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Centile Charts have a Special Place in Hell

Uncategorized Dec 04, 2017

If you work in the area of health and wellbeing looking after babies and kids in your community, look away now! Based on my experience, allow me to make a sweeping generalisation: centile charts are not the be all and end all.


If there is one message to mums, especially new mums, that I’d like you to take away from me, it is this:


trust yourself.




As a member of numerous reflux support groups on facebook, and one of the biggest complaints I'm reading about in my Reflux Survey, is that if baby is putting on weight, baby is fine, or baby cannot have reflux.  Centile charts are used to beat mothers into submission, to tell mums that they are paranoid and undermine their gut instincts.



In addition, centile charts are used to scare mums into not trusting themselves.  If baby changes which centile line they follow, health visitors raise an eyebrow.  This was my personal experience, told me I should be prepared to supplement my daughter with formula because she dropped a centile line.


The problem I have with centile charts is not about measuring baby's weight, progress or health; it’s about health visitors and mums' confidence.


I trust that the health visitor believes they are acting in baby's best interests, but they are generally following a “rulebook” and applying rules where none (or at least simpler ones) should apply. 


But NO BABY has EVER follow a "RULE".


And in reverse, if a baby is gaining weigh, parents are told by health visitors and GPs that "baby cannot have reflux because they are gaining weight".




I'm not sure that health visitors comprehend the severe impact their words have on a mum at the most vulnerable time of her life.


Parents are not allowed to trust their own instincts that their screaming unhappy baby is in pain. 


Not only are parents knackered, unable to get a good night’s sleep, but they are also solely responsible for the life and sustenance of another human being! 


Let me say once and for all. (And I apologise for shouting but I feel it needs to be heard.)








Feels good to shout once in a while.


How do I know this? Well, I'm an engineer by training and I understand statistics. Here’s my take.


The growth centile charts are a graphical representation of the growth of thousands of babies. If you take a reading of the weights of babies at 1 week old, the chart would show that only 2% of babies were under X weight and 98% of babies were under Y weight. You have a reading for each of the centiles. Moving to 6 weeks, we could do the same. There would be 2% of babies were under X weight and 98% of babies under Y weight and so on. So, the charts show growth of a group of babies over a period of time in their lives.


Yet, what these charts do not tell us is the growth trajectory any individual baby or what growth should be. And in that regard, every baby is different. No two children will grow at the same rate, have the same ratio of length to weight to head circumference. 


What these charts do tell us usefully is that babies should always be gaining weight and physically growing. If this is not happening, or if baby lies outside the <2% and >98% marks, we might want to keep an eye on them. If baby loses weight, this is cause for concern.


If baby gains excessively (or is way above the 98% mark), then we also need to understand more. Remember, a little baby could do a poo the hour they’re weighed that literally weighs 200g (1/2lb!) and resultantly could drop two centiles just because of the timing of their bowel movements!


Over the last 100 years, Western culture has beaten instinct, intuition and gut feeling out of us, so much so, that us women sometimes trust what certain men (like, highly qualified consultants in a fancy hospital office) say about giving birth more than the women in our lives who have done it, or supported it, such as female midwives and doulas.


We have become so used to trusting our doctor that we forget to trust ourselves, our observations, out gut instincts.


Ask yourself this. If you wanted to know what the new restaurant in town was like, would you ask and trust your best friend who had been there several times or a stranger in a town 100 miles away whose only knowledge of the restaurant is from the website?


Why do I suggest trusting your intuition over your baby’s numbers?


Because I hear of far too often that many babies are truly suffering and in pain, but being ignored by their GP because they are gaining weight. Just because a baby is gaining weight does not mean there is no reflux, colic, allergy or intolerance problem. No amount of suffering is acceptable. Being brushed off as a neurotic mum is not okay.


If your GP tells you your baby does not have reflux because they are putting on weight, call them out on their BULLSHIT.


The centile charts can be useful to see if baby gaining too much weight over several periods (for instance, comfort-feeding due to pain of reflux), losing weight, or on a trajectory that indicates less-than-ideal health. The sooner babies who need support can be identified the better, so we must use the tools available effectively.


We should not use the tools as a way to beat up mums.


That said, I disagree with medicals telling mums that, because their baby is gaining weight and on a good centile line, everything is okay.


If baby is suffering with ongoing discomfort and pain, regardless of weight progression, this should be given fair and due attention.




You are the expert on your baby.



My book, The Baby Reflux Lady's Survival Guide is out now and has so much more information on what you should be looking for to support your baby.


You can also subscribe to my email list to get a free guide: 12 Questions to Ask Your GP about Medications.


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