Healthvisitor has confused me!

[michelle33]

Hi,
I took my DS to be weighed the other day and at 9 months he is only 17.7lbs. He was born  at 35+5 weeks and was only 5lb 110z. My healthvisitor said that this is to small and to give him more food. She said that it is probably due to him having too much milk and not enough solids. He still feeds 3 or 4 times troughout the day and a couple of times during the night. He only feeds for about 4  minutes a time, sometimes less, but I think he is quite an efficient feeder.
 The Hv said that he should only be having at least 16 mls of milk a day, including whats in his food.
Do you think taht I should stop feeding him in the day so that he east more soilds? He isn't a great eater, he'll have about 3/4 table spoons of veg/meat/fish etc and a small yogurt. He isn't really interested in breakfast and will have about a 1/4 to a half of weetabix.
I am really worried now that he is to small and it's my falut. Any advice appreciated xx

[MasynSpencerElliotte]

As far as I know, milk should be the basis of his diet until he is one, and even then still very important. Spencer was on formula by 9 months and having upwards of 28-32 oz a day, we only cut back to 16 oz after she was 13 or 14 months old.

Now, about his size...17.7 lbs doesn't sound really shrimpy...Spencer was 19lbs at that age but super short, barely made the charts for height but was somewhere in the middle for weight.  Really, they can only make the charts if there are babies of all sizes!
What does your Dr. say about it? 

HTH
Heidi

[~inbalance~]

Ok, I am not the professional obviously but my mummy-instinct tells me that's a bit of crap the HV is telling you.  What I know is to the contrary, milk SHOULD still be the most important part of your LO's diet up until a year, and feeding more solids doesn't put weight on their bones. 

You LO sounds just like mine, in fact I think DS weighed about the same at that age (and he WASN'T premature, he was a healthy 7lbs 13oz at birth!).  DS was always a decent breastfeeder, and did well with solids.  And he has ALWAYS been on the low end of the scales for weight and gained weight slowly (despite enjoying his solids and eating well - more solids doesn't mean bigger babies!).  It's just the way he is, I know that and I don't need anyone to tell me he's not doing well.  I know he is happy, healthy and developing normally, I also know that DH and I are not huge people so it makes sense that our kids wouldn't be huge.  I myself was only 17lbs at a year, and there was never anything wrong with me!!

I think your DS is staying on his growth curve.  Is he developing normally?  Having lots of wet and dirty diapers?  He sounds like a normal 9mo to me!!  Adults come in all shapes and sizes, why shouldn't babies?  I agree that he doesn't sound too small for his age.

It's always important to keep an eye on how your baby is doing and be on the lookout for issues, but I think it's equally important to trust your mummy-instinct, and if it's telling you there's NOTHING wrong with your LO, then please don't let an HV scare you.  Talk to your doctor if you're concerned, and talk to other moms and I assure you you will see babies grow in so many different ways, it's not fair to compare them.

About the feeding, I WOULD NOT cut down on milk intake in favor for solids at this point.  It's hard to gauge a BF baby's milk intake, but at that age it's not uncommon for them to be getting enough milk in a short period of time.  Are you doing one side or both?  Some things you can do to try and get him to BF a little longer are switching sides, and compressing as he is feeding so that he empties the breast and gets to the hindmilk.  But really by this point I think he's probably got BFding figured out so he's probably doing a good job of getting what he needs.  You could always check out some more breastfeeding FAQs to see if there are other ways to encourage more intake, or if maybe your supply is low.

Sounds to me like your DS is doing GREAT! 

[donna_issabella]

Ask her to whip out a growth chart and chart his measurements prior to talking out of her blow hole (Oops, did I say that out loud?)

Your baby was prem, yes. Was born on the 5%. If you plot him on a normal chart - so not even one for a prem baby!! - he is virtually on the 10%, so going up on the centile charts, not crossing them downwards.

The other thing to bear in mind is his height. There is a reason they are supposed to weigh and measure them and do the headcircumference, as all should be evaluated as a global picture.

Milk should be the mainstay of nutrition until about 12 months, as babies cannot really 'extract' all the nutrition from solids like they can from milk, breast milk even more so.

I would ask for a second opinion before you try and stuff your baby with solids which might actually worsen matters instead of improving things! Adding some high calorie food might be useful, but not just the mere increase in volume of solids. If she is this concerned, has she at least referred you to a dietician?



ETA:

http://www.kidsgrowth.com/stages/viewgrowthcharts.cfm?id=BW036

Breastfed babies actually have specific percentile charts as well, as they are mostly on the smaller side. So for your DS to have gone up, is a good thing. Yes he is small, but he is consistent, KWIM? Also if you and DH are small or average in size, I would be surprised if you churned out a hulk of a 6 foot something rugby player. Not impossible, but improbable

[MasynSpencerElliotte]

Ask her to whip out a growth chart and chart his measurements prior to talking out of her blow hole (Oops, did I say that out loud?)

  

[deb]

D-I beat me to it - BW keeps locking up when I try to reply these days.

But yeah, he's already born early, DUH he's likely to be a bit under the non-adjusted chart measurements.

Sure, you want to make sure you kid is getting a nutritious diet and all, but for now, breastmilk and beginning solids IS all that!

I've gotten some pretty ridiculous medical advice from doctors and nurses too. to a lot of that!

[First Time Mom]

 
What is your healthvisitor smoking??

My dd was born at 10% on the chart and maintained from less than 0 on the chart and up to 10% on the chart for over 2 years. She's petit, both dh and I are quite slim. I was always concerned about her weight and my ped said to bf her MORE if I want to add weight for the first year and AFTER the first year to increase solids if I wanted to add weight BUT she added that dd was "just fine" and that "someone had to be low on the charts". No matter what I did, dd did not gain extra weight.

Your lo was a premie and my guess is that your lo is following his "line" on the chart, or close to it. If he is not and needs to increase his weight the way to do it for up to 12 months is to add breast milk NOT solids!

[michelle33]

Thanks for all your advice guys, has made me feel loads better, although I am stil slightly worried. At birth Harvey was on the 9th centile but then went up to the 75th. Now he is between the 9th and 25th for his weight. He is just over the 50th for his length and 25th for head circum so I guess that he is going to be slim and tall. I'm only 5 ft 2 and his dad is 5 ft 8 so we're not huge people.
I don't know how she expects me to add more food anyways he will only eat what he wants, and I think that is quite alot actually. I think maybe I should get him to take more bm. I'm worried though because when I go back to work in 7 weeks I have no plan as yet regarding feeding. He won't take a bottle and I can't get anything off by pumping. He will have sips of water from a cup but he isn't great with it. I also work shifts, 2 lates from 12 to 9 and 2 early's from 7 to 4. If anyone has any ideas i'd be grateful, time is running out and i'm getting worried. He is also a snacker as opposed to taking 4 feeds a day and as I said still feeds throught out night, god help me I'm going to be knackered. Anyways thanks again for making me feel better regarding weight and HV xx

[KellyC]

Honestly, I have to agree with the others, he sounds like a perfectly healthy 'normal' 9 month old but you're the best judge of that - were you at all worried about his growth and/or development before his weight was plotted on a graph by the HV?!  Somebody has to be on the lower end of those graphs, the same as somebody has to be on the higher ends - our babies can't all be on the 'average' line.  Breastmilk is still fantastic for him at his age (any age really, but he's only 9 months old for goodness sake!) and it doesn't sound like he's having excessive amounts in place of solids.  Of course, you can make sure your day is structured so he eats the best for him (ie. he doesn't have his breastfeed too close to his solids and vice versa) but after that it's up to him.  I think if your routine is structured appropriately and he's being offered a wide variety of foods from across all food groups then you're doing all you can.  {hugs}

Kelly x