Baby dropping centiles

[MissHoney85]

My DD is nearly 17 weeks, and was born at 36+3 weeks. She was 2.78kg at birth which is 50th centile for her adjusted age.

I had her weighed a couple of times in the first couple of months and she was tracking the 25th centile then. She was 4.25kg on the 24th Feb, at about 9 weeks. I've just had her weighed again and she's 4.9kg, which is just over 9th centile for her adjusted age.

The nurse who weighed her wasn't too worried - she's alert, smiley, interested in toys. She feeds (breastfed) every 1.5-2.5 hours in the day and 2-3 hours at night, and has plenty of wet and dirty nappies. I'm fairly small (about 5'2") although my DH is quite tall and so are the women in his family.

I can't help but worry. I was quite shocked that she's only put on 650g in nearly two months. My boobs are quite small and I've always worried that I'm not giving her enough milk - sometimes she gets really frustrated at the breast. But surely she wouldn't have so many wet and dirty nappies if I wasn't making enough milk?

I had Gestational Diabetes when I was pregnant so maybe her birth weight was inflated and she's settling into her natural centile? I just feel so sad seeing the line flattening on her chart and I'm worried that there's something wrong. Does anyone have any experience of this?

No direct experience as DS was a poorly baby and the twins are fat. But I'd say that it takes a while to find their line, esp as you had gtt.

Take your cue from her. Is she growing in length? Does she seem mostly happy? You've already said lots of wet and dirty nappies so it's Def going through. She's alert so she's getting enough to make her perky. Just give it time xx

I would do top ups and see if she seems more settled and also regains her centile.
But that’s because I got very anxious with both of mine that they were not getting enough milk. I’m not saying it’s the right thing to do - just what I would have done.

If I were you I’d get her weighed again in a couple of weeks. It could be that she’s just settling onto her natural curve. It’s good that she’s having enough nappies and is alert.

Boob size has nothing to do with milk production so I’m sure your boobs are doing a great job. You could try breast compressions during a feed if you want to try and get more milk in her, or switch nursing.

Has anyone measures her length? We had this same issues that baby was born at 75th centile (a real surprise!) then dropped to 25th then 9th. HV couldn’t work out why as she was ahead on milestones, alert and happy. Eventually she measured her and she’s only on the 2nd centile for height (I’m only 4ft 10!) so in theory that made her overweight, rather than under!

No she's never had her length measured, or head circumference. I feel a bit let down that we seem to have had a really skimmed down service from the HV due to Covid. I think her length is ok, she just about fills a 0-3 month sleep suit lengthwise now.

@MissHoney85

My DD is nearly 17 weeks, and was born at 36+3 weeks. She was 2.78kg at birth which is 50th centile for her adjusted age.

I had her weighed a couple of times in the first couple of months and she was tracking the 25th centile then. She was 4.25kg on the 24th Feb, at about 9 weeks. I've just had her weighed again and she's 4.9kg, which is just over 9th centile for her adjusted age.

The nurse who weighed her wasn't too worried - she's alert, smiley, interested in toys. She feeds (breastfed) every 1.5-2.5 hours in the day and 2-3 hours at night, and has plenty of wet and dirty nappies. I'm fairly small (about 5'2") although my DH is quite tall and so are the women in his family.

I can't help but worry. I was quite shocked that she's only put on 650g in nearly two months. My boobs are quite small and I've always worried that I'm not giving her enough milk - sometimes she gets really frustrated at the breast. But surely she wouldn't have so many wet and dirty nappies if I wasn't making enough milk?

I had Gestational Diabetes when I was pregnant so maybe her birth weight was inflated and she's settling into her natural centile? I just feel so sad seeing the line flattening on her chart and I'm worried that there's something wrong. Does anyone have any experience of this?

Totally normal, someone has to be the smallest. If you had GD then yes that’s probably why they aren’t worried - plus she’s still within 2 centiles of her birth weight which is good. My son actually lost weight from his birth weight which is why the the midwife was worried, but he only regained birth centile (50%) from 14 months. Til then he was 9-25th centile for weight And 75th for length

This happened with both of mine. Normal birth weights, then a gradual fall down the centiles over the first few months until they were more or less scraping the bottom. If I recall, my daughter fell to about the 5th centile, possibly below.

Kids are now 12 and 8. Both definitely on the small side for their age, particularly my daughter, but she's starting to sprout a bit now. I think they'll end up reasonably average.

We (parents) are normal height, so who knows what's going on there, but I do remember being small-ish for most of my childhood and ending up above average, so who knows!

I wouldn't worry too much. Both of mine were small, but were early crawlers, walkers and talkers, so I like to think they spent that early energy on brain development

Something similar happened to me with DC1 - he was 2 weeks late and a HUGE baby - 98th centile. By 9 months he'd dropped to 9th and the HV worried me sick about it even though he was obviously thriving: eating well, still BF and crawling like mad. Both DH and I are quite small so I don't think he was ever going to stay so big. He's 15 now and smallish for his age until recently when he's just shot up. Probably about average height now.

I wouldn’t have known that mine was ‘short’ without measuring her as she seemed to fill her 0-3 month stuff quickly. Apparently it’s normal not to measure them now unless they have a reason to - it’s worth a go as may put your mind at rest

How many dirty nappies a day?

Could be cmpa. Any other symptoms?

I had a huge second baby (probably undiagnosed GD), he dropped through the centiles over his first couple of months despite otherwise being perfectly happy and healthy. I was totally stressed by my health visitor and GP, and ended up with a paediatrician.
Being born heavier than they were 'meant' to be is definitely a thing, I read a good article calling it catch-down growth. Mine found his own upwards curve after a few months and never needed anything but breast milk on demand.

My baby was on the 50th centile at birth then after a weight loss in the first week quickly shot up to the 75th! By 6 months she was between the 9th and 25th and has been small ever since (she's 6 now). But I was small as a child and my husband is very skinny. She breastfed very frequently, ate well as a toddler, had plenty of wet and dirty nappies and mostly hit her milestones ahead of time except a gross motor delay which sorted itself out. If the health visitor isn't concerned and your baby seems happy I wouldn't be worried.

It's quite normal not to have their length or head circumference measured - it's not something you've missed because of Covid, my area haven't done it for years and years. My sons both had their HC done at birth and then not again. So weight is all you have.

But you actually have much more. Is the baby happy? Alert? Meeting their milestones? Sleeping well (as well as a baby will!)

If your gut tells you there's nothing wrong and the HV isn't raising concerns then I think you've probably got a healthy baby and you shouldn't be worrying.

You'll find more changes to their growth pattern once you start weaning. And some delightful changes in bowel movements!

You can ask the HV to measure length if you’re worried. I did throughout lockdown and if they do it once its easier to get them to do it again.

Sounds okay OP. As said above, a drop of 2 centiles is considered normal, especially in the context of an alert, happy baby, peeing and pooing well and meeting milestones. Were you induced or have an unplanned c-section or anything like that? As you said, often GD babies can be a little falsely ‘big’ at birth and this can be confounded further if you received IV fluids during delivery.

I’d politely disagree with a piece of advice above to offer top up bottle feeds. Firstly, there is currently no indication and secondary you’d be better just bringing her to the breast more, especially if you are worried about your supply. I don’t think anything in your post implies your baby is unsettled - at 17 weeks BF every 2-3 hours is exhausting, but completely normal. Babies get frustrated at the breast a lot at ~ 4 months. They want a slower flow or a faster flow or to look at the cat or practice rolling instead of feeding...the list goes on.

Storage capacity of boobs plays a small role, but supply is far more correlated to demand. ‘Empty’ feeling breasts are stimulated to produce more milk than full feeling breasts, so please don’t worry about their size or how they feel. The best barometer of feeding efficacy by a long stretch is dirty nappies and your DDs behaviour.

If you wish to continue breastfeeding but are concerned about how it is going you could always speak to an IBCLC to get latch/positioning/tongue tie etc checked.

I also would question the likelihood of CMPA as mentioned above as well. If still gaining weight, but slowly tracking down

Thank you so much for your advice everyone! Feeling much better about things now 🙂

My dc was a big baby and was on 98th centile. She dropped down to the 50th after a few months and then had progressed on that line. I would just get baby weighed a bit more regularly to monitor it.