment wouldn’t have helped even if there was an issue with the weight loss.

Original poster

BT11 · 09/03/2023 21:47

@BouncingWorms thanks for letting me know - I'll remember that if it happens again.

It's always best to get a check up with GP just in case and glad it's all been sorted for now 🙂

OP posts:

Ally638 · 24/12/2023 04:46

I’ve come across your post, I really need to wake my baby in the night because she is also a long sleeper… But I am sleeping through alarms for like four hours, I seem completely incapable of waking up and until my baby wakes up naturally… Have you any tips on how you were waking to Feed your baby? X

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