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Baby weighing is one of those classic contentious issues. Many parents like to have their babies weighed every week, and many health visitors are happy to oblige – in fact many parents are actively encouraged to have their babies weighed so frequently, and this can lead to parents feeling worried and undermined.
I assure you that it is unlikely (I hope!) that any health care professional consciously wants to disempower parents, but the fact remains that constant testing can have this effect, however subconscious it is.But having your baby weighed this frequently can be very worrying and undermining to new parents. It’s just one more way that a mistrust in your ability to parent is implied.
It can also lead to parents being pressured unpleasantly to stop breastfeeding by health professionals who aren’t trained enough to know how to support breastfeeding mums. So this weighing babies business is an important issue.
Why do we weigh babies?
Babies’ weight is a nice clear sign that your baby is growing. It can be plotted on a chart, which most people like, and which makes it objective so that continuity of care isn’t so important – it doesn’t matter if the health visitor you see this week is the one you saw last week.
Why not weigh babies?
Because it is only one sign that your baby is growing and weighing babies every single week can show anomalies that aren’t important in the slightest but can cause health visitors and parents are likely to worry and panic.
This often leads to health visitors talking very forcefully about formula milk if you’re breastfeeding (ideally, if a baby isn’t getting enough milk, and it’s important to the parents that breastfeeding continues, then the breastfeeding should be fixed, not abandoned), and further check-ups if you’re formula feeding.
Or you can be sent to the hospital for paediatrician appointments, x-ray checks and blood tests – a scary and worrying experience, which could well be entirely unnecessary.
Why are weight charts so unreliable?
Firstly, if your health visitor is using the old charts, often referred to (erroneously) as ‘formula feeding charts’, then these are actually very inaccurate. They were created using the data from hundreds of different research studies, which you may think is good, but actually all of those research studies were done very differently.
Some had just breastfed babies, some had just formula fed babies, some were mixed. Some were longitudinal (followed babies from birth for the first few years) and others were not. This has produced charts which don’t actually tell us what is physiologically normal for babies, just what is ‘average’.
What the World Health Organisation has done to produce the new charts, often (erroneously again) called ‘breastfeeding charts’, is to do a massive longitudinal study of exclusively breastfed (for the first six months) babies over the first few years of their lives in various countries around the world.
This was not so they could produce charts that showed how breastfed babies should grow, but so they could produce charts that showed how all babies should grow, because what is physiologically normal for human babies is for them to be fed human milk for the first six months of their lives.
However, even these charts aren’t perfect if they’re not being interpreted by someone who really knows what they’re doing and this is sadly often the case. It is often forgotten that weight is only one sign that a baby is thriving, and in the absence of any other signs, should not have so much emphasis placed on it.
Here’s an example of what can happen and often does: a baby of shorter than average parents is born large – over 8lb for example – but then they need to ‘catch down’ to the weight they’re meant to be, and this manifests itself as dropping centiles (those lines that health visitors are so keen on!) which really worries health visitors.
It doesn’t worry health visitors if they look at your whole baby and not just the chart. If they see your baby is developing, and growing; healthy, and happy; and born, for example, to shorter than average parents, then they’re likely to just say: ‘OK, bring him back in a month and get in touch sooner if you worry about anything else.’
Are you saying I shouldn’t get my baby weighed? Surely there’s a happy medium?
No, I’m not and yes, there is. The Royal College of Paediatrics and Child Health recommend that babies are weighed a handful of times at birth – this is the age when weight gain is important, although it’s normal for babies to lose a little weight in the first few days after birth. After two weeks of age, babies should be weighed no more than monthly and that it is perfectly all right if they’re only weighed at 2, 3, 4 and 13 months of age. Only if there is some other concern should babies be weighed more frequently than this.
Of course, parents of third and fourth children often only ever have their babies weighed at birth, but by this point they may have broken free of the worry that they won’t be able to parent their own babies without ‘expert’ intervention, and they trust that they will know if there is anything to be concerned about.
It is entirely normal, as a first time parent, to need this external validation that you’re doing a good job, but try not to rely too heavily on weight charts and trust that you will very likely know when your baby isn’t growing enough and can get in touch with your health visitor then.
Images: Heather Posey, Flickr; Healthy Start Sarasota
I got mine weighed weekly, even though the HVs said it didn’t need doing (twins, BF only). I found it encouraging to see that they were gaining weight, even when I worried that they weren’t getting enough milk. To me it was proof/reassurance that they were getting what they needed (regardless of centiles, just in terms of actual weight).
Yes, it can be very reassuring – should have put that in really. But only if it’s going well – it’s when it doesn’t go so well that it can start causing problems.
Good post. I had rows with, erm, someone, on this subject. Back when she had kids it was the done thing to rent baby scales from the pharmacy (still possible over here in France) and weigh daily. I was insistent on not weighing any more often than the obligatory paediatrician appointments: Day one and three then monthly up to 6 months, then nine months and twelve months (over here we don’t have health visitors).
I’m no expert but I would agree that weight is so up and down within short periods (I’m talking an ounce or two not obviously massive leaps) that it would be far too easy to panic and visit the paediatrician needlessly.
New mums have enough to worry about, and there are other signs that a baby may not be doing as well as we hope.
Daily!? :-O
Yes, the normal up and down thing is why they don’t recommend weekly weighing.
Yes, daily. And I’m not afraid to say that this led to almost weekly trips to the doctor for her two children, who were then treated for various non existant illnesses with antibiotics etc (the French used to love their pills and potions and doctors will treat unecessarily if you bother them enough) and two grown up hypochondriacs several years later.
I could go on. And on. But suffice to say we have enough to worry about and it is fairly obvious when a baby is not healthy. I think they recommend over here now that premas are weighed more frequently but only for a couple of months.
Premature babies is a different matter entirely, but yes, I agree that parents are likely to know when a baby is ill. I think that the health care system is very one-size fits all, though, and the regular weighing has another motive personally…
What motive would that be, just out of interest? I have my own theories too :)
Hi Jane
Personally, I think it’s about getting parents to come into the clinic so they can be checked up on regularly. Of course, some parents need this, but I doubt it’s the ones who would be concerned about coming in regularly to get their babies weighed who do need it. What do you think?
HV / Sure Start people making themselves look busy (possibly to fulfill government quotas) in a climate of cutbacks in these services. At the expense of people who don’t need a close eye kept on them.
Hmm, now that *is* an interesting thought!
Like I said on twitter, I weighed my first baby every week without fail. He always gained well and steadily so it was reassuring and never posed a problem. However number two was weighed a handful of times as a newborn and since then he has been on the scales maybe… 3 times? 4 at the most. I haven’t even recorded most of them on his chart, much to the dismay of the health visitor who was there last time we went to baby clinic, haha. My own health visitor is ex-LLL, and therefore knows her stuff when it comes to normal breastfed baby weight gain so no issues here.
I did get mildly concerned a little while ago when I discovered that littlest had dropped a couple of centiles but I quickly got over that. I have no problem with milk supply, he eats well and is happy and thriving. He’s just tall and lean (takes after his dad) :)
Great post!
Thanks, Imogen. Sounds like you’ve got a great health visitor there :)
This is a great article. I had 2 children that were born healthy and even on the big side but both did a big nose dive off the charts once they hit 3 months. Health professionals wanted to weight them both weekly and they were sent for numerous tests because i was told there was something horribly wrong. my 2 and a half year old is now a perfect size and my now 1 year old is still incredibly tiny but that is obviously just her she is very happy and healthy and eats more then me most days
Thanks, Jenna. I had a baby born average size, then dropped centiles. At eight she’s now the perfect weight and height for her age, and very, very healthy and strong :)
HV‘s wanted my eldest weighed every 2 weeks which just led to them making me worry when he started dropping centiles. He was just catching down, I was only little when I was his age and DH is smaller than average. So it seemed normal to me, but the HV‘s worried and constantly questioned what I fed him and so I worried too (and felt useless). I remember being so stressed about weaning because of it.
Weighing can be reassuring when they gain according to the charts but when they don‘t it can cause unnecessary worry. He‘s almost 2.5 now, on the small side, but fine. Needless to say I don‘t get DS2 weighed that often, no HV has batted an eyelid at this, they seem more relaxed about 2nd babies.
Thanks for your comment, Junemummy. I agree entirely that it’s fine when it’s going well, and a possibly unnecessary worry when it doesn’t.
Good post. Thanks!
One problem, I believe, is that many health professionals either don’t themselves understand or don’t empower women with an understanding of the maths behind the charts. Essentially, the charts do not show ‘healthy’ or ‘unhealthy’ weight, nor ‘acceptable’ or ‘unacceptable’ rates of growth but simply population averages based upon logarithms and normal distribution curves… and therefore, not fixed absolute norms but mere statistical constructs. This means that babies whose genetics or ethnicities predispose them to be bigger or smaller than the average are often seen as abnormal when they shouldn’t be.
The other problem, I believe, is the climate of suspicion and paranoia which surrounds the whole task of child health surveillance, and the way in which health professionals are expected both to engender the trust of mother and to regard them as potential child abusers. A friend of mine was reported with ‘safeguarding concerns’ for refusing to bring her (9th centile but entirely healthy) son to be weighed each week. Her health visitor then expressed surprise when the friend chose to seek help from elsewhere with her breastfeeding difficulties.
And then (sorry, excuse the essay) the problem then becomes what the constant experience of weighing becomes for the parents of the small minority of babies who do require such constant growth monitoring. In some areas, clinics are set up in such a way as to encourage socialising and peer support between women. But in others, the very clinical focus of the set-up is still – and, as you say, unintentionally – tend to disempower women.
OK, essay over.
LOL – essays are good!
I don’t envy health visitors their job at all – damned if they don’t and damned if they do. I’m really shocked that a mother got reported for refusing to bring her baby in for weekly weigh-ins, though :(
I am surprised at the RCPCH’s recommendations! Not in a bad way, but you would never have guessed that those are the recs the way some HVs and mothers go on. Weight seems to definitely be one of those things groups of mothers like to compare, as well, which might put another pressure to go into the clinics. I hardly ever get my son weighed, although a large reason for that was he went through a phase of not enjoying getting dressed/undressed/nappy changed. I didn’t really want to put either of us through that if not necessary. I did get him weighed to make sure he wasn’t getting too big for his car seat, though! (Wasn’t even close to the limit, but I had no idea!)
There does appear to be a bit of competition between some mums – I wonder where that stems from? And I think car seat weighing is a very sensible idea – no need to do that weekly though! ;)
It says in my little one’s red book that he shouldn’t be weighed more than once a month between 2 weeks and 6 months; then once every 2 months until 12 months and once every 3 months after that. It also says ‘weighing your baby too often may cause unneccessary concern’ and that most babies wouldn’t need to be weighed more often. It also implies that only children on the 0.4th percentile will routinely be checked by a paediatrician.
Of course, my HV has been saying to bring him to the clinic more frequently than that – however, the red book does also say to remember you can go to the clinic without having your baby weighed (although to be fair how many people would do that?!).
I know the books have changed recently (a girl who had her baby 6 weeks before me got the old yellow version) – so maybe the ethos is changing?
I’m going to something called Expert Mums at a local(ish) Children’s Centre – which is trainee Drs and senior nurses getting used to healthy babies, and to weighing and measuring them – which does mean he’s getting weighed more often but seeing as he’s been rampaging up the centile charts at a rate of knots this hasn’t caused me anything but amusement. (He was 75th percentile when born; now closer to 98th than 91st. Fully breast fed and at 18 weeks has never had anything but breastmilk, vitamin D, infacol and gripe water (and not much of the last two either!). Yeah, I’m proud :) And I like the ‘expert mum’ bit – the ethos of it is that the mum is the expert on her child and the med students are learning from us. I think that’s the right way round, and if they can keep hold of that ethos they’ll end up good doctors!
Basically if my child starts massively dropping centile lines and I’m worried, honestly? I’ll skip the HV and go straight to the GP. But as long as he’s cheerful and happy and peeing and pooing lots, I’m happy too.
Err, sorry for the essay :)
LOL Lots of fantastic essays in the comments on this post!
That Expert Mums scheme sounds fantastic! I do agree, though, that whatever the red book says, it sounds like lots of health visitors haven’t actually read it themselves!
Great post & topic!
With my oldest, I just followed the “rules” about vax and, so, he was at the doctor’s often throughout his first two years of life – and weighed at each appointment. He was exclusively breastfed. At 4 months old, and every month or two until he was 2 years old, his doctor had him poked for anemia tests. He was skinny and pale, so the doctor was concerned. I must point out that we lived in Los Angeles, CA at the time and majority of his patients were Hispanic. It never occurred to me that the doctor was comparing my son to his other patients and not looking at myself and my husband (both tall, skinny, and pale!) By the time my son was 2 years old, I began to learn of the dangers of vaccines and alternative medicine. He only saw the doctor once a year for a physical and rarely when he was ill.
Fast-forward 10 1/2 years and we come to my little guy. He saw a doctor when he was 10 days old. Because we wanted to delay and possibly completely avoid vax (which we have since done), we could not find a doctor who would accept him. That 10-day-old appointment was the only one he had until he was 2 years old! He was never weighed after that, but I knew he was healthy. Thin? Yes. Pale? Yes. But he was growing steadily, had a healthy appetite, and had more energy than I could keep up with!
Goodness me! You can’t get a doctor for your child if he’s not vaccinated!? That’s awful. Thankfully the UK system is clearly better in some ways. Although some doctors do like to tell parents off for not following the rules, they would never refuse treatment, and some doctors are very open-minded.
I remember with my son , who is now 2 1/2yrs old, i used to get him weighed every few weeks or so…..i used to worry myself he wasn’t taking enough formula as he wasn’t taking as much as the ‘guideline’ on the tin said he should be…..A very sensible health visitor said without even weighing him “does he look unhappy/underweight/hungry etc etc??…babies can’t read & don’t care what it says…..he’ll take what he needs” some of the best advice as a first time mum i ever had! :-))
That’s great you had such a good health visitor!
My baby is 9 weeks old and has been weighed weekly for several weeks in a row. With the exception of two weeks where weight was static (2 weeks apart, likely cause of lack of weight gain was identified and acted on) baby has gained weight each week. I want to move on to fewer weigh ins and want to know if I can reasonably expect to let the health visitor / clinic know this without them getting the wrong end of the stick and reporting me to social services for bad parenting (worst case scenario). If getting my baby weighed is compulsory, I’ll stick with it but if not, I think my baby will do fine without weekly weigh ins.
Hi Jane
If you’re in the UK, then weekly weigh-ins, even visits to the health visitor at all, are not compulsory in the slightest. Is it a walk in clinic? If so, then just don’t go – it’s likely nothing will come of it. If you make appointments, then just say ‘I probably won’t come for a few weeks – I’ll call and make an appointment when I next feel I need to get him weighed’. How does that idea feel?
Thanks for the helpful advice. After reading it, I did something along those lines and (I think) the clinic / health visitor is OK with the situation. After a satisfactory weigh-in, I told HV I’d be getting baby weighed at least once a month, either by her / clinic or my GP. Up till now, it was weekly appointments with HV at a walk in clinic. I wanted to see less of her / clinic as I was increasingly unhappy with some of the things said and done during appointments. Final straw for me (although I didn’t show it at the time) was where HV showed up for a pre arranged home appointment – with her supervisor in tow…! I didn’t know about the supervisor in advance. It made me feel like I was being spied on (I didn’t much care for that) and that given half a chance, HV (and others connected to them) could have a lengthy (and unwelcome) presence in my life. The visit itself went fine, though :) I wonder if HV didn’t go away with egg on her face. I think you can guess I will be opting for weigh-ins via my GP rather than HV / clinic, from now on ;)
That sounds like a lot of pressure! Although it seems as though you’re happy with how you’ve taken control of the situation :)
I’ll be happy when I’ve successfully got through several weeks without any “well meaning” contact / correspondence from agencies tipped off by the HV…! I won’t miss going to clinic. I feel bad for thinking it and can’t detail specific incidents, but the HV / her team and the linked local Sure Start centre people are worthy of a sketch in the League of Gentlemen programme :/
Eek! Good luck on avoiding them, then!
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i know its a year since this article was published, but i just wanted to share my experience. My health visitor told me that my exclusively breast fed 4 month old baby was gaining too much weight, and as a result would have decreased mobility and not learn how to move and walk, and that he was eating out of habit as opposed to being hungry, so i should only feed him every 3 hrs and wean him early. She said this because my perfectly healthy baby who is on the 98th centile for length went above the centile line for weight. even though he has been able to support his own head since birth, and bear his own weight since 3 months, she still decided to give me this advice, which as a first time mum worried the hell out of me, and almost gave me PND. I have done much research which contradicts her advice, but after reading this article, i went and read the red book, which states that only when a baby is over 12 months and over the top centile line would they look into weither a baby is overweight, and that all babies gain weight differently. Why dont the health visitors read the books they give out, and understand that their ignorance can be hugely damaging. Needless to say, i have not and will not be going back to the weighins!
Sounds like you were really able to dig down deep enough to hear the truth, Elen. Thank you so much for taking the time to comment here and tell me about it :)
Really enjoyed reading this article on weight. My baby girl was born large at 9 lbs, she lost nearly a full pound after birth and took 4.5 weeks to regain her birth weight. The health visitor had me worried sick acting like something was wrong. She sent me to gp who told me to stop breast feeding as my baby needed “more beef on her bones” I switched to combination feeding and by 8 weeks dd was on formula only. Her rate of weight gain remained the same. She quickly dropped to the 25 th centile and has roughly tracked along it since. Basically she was born on 91st centile with extra weight and needed to find her own line. I only found this out after taking her to hospital myself ( out of sheer panic) and was reassured. The doctor in hospital was in no way concerned and explained charts and centiles clearly. The health visitor clearly didn’t know and just had me sick with worry, wanting her weighed all the time. All babies are different. My baby was always alert happy bright and well, weight is only one part of baby’s well being. My confidence was shattered in my ability to feed my baby and I had to stop, something I found hard to get over when in reality I was doing great and so was she. She gained the same way on formula as she did on my milk.