Failure to thrive? Please help...v.long

Hello all,

I am an Indian mom to 2 little girls (2.5yrs and 11 months). We

ls...

Is this HV a nurse, or just a social worker? I cannot believe she
would tell you to stop breastfeeding, feeding during the night and
co-sleeping. That's just insane. You should so what you think is best
for you and your baby.
It sounds like she's eating and thriving. It's not always how much a
baby gains, but the rate at which they gain.

I live in the US and have a friend here from India. Her son was born
weighing 2.5kg. She had to buy "preemie" clothes for him. My daughter

Anonymama...

I'm not Amy, but I do get that impression. If they're checking out the
condition of my house and that I have a stable home environment, then
there are similarities.

Iuil...

Well they're checking for signs of PND so that the mother can get
appropriate treatment asap rather than for signs that you're an unfit
parent.

Personally, I can fake my way though a 10 minute doctor visit whilst in the
throes of PND but a 30-40 minute visit at home would be much more
insightful.

(white) was born weighing 4.4kg. She barely fit into "new born"
clothes. Her son didn't weigh that much until he was 6 months old!
Ha!
We're all different. But the HV may have been comparing you too much
to the *average* person in the UK.
Going to the doctor might be a good idea. Maybe you could find one of
Indian descent.

Good luck :)

recently came to U.K. and we will be here for a year or so. We got
enrolled into NHS and today I had a health visitor come over. My DD2 at

Welches...

Right before you get too panicked:
Health visitors seem to be programmed to panic if a child under 5 years of
age is less than average weight. After age 5, they panic if they are over
the average weight.
My #2 is like yours. She was very active and skinny. But she's tall so her
weight doesn't look bad until you compare it with her height. I breastfeed
her (she's over 2) and she still isn't brilliant at eating solids. She
refused all solids until she was about 8 months. Had mostly breastmilk until
over a year. She still wakes at night for a feed. Some children are
programmed like that and if you're happy to continue I can't see the
problem.
Smile nicely at your health visitor, say "thank you" and take the advice you
want. Don't tell her what she doesn't need to know. If your child is healthy
and active then they're getting what they need.
If you're offering solids first then I'd continue the breast feeding.
I would see the doctor. Most drs. seem to know that the health visitors
panic like this. I've several friends whose children are just naturally
small and the health visitor says things every time they see her.I expect
you'll get reassurance from your doctor.
I really don't think you're at risk at having your children taken away.
Really.
Don't worry about that.
My doctor always says that if the mother thinks that their child is not ill
then the child is almost certainly fine. He has great respect for mother's
instinct: If I went in and said "she looks fine but I know there's something
wrong" he would act on that because he says the mother often pick up what
can't be seen.
"health visitors don't know everything!" is a good thing to remember.

Leann and Donald...

On that end, neither do doctors. It sounds to me like your child is
thriving just fine. My 3 year old (turned 3 in October) barely weighs 25
pounds. (I'm not sure what the conversion is). I know 1 year olds that
weigh this much. She has always been in the 3rd or less than 3rd percentile
and is just fine. She is a picky eater, but eats when she is hungry. I get
so annoyed at people who stress when a child is "too" small. Heaven forbid
if we make comments about children being too large, but we have no problem
telling a child or his/her parents that their child is too small/skinny.
IMO most children in the lower percentiles would have been average several
years ago. Don't forget that the percentiles are based on children today,
and in general children have gotten bigger.

(going back to lurk now)...

Debbie

11 months weighs a shocking 6.4Kg. Her HC was 43. I can't seem to
recall her length. I was shocked when I saw her weight. She has gained
only .5 kg since her 7 month visit that we had in India. My DD2 is very
quite thin (not all skin and bones but on the this side). Her main
'food' is my milk. Past one month she started showing interest in other
foods and has been eating little amounts of full fat yogurt, cheerios,
millet porridge and some fruits. She decides how much she eats which is
quite little like 2-3 table spoon full of porridge or yogurt if she is
really hungry. she likes to nibble on pieces of crackers. but again
does not eat much. Nowadays I offer her food before I breastfeed her.
But that hasn't changed her appetite for non-milk foods.

Penny Gaines...

[snip]

There are really two different issues here

1) the HV's advice
2) the baby's weight

Firstly: HVs do have a certain amount of medical training, but they
tend to have biases of their own. They also have to cater for everyone
from uneducated 16yo mothers up to well-educated professional mothers.
So they can be a bit patronising, and in addition their advice can
be a bit iffy. Its better then no advice, but you don't have follow
it.

Your baby won't be taken away just because you co-slept or anything like
that. Like other people have said, don't stop feeding at night, don't
stop breastfeeding etc.

If she only started solids at 10 months, this is relatively late, especially
compared to UK recommendations. I would expect most babies in Britain to
have started solids several months earlier then this.

2) The baby's weight. You said the baby was 3.1kg at birth, 5.9 kg ? at
7mo and 6.4 kg at 11 months. I've checked the charts at the back of my
red book health record (you may have been given one by the health visitor).

Head circumference of 43cm at 11 months is 0.4th percentile

3.1kg at birth is 25th percentile (6.8 lbs)
5.9kg at 28 weeks is 0.4th percentile (13 lbs)
6.4kg at 48 weeks is well below 0.4th percentile. (14 lbs)

That would imply a possible problem. The first action would be to
re-do the HVs measurements - they may have been a problem with
the scales or something like that.

cjra96...

That's possible, but I'd wonder first what's the average range for
people of Indian descent (in India or abroad) and compare to that,
rather than to a typical Western European. What's small in one place
may be perfectly normal in another.

Irene...

All very good points. I don't think the OP has told us her and her
dh's sizes, which would also help tell whether she's ok. But I would
definitely tend to think that your average Indian baby is smaller than
your average UK baby of non-Asian parentage. Since the baby sounds
like she is healthy and active, it sounds like a matter of different
averages to me.

My dd is also petite - about 5th percentile, but since her ped is
Chinese-American and has a daughter around 3rd percentile, he is not
concerned. ;-)

Irene...

Friends of mine, with their first child, the docs were overly concerned
with the baby's small size, but given both parents are *tiny* (mom is
Anglo and about 5'3" but weighs about 95lbs, dad is Indian, about 5'4"
and weighs probably 120lbs max) -them having anything but a very small
kid would seem strange!

And after working in SE Asia with newborns who were quite healthy but
extremely small by western standards, I've realised there are vast
differences.

I'd still follow the recommendation to see the doctor and look at any
possible concerns, however. I'm just wary of making comparisons - make
sure we're comparing apples to apples.

Stormlady...

Very good point!!

She started walking holding on to furniture etc when she was 6.5 months
and stood without support when she was 10 months. I would say she is
developmentally appropriate in her motor skills. She pees a lot and
poops once a day. And seems healthy in all respect. Not sickly or ill
at all. Never been really ill other than one or two colds.

The health visitor was obviously concerned and she said that I should
STOP breastfeeding and offer more food. I should not feed her in the

Ericka Kammerer...

Oh, puhLEEZE! The *last* thing you should do if
there's a possibility that she's not growing well is pull
the rug out from under her by removing the most reliable
and *nutrient dense* food she's eating! Sure, offer solids
before breastfeeding so that hunger tempts her to experiment

Welches...

They're not checking anything of the sort. If the mother does not want to be
seen in her own home then they have no rights to insist.
Debbie

more, but I wouldn't even think of stopping breastfeeding.
In fact, I'd make sure she got plenty of breastmilk.

night when she wakes up and should stop co-sleeping. I do not want to

Ericka Kammerer...

Huh? Again, if the health visitor believes that
she isn't getting enough nutrients, then why would she
recommend cutting out feedings?

do all that she is telling esp the stop co-sleeping and stop
breastfeeding parts. I can offer her more food and try offering more
often than just 3 times a day.

Dave {Reply Address in.Sig}...

The health visitor is concerned to be able to tick all the boxes on her
little check sheet and gets upset when a child doesn't oblige. If your
daughter is still gaining weight then she's probably fine. However:

Ericka Kammerer...

That's what I'd do.

She has adviced me to see the GP and conduct tests for anemia which I
will do. If they do not find anything wrong with her, do I need to be
concerned about her weight ad stop breastfeeding and put her on
formula? My instict tells me that there is nothing wrong with her. But

Kate...

Ah, well it was my Health Visitor who got me out of the house with DD by
suggesting I came along to the health centre's post-natal group when DD
was 2 weeks old. I just did as I was told but have wondered since
whether she suggested it because she thought I needed some company or
was at risk of post-natal depression - most of the other babies there
were a month or so older. I'd never have gone without her encouragement
and I'm still friends with 4 of the other mums I met there 4 years (and
second children) later.

Ericka Kammerer...

I wouldn't.

I will make it a point to check it out with the doctor. The HV did say
that the baby looks healthy and active and not skin and bones.

Dave {Reply Address in.Sig}...

Going to see the doctor and confirming things is harmless and most GPs
will tell you to trust your instincts anyway.

Ericka Kammerer...

I think it's quite common for babies who have started
crawling and are learning to walk to plateau a bit on weight
gain. All of a sudden they're burning more calories and it
takes them a bit to ramp up their consumption to compensate.

I am new to this place and I have heard that here kids will be taken
away from parents if authorities feel that they are not properly looked
after. I cannot even bear to think about that. I will not ignore what
the doctors tell me if it is for the best of my baby. All these years I
heard that breast was best and blah blah. Then why is it not doing the
best for my DD. Any advice, tips, consolation? I am so confused...

Dave {Reply Address in.Sig}...

Breast is best, it's just that not everyone has heard/believed the
message and still persist with old and bad habits and worse, try to
force them on those who know better.

Health visitors do serve useful functions and it's their job to look for
things outside the norm. With some recent unfortunate cases, they're
more likely to err on the side of caution and recommend checks (harmless
and keeps the government out of your hair if there is nothing wrong) and
give advice that might be somewhat outdated and wrong. Half of what they
do seems to be to scare the ignorant into conforming to the system
(which may be local policy rather than enforceable law) but once you
demonstrate you know the rules and procedures they'll go bug someone else.

Ericka Kammerer...

I don't see any evidence that it *isn't* doing the best
for your baby. I think your health visitor overreacted. I
would talk to the doctor, and there may well be cause to try
to get more calories into her, but it seems foolish to me to
take away the main staple in her diet right now, especially
since it is one of the most nutrient- and calorie-dense foods
you could offer her.

Best wishes,
Ericka

Many thanks for reading

Mom to N & A.