dropping through centiles

[forevermore]

dd has never been a big eater (4-5 ozs every 4 hours, 5 times a day) however always put on weight along the 75th centile. she is now 14lb 5oz at 20 weeks (measured as a 15 weeker since 5 weeks premature) and was born as 6lb 3ozs.

she has in the last month dropped to 50th centile and HV has advised weaning since the milk intake is not providing enough calories now.
i had started her with baby rice this week at 11am feed, just one teaspoon (such a small amount??) now feel eager to pile it on since worried she will keep dropping through the growth charts...any advice?

will solids make her put on weight?

i thought milk was all they needed for first 6 months?
also i presumed she would need to eat at least 7 0zs 5x a day to be ready for solids?
if her stomach cannot hold milk how will it hold food

milk has more calories than food. ignore the HV.

Milk's far more calorific than baby rice - the weight "drop" you describe is not cause for concern if she's alert, producing wet and dirty nappies and learning new things.

DS went from the 75th to just above the 9th by the time he was the same age as your DD - babies often do, especially as they get more active. He's just found his natural weight, that's all. He's 20mo now and has never been back above the 25th (hovers between there and the 9th.

Please look at the baby, not the chart - a much better indicator of their health, I promise.

yeah forget solids! they will fill her up, but not make her put on weight.
in fact, i would imagine you risk her wanting less milk if she has too much other stuff... and as the milk has far more calories than the food you don't want that.

she is on the 50th centile... that's fine!

my ds dropped from 75th at birth down to the 50th and no-one even mentioned early weaning to me!

what happens if you offer more milk?

In a word no, you probably won't see any significant weight gain in the short term as milk has a higher density of calories. I would have thought more milk would be a more efficient way of getting her to gain weight although frankly your dd sounds fine to me and I wonder if your hv just has a thing about it, worrying you in the process. She wouldn't be the first , for some it is almost as if they feel they need to achieve a statistical distribution across their clients !

You need to make sure she doesn't drop those milk feeds yet, as the rice may stay in the system longer but the quantity won't replace the equivalent volume milk. If you decide to try it give her the usual amount of milk first and the solids later. tbh she's still pretty young for a hv to prescribe weaning (especially given her prematurity) and your comment suggests that you may not think her "ready" so don't rush.

if she won't take anymore mile (and she won't) and is dropping through centiles what are my options?

i have heard that there are supplements you can have added to milk is it worth asking GP to prescribe these?

from what you say weaning will not allow her to put on wieght!

sorry milk not 'mile'

i would ask the gp if you are really worried... how is she in herself? is she weeing and pooing plenty? is she happy? is she alert and playful?

what times does she have her feeds? could you do a dreamfeed (if you aren't already?)

maybe she wont drop more. tbh she seems a healthy weight to me, being born 5 weeks early and 6lb 3oz, and now weight 14lb 5oz, well she has more than doubled her weight hasnt she? how is she in herself? is she alert? wetting and pooing enough? i personally feel she doesnt need a supplement. but then i am not a HV/Gp or anything just a mum.

HV place too much empanthis on the bloomin charts. my dd2 shot off the charts, they told me to put her o na diet at 12months old. i made themcheck her height and again she was off for that.

oooh x posts misdee! lol

was also going to say the same as you... wait and see if she does drop more! she may not

i don't think i would worry unless she was actually losing weight

btw my dd3 has dropped through 2 percentiles, at 8months her weight stay pretty much the same for a month, she has recently gained another 2lb, but not by increasing solids, but by giving more milk. she is a skinny thing,m weighed 7lb 14oz at birth , 2 weeks early, now weighs around 18lbs at 10months old.

she feeds as follows:

7am - 3 ozs
11am - 4-5 ozs
3pm - 4-5 ozs
7pm 4-5 ozs
11pm 3-4 ozs

thinking of feeding again at 3am?????
sge does stir at 4ish but usually a dummy will put her back to sleep.

I'd try giving her a bottle when she wakes at 4am-ish, it may help.

There is a case for adjusting weaning ages for babies born pre-term - reason is iron, as babies born early don't get their full quota of iron stores which they build up all the way through when they are 'inside'.

There's no special worry about calories, though, and if this is the issue your HV has brought up, then (frankly) she is not well-informed (there's a surprise....).

Risk of giving solids as a way of addressing a slow weight gain is that the net calorie intake actually lessens - even a small amount of solids (esp rice) fill the baby up, take longer to digest, and as a result the baby has less milk than before, and therefore fewer calories. A baby of 20 weeks who seems to need more calories (and nothing in your post makes me think this applies to your baby, but your HV seems to think this is the case) should first off be offered more milk - maybe small amounts in between feeds.

Ask your HV her reasoning for her advice.

Hi similar story with ds born 5 weeks early though at 4lb 6oz. He gained weight well and at 15 weeks dropped from 50th to just above the 9th over a number of weeks. i was obviously worried but could see he was more active etc. I held off weaning till23 weeks but then he was ready and woofed food down. But he still has slow weight gains and thats just cos theres not the calories in food. He is just picking up his weight now but it takes time. I had a chat with HV and was really reassured as she said most babies do this, tail off the weight gains as they get more active. But when they are born early, small and arent brilliant eaters its hard not to worry. I think the thing is not to push weaning till they are ready and try not to worry if they are active with wet/dirty nappies. Easier said then done though!

thanks for words of encouragement

just seen GP who also advises weaning, but not to gain weight more but to get used to different tastes

she also prescribed 'Nutriprem' (Cow&Gate) a higher calorie formula given to preterm babies. she said it would help with weight gain but is perfectly safe?????i am to try this as well as 'gentle' weaning?

many conflicting messages so very unsure of best way forward

think i will concentrate on milk first using nutriprem instead if aptimal and introduce foods for taste not nourishment, once a day.
How does that sound?

just re-read your post tiktok. what do you mean when you say calories are not an issue in this case?

dropping centiles must surely relate to not enough calries being ingested on a daily basis??

I agree with Hunker's first post. My ds1 went down from 75th to 9th centile too and there he has stayed for a good long while. He's actually just been weighed and measured by school nurse and he's up to about the 20th but all through toddlerhood he was on the 9th - like Hunker says, he was born a biggish baby but found his own weight once he was out!! He's little just like I was!

I meant not in the case of prem babies in general...iron may be an issue for prem babies because they have not had enough time 'inside' to build up iron stores. So that might mean weaning ages are adjusted to compensate, as a baby born very early may not have as much iron to keep him/her going . In practice, this might mean an age-adjusted baby may have iron-containing solids a bit sooner. But he wouldn't have solids sooner because of a concern about calories....hope that explains it!