10 week old slow weight gain

[jarofpickles]

Just wanted to run a situation past you all if I may... DD is my third baby, I've breastfed all of them so thought I knew what I was doing! She was born on the 91st centile and fed really well from the start, very similar to my DSs although possibly not as hungry, and not growth spurting in the same way. Anyway, she regained her birthweight in 10 days, and initially gained well, but by her 8 week check had dipped to between the 50th and 75th centile. So the HV gave it two weeks and then last Thursday re weighed her and she's only gained 3oz in 2 weeks and is now below the 50th centile, and 'failing to thrive'. I know this is potentially a problem, but otherwise she seems so well, is very contented after a feed, is alert, smiling, cooing, developing normally. She doesn't have any worrying symptoms eg sweating/breathlessness etc (and I'm a GP so I have checked her over).

So on Thursday, the HV was convinced it's a supply problem and suggested expressing/top ups/ feeding 2 hrly etc.I've now done this over the weekend and really trying to get her to feed more. But today she was getting distressed when I was trying to latch her on, and then at bedtime she had the most massive vom (she's not normally pukey at all). And I just feel so frustrated because I think I've been over feeding the poor little thing. I feel really confused about the whole thing. My instinct is she is just finding her line and she knows how much she needs but I'm seeing the HV again tomorrow and dreading another battle about it. I've got a GP appointment for later in the week and I'll get a paeds appointment just to make sure there's nothing else going on... But what does MN think? Do I need to increase supply or just listen to dd and trust she'll take what she needs?! Thanks for getting this far!!

My DS1 was born on the 75th centile and by 12 weeks had dropped to the 25th, so a similar pattern to your DD. He was a healthy baby and is now a tall active 9yo! I'm surprised your HV is so worried - mine didn't turn a hair. If I were you, I'd carry on feeding on demand and let her settle to her own weight. Some bf babies just do this!

My dd dropped from the 39th to 7th centime by 6 weeks (I BF for first two weeks but it all went wrong tbh with bad latch and tongue tie and reflux). Hers was reflux tbh as she wasn't feeding well so we knew why she wasn't gaining but she's started gaining better now and following her centile instead of dropping.

I would just trust your instinct tbh. If she's having wet and dirty nappies, meeting developmental milestones and seems happy in herself then I'm not sure how she is really failing to thrive.
Not all babies follow charts x

Thank you! That's good to hear!

I have a DD around the same age who was also on 91st centile at birth and is now between 25th and 50th centile. She had poor weight gain at the beginning, hence dropping down the centiles, but has now 'found her line'. The midwife and HV have been relaxed about it because she looks healthy, latches on well and because she was big to begin with so is still a healthy weight. Noone mentioned 'failure to thrive' to me. I thought that applied if they went below 0.04 percentile?

My GP told me only a GP or specialist could diagnose failure to thrive, NOT a HV!
If you are a medical doctor and feel it's ok it probably is. TBH one of my HV converted from a nursery nurse ie not medical at all!!

MG My dd was born small so could lose a little weight and be 0.4 ... whereas for a big baby to plunge to mid centiles involves less "thriving" iyswim. As it was explained to me, slipping 2 centiles = "initial concern" - only with other problems and further lack of growth would lead to further diagnosis (and I believe they no longer use the phrase "failure to thrive" at all- it's something like "long term slow growth/weight loss").