4month old dropping percentile

[AK06]

My baby girl was weighing 2.4kg at birth which put her at the 2nd percentile.
Over the weeks she gained pretty well and got nearly up to the 9th percentile. We mix feed her so pumped breastmilk during the day and Aptamil advanced after 6/7pm onwards through the night. After her 8w, 12w vaccination she started reducing how much she drinks per feed. Its now more of a battle to make her finish the bottle (120ml). She often drinks about 90ml. The 16w vaccination put her off her feed for nearly two days where she would refuse the whole bottle for like 6hours. She is back to her drinking now at 19weeks but 6/8 feeds she would not finish an entire feed. She just pushes it out with her tongue and hands.

At 18 weeks she weighed 5.045kg and at 19 weeks 5.120kg making it 75grams of weight gain for that week. I was expecting her to weigh at least 5.5kg.

In terms of her night feedings she has one bottle of 120ml between 10-11pm which she finishes. I then pick her up again around 4am ish to give her the next feed. Lately she does not want to finish the whole bottle. How can she not have the full appetite after this many hours ? For example today she drank 120ml at 12am, then woke up at 4.30am for a feed to only take 80ml. Pooped at 7am and tried feeding at 7.30am which is now 3hrs. But she refused the 7.30am.

Then at 8.30am she had another 60ml.
Yesterday her total intake for 24hrs was 770ml.

The broken feeds is driving me insane especially with her weight not increasing as much as I'd like it to be.

Her wet nappies and poo nappies are fine. She has so far met all her milestones. Turns from back to belly, lifts head up, tracks objects, turns around to familiar voices, smiles at people, wiggles in excitement, sleeps uninterupted from 7-8pm onwards except the 4am wakeups. She seems like a happy content baby but her slow rather barely weight gain is concerning me.
Has anyone experienced this ?

OP my first DC did not gain weight well for the first 4/5 months but we had support
of health visitior - regular (I think weekly at one point) check ins, weigh ins and discussions. Do you have contact / support of a health visitor? They are the experts

Sounds like she's nicely following the 2nd-9th percentile. Why were you expecting 5.5 kg?
It's rare that they perfectly follow a line. It reads like when everything was going well she moved from the 2nd to the 9th. There was a hiccup post vaccines where she dropped back down to the 2nd. Developing well but now moving burning more energy and is following the 2nd percentile now.
I wouldn't be panicking or overly concerned but would move towards monitoring weight and feeds and getting some advice from your HV

Weight gain isn't linear. My daughter only gained 200g between 7 and 12 months as her appetite didn't increase with her activity. We had regular weigh ins as she had feeding aversions too these were triggered by allergies and reflux. She was born on the 9th reached the 35th percentile by 7 months dropped back down to the 15th at 13 months she made it back up to the 35th by 2.5 she stayed there until 3.5 and has gained very little in the following 2 years and is now back below the 9th again!

What centile is she now? As long as she’s still around 2nd-9th and not dropping below 2nd, she’s fine. Some babies will be 2nd and some babies will be 95th. Neither is better.

Unless you’ve been advised otherwise, I’d stop with timing and recording feeds. Feed her as much as she’ll have whenever she shows hunger signs. If she is finishing a bottle half the time and leaving some half the time, it means you’ve got the amount right. You actually don’t want them finishing every bottle as it indicates you’ve got the amount wrong and are possibly under feeding. It sounds to me like she’s doing fine. It’s time to start to move on from those early weight gain worries.

Ach OP I sympathise, it is stressful when they don’t gain as much as expected. My little girl dropped from 25th to 9th, I was breastfeeding and panicking about milk supply but I’ll repeat what every health professional told me: look at the baby, not the graph. If baby is content and happy, meeting milestones, plenty of wet and dirty nappies, there’s no problem. Health visitor told me they’re only concerned if they drop two centile lines and even then it’s often fine and no issue. Are you getting support from your health visitor? They’ll be able to tell you if there’s an issue. If it helps, my baby is now 9 months and has moved back up to 25th centile

Thank you all for your advise and experience. Yeah I did check with a health visitor who has advised to make an appt with the GP to review her. She does seem content and happy and has so far met her milestones one by one. I just find it challenging to see why she is suddenly not hungry even after 3-4hours especially when she only consumed like 90ml on the last bottle ...

It might just be that she's a 2%er. I don't think there is a way to force her to drink more - all you can do is offer.

Similar to other posters, after some initial fluctuations my baby returned to her birth percentile. I'd love to see data about how common this is/whether your percentile is 'locked in' (for a time, anyway, before social influences kick in).

My daughter at 4 months breastfeed for a total of 2 minutes between 10 am and 8pm and then fed over for about 20-30 minutes over night!

Her feeding issues were caused by reflux, she didn't want to feed for very long as feeding was painful.

Tongue ties can also cause short feeds as it's tiring to feed. It might be worth getting a feeding assessment as well as seeing the GP. Do you have an infant feeding team? We saw ours a couple of times with my daughter due to reflux and my son was born with a 100% tongue tie which was cut by the infant feeding team on day 8.

Yeaaah, she did not latch properly at the start so we did check for tongue ties and the feeding team said that she does not have a tongue tie. I am not sure of a lip tie because she does make these clicking sounds whilst feeding occasionally for a little bit.

I have spoken to my GP and hopefully they will call back with an appt.
So far this has been her intakes.

Monday - 770
Tuesday 570
Today: 4am (80ml) 8.30am(70ml).

She was okay taking 120ml per feed from around 12weeks until her 16week vaccination. The next day she striked for good 6-7hours not wanting a single feed... Ever since then we have been having this issue where she barely finishes the bottle. A part of me wants to just wait and see whether she will eventually cry in hunger before I offer it but as the hours pass, waiting on makes me anxious and I give in onto trying to feed her.

By now I would assume that she should be able to take easily drink 120ml at least or a bit more. She has done it before so not sure what is stopping her now ...

Try moving her onto faster flow bottle teats? My DD was pushing the bottle away too. Turns out it was frustration.
You will need to sit her a bit more upright for the feed so she can pace it better.

Embarrassingly, we also discovered after two disastrous nights that one of the teats was blocked. Can't remember which type of teat but we'd obviously used the same teat two nights in a row and she was ravenous by the morning. Couldn't fathom why and then there was a lightbulb moment [very few of those in the fog of the early months] and the shame.... I laugh now but I was devastated at the time.