Disproportionate growth

[Eleano]

My DS was born at 37+4 weeks and is now 3 months old. I wondered if anyone here has had an early term baby measuring at 90th+ centile for head and height but 50th for weight?

His head and height shot up and jumped centiles in the first few weeks/month but his weight remains at the 50th centile. I know he's feeding well since he hasn't dropped centiles and healthcare professionals aren't worried. I'm guessing it's because he missed out on that extra fat that babies gain during the final weeks of gestation and breast milk can't compete with the placenta in that respect.

He's EBF but I'm now considering introducing a bit of formula to help him gain some weight. I'm not sure though as I don't want to disrupt my supply and cause unnecessary problems. I would of course only do this after consulting healthcare professionals but wondered if anyone here has had a similar situation?

If you do want to supplement and don't want to affect your supply, could you supplement with BM?

Why do you feel the need to fatten him up?

As long as he is maintaining his weight along a centile it doesn't matter. He might just be tall and skinny.

You are doing great EBF.

I have 4DC.

Youngest 3 all born heavy and tall.

Youngest dropped down through the centiles for weight and remained tall. Still is as an adult.

Some babies are just much leaner.

I wouldn't worry, OP. If he isn't losing centiles you are doing fine. DS has always been in the middle for height and towards the bottom for weight. He is a teen now, and still the same, but I suppose he is what people used to describe as wiry as he is quite muscular. DH was the same when I met him though he has too much unhealthy weight now!

You don't have to have weight and height on the same percentile. Normal can be as much as 2-3 percentiles different.
My daughter is the opposite higher weight than height and her paediatrician and dietician are happy and not concerned. She is on the first for height and 25-50th for weight. Her BMI is 80-88th percentile which is the top of normal but still normal.

There are also huge errors in the length measurements. My daughter had 2 at the hospital 4 weeks apart and apparently she shrank 4cm in that time. In reality the first one was slightly over and the second was under and her actual length was somewhere in the middle. This moved her from the 25th to 4th percentile so it can make quite a difference.

Did the person doing the measurements raise any concerns?

It could just be his natural build? My daughter has always been about 90th percentile for height and 25th for weight right from birth up until her current 2 years. Never had any fat rolls or ‘baby fat’. She was born at 38 weeks and on formula pretty quickly due to not latching well (tongue tie) and has always been fed on demand.

How tall are you and his dad? It sounds absolutely fine. He’s average weight. You don’t want to push him above the average at the risk of setting him up for being overweight. It sounds like he’s had a growth spurt. Head circumference and length aren’t massively accurate anyway, which is why they don’t usually measure them after birth/first few weeks, but it would be unusual for them to all be the same. All sounds perfectly normal and healthy to me.

As long as he is health and thriving you shouldn't worry. I certainly wouldn't supplement with formula.
If you want him to feed more just feed him more regularly.

My son was 98th centile for head circumference; weight was around 68th I think. Initially his weight dropped below 50th centile (ebf), then after the first year he's been steadily on the 55th for weight. He's now 3 and still has a massive head - wears age 6 hats!!

The HV advised me to flag this to the GP at his 8 week check, because head and weight were over two centile lines apart. GP glanced at him and said he seemed in proportion. I also mentioned to my friend (a paediatrician) who also said he was in proportion.

As I said he's now 3 and has always been pretty healthy. No one has any developmental concerns, and we've not had any weight issues since my supply was properly established (apparently he has a ridiculous appetite and I don't produce very fatty milk!). I never used formula, and he's just never been a chubbster - always slender (but appropriate weight)

Apparently the placenta gets less efficient as feeding babies as they come to full term, so I really wouldn't worry about that.

Obviously if your child has a big difference between weight and head size do speak to a doctor. But I hope this helps reassure you that there may not be anything to worry about.

I read somewhere that the first investigation to do for high head circumference is to measure the parents' heads as most variation is heritable.

We were the opposite. EBM fed baby for 6 months and he just grew - outwards!

I think he gained a 1lb each week from week 2 till week 10! When he was 5 weeks he was admitted to hospital with RSV and was poorly, the staff were amazed how huge he was and despite being poorly with an oxygen nasal cannula - he still managed to BF well and put weight on during his inpatient stay....

I know that this is the complete opposite to you but it just shows the huge range of "normal".

He's now 13 and it's taken him this long to slim down a bit. His hands and feet are huge and his thighs are massive. He is just started his growth spurt and he looks taller every morning.

Formula isn't as easy to digest as BM - you are doing a great job - as long as he is gaining weight, I'd carry on as you are doing.

Thanks everyone, with your help I've decided not to supplement with formula and not worry about his difference in centiles between head, height and weight. He looks perfectly normal, doctors are happy and like you say, it could be his body type. Me and DH are both on the tall lean side and while DH was chubby as a baby I wasn't. Also I've got a big head circumference which explains his head size too