Underweight baby - how worried should I be?

[MBB]

I hope someone can offer some advice, as I'm not sure whether I should be worried or not. DS is 24 weeks and 15lb 10oz. He started on the 50th centile, was on the 75th until he was 10 wks, then has dropped back and is now halfway between the 25th and 9th. As he's crossed 2 centile lines, the HV said I needed to see the GP who would refer us to a paediatrician. DS is happy, full of energy and sleeps well. He's not a complete porker but he's pink and round in all the right places! I'm still BF but trying to introduce one formula feed a day. His diet ON A GOOD DAY is roughly as follows: morning -both boobs and breakfast ( usually banana porridge or yoghurt and fruit). mid-morning BF if he wants it. lunch - combination of veg (and started on chicken today which went down v well), and fruit for pudding, follwoed by BF. 2.30pm BF. midafternoon BF if he wants it, or water. supper - both boobs, fromage frais mixed with fruit and padded out with a bit of baby rice. However, for about 2-3 days of the week, he just seems to decide he doesn't want all this and 'snacks' instead. He's been doing this since he was 15 weeks, and I have repeatedly told the HV who said not to worry as 'he looks ok'. He has remained on the 50th centile for his height, so its not as if he's not growing at all.

I'm sorry this is so long and drawn out, the thing is that I feel that he's doing really well but this is not backed up by his weight gain. I would have no worries if I hadn't seen it recorded on his chart. my friend has not had her baby weighed since the HV stoppedcomeing to the house and doesn't seem to mind. DS has only out on 2oz in the last 2 wks, yet has been eating really well. I feel so responsible, like I'm not doing my 'job' properly and am letting him down.

[Demented]

MBB, someone more informed may be able to give some advice but for what it is worth my DS2 is about a week older than your DS and certainly comparing your good day, he sounds like he eats more than my DS2 and if he takes all the b/feeds has one more feed as well. They don't put as much weight on at this stage, do you know what his weight gain has been over the last month? That may give you a better picture than looking at two weeks. I am tempted to say go with your friend and don't get DS weighed but if you are already worried and if you are anything like me you won't be able to resist.

[Lois]

Relax MMB and check out some the BF weight charts. You'll probably find that your DS is closer to the 50th centile on those. I posted a similar query a few months back and there is a link on there. Sorry I don't have time to look for it now. I'll have time on Saturday to look if you still need it.

Try to enjoy your happy, healthy baby!

[SoupDragon]

The phrase "DS is happy, full of energy and sleeps well" stuck out when I read your post, MBB. Sounds like a healthy baby to me.

[GillW]

Don't panic - my DS slipped from 91st centile to 25th and I was constantly being told he was underweight when I felt he was doing just fine. As you say your DS is full of energy, chances are this is where the "problem" (not that it is one) lies.

My DS was always very active too and I'm sure the reason he wouldn't put on as much weight as some other babies was that he was constantly using so much energy. For what it's worth, he kept on slipping down the charts until very recently, but has now gone back up to almost the 50% mark as he's gained weight at a time when the curves tail off (or perhaps it's that he's reached the age where many other babies his age would also starting to walk and expend more energy? - something he's been doing for several months).

A couple of years down the line, when all the emphasis is on overweight children, you'll probably be very glad to have a beanpole rather than a sumo wrestler!

[Azzie]

MBB, I've just dug out my dd's baby book and looked at her weight chart. She was born on the 75th centile, and by 24 weeks was halfway between the 25th and 9th centiles, just like your ds. Like your ds, she crossed 2 centiles, but no-one ever suggested we needed to see a paediatrician - she was small but obviously lively, alert and healthy. (In our favour we already had a ds who had started onthe 25th centile, then shot up to the 75th and stayed there, so obviously as far as our HV was concerned we knew what we were doing!)

At 1 yr dd was 50th for weight and 75th for height, and very full of beans (walked at 9.5 months). There was (and is) obviously nothing wrong with her - at 3 she is a sharp cookie, and has throughout hit her developmental milestones slightly ahead of time. She will never be supermodel height, but is obviously destined to be one of those lucky people who will always be slender and will never have to worry about her weight.

I think my advice to you would be to go with your instincts - if you feel your ds is fine, if he looks fine and is alert etc then trust your instincts. It is very easy to get hung up on weight charts etc and lose sight of the fact that babies don't know about the charts!

[Clarinet60]

Don't intro formula (unless you really want to) as sounds as though he eats loads compared to my 6 month old! He also started to fall through the centiles and I got so fed upp with the inaccurate rubbish peddled by the HVs that I stopped taking him. Breast is still best at this age and as you say, he looks fine. Probably using the calories to develop in other ways.

[elliott]

I think he vsounds fine. I stopped getting ds weighed around 26 weeks - I think once they are past the little baby stage you can tell if they're ok just on your gut feeling. I'm not sure whether you were starting formula because you're ready to phase out b/f - fair enough if so, but please don't feel you have to do it to help him gain weight. If you are concerned about weight gain, I'd think about giving some more calorie rich foods - veg purees are all well and good, but it was about this stage with ds that I felt he really needed something more substantial!
(and I was getting bored....) Once he hits 6 months the range of foods you can try really opens up.

[jac34]

I was constantly being told by my HV that mine were underweight, but they could eat for Britain!!! They just burn it off. I too stopped taking them to be weighed, because imo there was nothing wrong and I refused to be paniced into believing there was.
I also took exception to the HV, standing and huffing, while I scrambled to redress two babbies, so that the next person could have their child weighed.

[musica]

My ds was born on 98th centile, and settled just below 25th - it just takes a while for them to find their curve. Once they're on it they seem to stabilise!

[mears]

I agree with what everyone else says. Your baby sounds absolutely fine. Also no need to introduce formula at this stage for weight gain, it will make no difference.

[tiktok]

MBB, your baby sounds fine. I spoke to a paediatrician recently (one who specialises in growth) and she told me some paeds are getting mighty irritated when healthy babies are referred to them with so-called poor growth.

Charts are of limited value when it comes to asessing an individual baby - I have posted about this on the thread that talks about advertising and stuff, if you want more info.

[JanZ]

Stop getting your baby weighed!

My ds was 91st centile at birth, big inital drop off, and then such a slow weight gain that he eventually dropped OUT of the growth charts! However, I was fortunate in that I always had great support from the b/f counsellors at the maternity hospital - and ds was always a manifestly healthy, happy and alert baby, thriving in every respect except weight gain.

For extra reassurance, we were referred to the consultant paediatrician - and to back-up Tiktok's comments, he was totally unconcenred about his growth curve - saying it was more important that ds was obviously healthy! To tell the truth, he was more interested in what my Dad (who had been a colleague) was up to. He just said I would have a skinny child with a big head, following in the footsteps of his grandad and his mum (at least, I USED to be skinny!)

At about 3 months he started to creep back up the centiles and I started solids at 4 and 1/2 months (next time I'll leave it to 6 months - I know beter now!). I continued to b/f until he was a year old.

The point is that every child has its OWN growth curve - the nice smooth ones in our red books are only averages.

As an aside, my dh wanted me to stop getting ds weighed and refused to get worried about ds. His view was "if your dad [who is a recently retired paediatric radiologist] is not worried, then I am not worried".

[Joe1]

I hate those charts. As with Janz my ds dropped off the charts and was there, gradually gaining weight and went up as we started solids. He was always alert etc etc showing all the signs of a healthy baby. We got referred had to go through all kinds of blood tests as the horrible doctor was convinced he couldnt be healthy, she even implied was stunting his brain growth by not feeding anything to fatten him up. He never showed any signs of being unhealthy, underfed, just not fat. Needless to say he is a happy, healthy little boy and move advanced in some things than other children of his age.

Am I going to go to regular weigh-ins with dd, not likely. Enjoy your baby and dont get hung up with the charts, you will know if there is anything wrong.

[MBB]

Thanks everyone, I've been offline for a couple of days with pc problems and was really pleased to see so many reassuring responses! To update, I saw the GP yesterday who photocopied the chart to send on, and it's then up to the paediatrician whether to make appt or not. I was a little surprised that the GP barely looked at DS.

With reference to some of your sugestions, I introduced a sort of 5pm teatime on Wednesday - cheesey mashed potato and carrots, followed by fromage frais - and then he had his milk feed as usual after his bath. This went down an absolute treat! I couldn't believe how enthusiastic he was, he couldn't get enough and he was the same again yesterday. If this continues and he doesn't put much weight on this month I can only think he has a deal with the dog (who strangely enough is putting on weight!) I was trying to introuduce formula as am getting fedup with BF, not for weight gain purposes.

I'm torn between stopping getting DS weighed and the nagging doubt that perhaps something is wrong and I could therefore let it continue. I think I'll wait and see what happens, see if we are given a hospital appt. However, I will think carefully before any action is take. (A friend of the family's baby was in the same situation and ended up on a series of antibiotics which completely stripped his stomach of all that 'friendly bacteria' stuff and so ended up with sickness, pain etc. Afer 6 months they just stopped the treatment and said perhaps he's just going to be slim, or words to that effect.)

Thanks again, and I'll do as you suggest and enjoy my baby - who is an absolute joy this week, so must be due a grouchy day soon!

[ames]

Just wanted to add that my DD is now 10 months and when last weighed a few weeks ago (although I hadnt taken her for a while before that) she was a 'massive' 16lb 6 infact she had moved up a centile on the graph so at long last the hv was pleased! Whoop-ee! I refused to let DD's weight bother me and have always let her stop eating when shes had enough and have told my hv I'm not going to make an issue of food which would only make things worse. Those charts were produced ages ago and its important to remember that they are only a guide and no baby is the same. Your hv sounds sensible to me and you are undoubtly doing you job properly otherwise DS wouldn't be so happy and full of energy. Dont forget how tiny your baby stomach is and that weight gain is only part of the whole picture.