Dropping Percentiles...

cyanope

A little back information:
LO was in the 78th percentile at birth, but dropped a significant amount of weight in the first week. It took us over three weeks to get back up to birth weight, and by her one month appointment, LO was in the 24th percentile. She has had two weight checks since then. One at seven weeks, where she was in the 18th percentile, and then one at almost ten weeks, where she was in the 13th. She weighs 10 lbs. 1 oz and will be ten weeks tomorrow. LO is a great eater. Every two hours on the breast, and when I'm at work, she eats 4 oz of pumped milk every three hours. She is gaining weight, and has plenty of poopy/wet diapers...but she is still dropping percentiles. My ped suggested that we try to increase her feeds while I'm at work (4 oz. every two hours instead of every three) and to try to increase the amount of time she's on the breast at every feed. My fear is that she don't take well to the increased feeding. If LO doesn't want to eat...she won't. I know LO gets plenty at each feeding, but she is still so tiny, and not maintaining a growth curve. I feel like I produce skim milk or something!
Has anyone else dealt with this type of situation, and if so, what did you do? What did your Ped suggest? Did you end up having to fortify? Any stories of similar situations should be much appreciated...I'm stressing over here!

alisongem

If she's staying hydrated (wet/poopy diapers seem good) then percentiles is really just a number. It's a way of comparing babies to the average of other babies. So if there are 100 babies in one room, yours stared out having 22 babies bigger than her. Now she has 12 smaller than her. She's just little:) I wouldn't worry unless she seems dehydrated. 

alisongem

Also I wouldn't over feed. If she's not hungry don't make her eat. It will cause tummy aches and more spit up. 

Kimberlyain

I have no words of wisdom, but my LO is under the 5th percentile for height and weight and is dropping in her height percentile. I think was others have said is true the percentiles don't mean much and as long as they are growing and having normal wet/poop diapers they are fine. 

l4rk

My LO will be dropping percentiles once we start tracking on the charts. She was born big but is gaining weight slowly: 6.5 oz over the past 2 weeks. I read the advice "look at the baby not the scale" (either Dr Sears or Kellymom) and it rings true for me. If your baby is healthy, alert, feeding on demand, and meeting milestones, then the exact weight gain isn't really important. I'm considering declining to weigh her in the future because it's too easy to obsess and worry otherwise.

nackie

Mine was also dropping in the percentiles despite spending 20-30 minutes/side at each feeding (every two hours).  Our pediatrician was concerned even though he has a ton of wet/poopy diapers.  She told us to limit the time at the breast and supplement.  The LC I met with agreed with that approach.  I did a weighted feed and even with all that time he's still getting less than two ounces from me.  We started supplementing on Monday and he's already been sleeping better

teachmegs817

DS was born 6 weeks early, so I am not sure how preemie babies fit into this situation as most Pedi. would expect them to be smaller, but LO just turned 3 months old today and while we don't have an exact measurement, according to when we weigh him, he's just over 10lbs.  He was only 7.9 at his 2 month check up (in the > 5th percentile for everything except his darn head size, which was in the 25th) and the Pedi. said nothing to us about making sure we increase the amounts he eats in an effort to fatten him up, lol.  She was happy with his weight gain and that he was putting out enough wet/poopy diapers. 

Mommyduclos

My kiddos drop off their curve but usually when they get a little older than this. Then they stop dropping and maintain. We've had a couple extra growth checks for my first. He's always passed (has a growth spurt that brings him back up or whatever) but the ped mentioned doing blood work if he doesn't. If you are getting good diaper output I really doubt your little one isn't eating enough. So either she's just little and will start maintaining shortly or maybe you could ask about blood work to make sure everything is a-ok I know a mom who's kid stopped growing and they discovered he wasn't producing growth hormone. Treated the problem and he grew like a weed. 

Bunnumber4

My Son is also dropping percentiles. It seems like you know, but the concern isn't with how big she is, but if she isn't keeping up with gaining like she should (which causes dropping percentiles). There can be a few reasons this happens 1. Not getting enough calories (not eating enough, spitting up, formula being mixed incorrectly, not producing enough BM, etc) sometimes this is temporary and caused by a cold, learning to feed efficiently, etc. 2. Not growing enough can also be caused by the malabsorption (not using what the body is taking in).

Also, Some babies are also just going to be small and they will drop percentiles and then start holding steady.

It sounds like your ped is on top of it and is trying to make sure your LO is getting enough calories. If she is getting enough to eat and doesn't level off then there could be something to look into, but I certainly wouldn't stress now. Just focus on making sure she is full and eating as much/often as you can without forcing it down her throat. 

@l4rk I would be cautious about refusing weight checks, there is a reason they are done. I agree that weight doesn't really matter (as in a 10 lb 2 month old can be just as healthy as a 13 lb one) but failing to gain appropriately can indicate problems. Looking healthy and meeting milestones is certainly huge and usually means everything is fine, but it also doesn't guarantee that there are no underlying problems that are manifesting itself by slow/ no weight gain.

cyanope

 Thanks for your responses, everyone!  Little one is definitely eating enough ounce wise, the concern is just whether or not she is getting enough calories. It may just be my breast milk. We will talk about supplementing  with formula at her next weight check, which will be in three weeks. She is healthy otherwise, looks great, and is meeting all of her milestones. In fact, she is ahead on most of them. My hope is that she's just small, and there are no other underlying issues. 
Edit: spelling

rah938

Maintaining a small curve and staying at the 5th percentile over time is very different than dropping off a curve. Pediatricians worry about growth because it affects development.  So to say it's just a number isn't exactly true. Weight and then height and then brain growth/development are affected by nutrition in babies. So while I am not saying worry over it and obsess, don't treat it like it shouldn't be addressed either. If a pediatrician lets you decline weight checks, I'd find another one. 

MissMheMhe

My son dropped off the charts at his 2 month appt. Turns out he isn't getting near enough bm while nursing. I had no idea because he seemed content. I guess he was getting just enough to take away hunger, but not enough for adequate weight gain. I've been doing weighted feeds and pumping after he eats to supplement. Sometimes I don't get enough while pumping so I give him formula. He's up 1lb in one week of doing this.
If you don't have access to a baby scale, I'd def go in to your peds office to do weighted feeds. Sometimes, LLL or a local LC office will let you come in to do them. There is even a baby store in town that has a nursing room and scale for people to use. Good luck!

tennistar4253

*lurking from Dec15*  I have had the same problem with my son. He was having plenty of wet/dirty diapers, hitting all his milestones,  etc but wasn't gaining weight. At his 2 month appt he had gained less than a pound over his birth weight. His doctor had me test a few things (giving him pumped breastmilk after every feeding, switching to just formula for a few days, etc). Turns out I do produce "skim" breastmilk and we have had to supplement with a lot of formula to get him enough calories. Once we started that he gained over a pound in 4 days! It's hard emotionally to know I can't give him what he needs but he's doing great and finally starting to get little fat rolls which I never thought I'd be so happy to see.  Good luck to you and your LO. Hopefully it's just a calorie issue for you too and no underlying problem. 

leap_frog

My middle guy (9) dropped OFF the charts but still followed a growing curve. As of his last physical he is now in the 13th percentile. Which is huge! My pedi always said as long as he's growing, there is no need to worry. 

l4rk

@Bunnumber4 Yeah, I'm going to talk to the midwife at my final appointment next week to get her input and then I will be in touch with our public health nurses if she thinks I need to be concerned. I mentioned my weight concern to the doctor and he kind of blew it off because she's in the 51 percentile but it was our first visit with him. My doctor is a family doctor (not peds) and he didn't even touch my LO, which I'm pissed about, BUT there's a huge doctor shortage in my town so they don't let you switch. I teeter totter between being completely stressed about her weight and looking at her and concluding she's doing just fine. Looks like I'm back to totally stressed.

babym418

Did you try adding more healthy fats to your diet? I was having issues before and was needing to supplement with expressed breast milk after some feedings when LO was showing signs she was still hungry. One thing my LC told me was to eat avocados and almonds to increase the fattyNess in my breastmilk. It has seemed to help DD. She started making better weight gains and sleeping better. Unfortunately for me I started the mini pill and my supply dropped. So now we are looking to start supplementing with formula because we've gone through most of my milk stash.