Centile Charts and Weight are Being Used Against Babies with Reflux
If you work in the area of health and wellbeing looking after babies and kids in your community, look away now! I hate infant centile charts. There, I said it. 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:
One of the biggest complaints I often hear about is that if baby is putting on weight, baby is fine, or baby cannot have reflux. Centile charts are used to beat parents into submission, to tell parents that they are paranoid and undermine their gut instincts.
In addition, centile charts are used to scare parents 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.
My Issue with Using Centile Charts in Supporting Babies with Reflux
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 followed a "RULE".
And in reverse, if a baby is gaining weight, parents are told by health visitors, public health nurses, doctors and paediatricians that "baby cannot have reflux because they are gaining weight".
I don’t think that health professionals comprehend the severe impact their words have on a mum at the most vulnerable time of her life. This is gaslighting, and I believe it is unintentional.
Parents are not allowed to trust their own instincts that their screaming unhappy baby is in pain.
Not only are parents exhausted, unable to get a good night’s sleep, 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.)
BABIES ARE NOT SUPPOSED TO FOLLOW A CENTILE LINE! Up, or Down.
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 as a group.
How this works in practice is:
If you look at the charts, and take 2.75kg at 7 days old, the charts inform us that 7.5% of babies of this age were on or below this weight. And for the same age, 80.2% of babies were 4.2kg or less.
If we jump along the timeline to 3 months of age, we will see that 2.1% of all babies (in this large representation group) weigh 5kg or less, that 50% of babies weighed 6.4kg or less, and 96% of babies weigh 8.7kg or less.
Importantly, what these charts do not tell us is the growth trajectory any individual baby or what their 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!
Trust Your Gut
Over the last 100 years, Western culture has beaten instinct, intuition and gut feeling out of us, so much so, that we 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 our mothers, our friends, other mothers, midwives and doulas.
We have become so used to trusting our “doctor” that we forget to trust ourselves, our observations, our 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 your baby is much more than numbers. I hear of far too often that many babies are truly suffering and in pain, and being ignored by their doctor 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 doctor or paediatrician 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.
And on the other hand, 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.
How is Reflux Connected To Weight?
Reflux can cause pain and discomfort of stomach acid burning and irritating the oesophagus. Babies learn very quickly that milk washes this acid back into the stomach, so some will ask for more milk to soothe the pain. And these babies may end up over-eating and so gaining weight quicker, jumping the centile curves.
For babies who vomit a lot of their milk, this could be that they don’t keep sufficient milk in their bodies to gain weight properly and so are classed as “failure to thrive”, or they may even lose weight
There is another group who vomit a lot AND over-feed, leaving them following a “normal” curve on the centile growth charts.
The important thing here, is that weight on its own is NOT a reliable indication of reflux or not. We can use it to understand more about baby and their discomfort, and as a guidance of what we could do to support them, but only in conjunction with everything else that is going on for them.
So What is the Answer to Reflux And Weight?
When baby is experiencing reflux, the answer lies in understanding WHY baby is uncomfortable and what is causing this discomfort. When we resolve the discomfort at the root cause, your baby won't need to ease the discomfort because it won't be there! Then they will more consistently ask for milk on a hunger rather than a comfort basis.
Your doctors do not apply this approach because the NICE guidelines does not tell them to 🤦 ****
Get your free Reflux Symptoms Tracker in the box below to get started on understanding what the root cause of your baby’s reflux is.
Or just the queue and get the Reflux Free Baby Workshop which will walk you through everything you need to know so that you can start on your journey to Reflux Free as soon as possible, it could be just a few days away!
How to Cure Baby Reflux
The starting point for ALL babies and toddlers, regardless of their age, is to understand what symtpoms they are expericing that are connected to their reflux (this includes colic, silent reflux, CMPA and other allergies and intolerances as they all have cross-over symptoms).
Download your free Baby Reflux Sypmtoms Tracker right now and get started by understanding which of your baby's symptoms are related to their reflux.
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