I took Benjamin to a well-baby check up appointment a couple weeks ago and found he is remaining in the 10th percentile for height and weight (50th for head). The doctor wouldn’t have even noticed, since he’s been steadily short and “skinny” for the past several visits, if it weren’t for one particular weigh-in. There’s one spike on the graph where he jumped to the 50th in both categories, then dropped and remained low for the next few.
We both feel it was most likely a human error, but the doctor still would like to see him fatter (and taller) and recommended a high fat, high calorie diet.
But something in me fights that, and after a lot of pondering, here are my thoughts.
First of all, shortness runs in the family. Benjamin’s paternal grandma is 4’11”. Josh is the tall sibling at 5’11”. So if Benjamin is short, I’m more likely to believe he got it from his genes rather than his diet.
Second, our diet is NOT low calorie, low fat. I use butter, not margerine. I use sugar, not sucralose or aspartame. I would rather give my child a sucker with high fructose corn syrup than the sugar-free alternative. Not that I’m a huge fan of artificially intensified sweetness, but more so than the chemically invented sugar-free alternative.
Third, this growth chart they keep showing me makes me wonder: with the child obesity rates rising, shouldn’t a healthier child’s percentages be dropping? Do they include obese children on these charts? I’ve seen children Benjamin’s age and younger sipping from sodas in retaurants. And that makes me wonder how often they partake of all those hydrogenated oils so abundant in fast food. Eating out is a treat for us, reserved for traveling or visiting family. But I wouldn’t doubt most children eat out once or more a week. If my child isn’t, but rather eating meals made from scratch at home, doesn’t it stand to reason that he might be skinnier?
Fourth, Benjamin learned to walk ridiculously early; he was steady on his feet by nine months. And climbing everything in sight shortly after. He is a very active little boy. Wouldn’t it make sense that he not be as heavy as a child who learned to walk at 12 or 15 months? (Keep in mind, Benjamin is 16 months old, so that would be just a month ago!)
The doctor said he is “not concerned,” but scheduled a wiegh-in appointment in a month and told me that if I “wanted to,” I could add Carnation instant breakfast to his milk to get his weight up.
But that just doesn’t mesh well with me.
I am still nursing, and plan to continue to at least two years of age. I am feeding him healthily at home, and don’t restrict portion sizes. He is not fussy or indicating in any other way that he is not receiving enough nutrition.
Should I be concerned? What do you think?
I’m not sure, although I have been doing a lot of reading about IUGR.
Couple of things to think about.
Can you see a dietician? Write down what you cook and how much Benj eats. Take it in.
I actually don’t think she’s going to tell you anything different, I think she’s going to tell you that you are doing fine, and are a great mum, feeding her kids really well.
The only other thing I can think of is a referal to an endocrinologist, to make sure that everything is ok?
I do not necessarily agree. I have thin children. They are just thin. That is the way it is. Like my teenager. She is THIN…but she eats me out of house and home! Personally, I do not think doctors “know it all.” You know your kid. Go with YOUR gut. 😀
Hey! I have skinny one too! My sister is a family pract doc. She always tells me this…if he drops 2 bars on the development chart from one well baby visit to the next, then there’s cause for concern. Mine is 15 months and has not gained a pound since before he turned 1. He was a chunker for a newborn (14 lbs at 6 weeks, 8 lbs at birth), but has slowly thinned out as he’s gotten taller. He has a super high metabolism (from daddy who I’ve been trying to fatten up for years!). Super active, burns lots of calories, sleeps like a rock. Just how the Lord made him!
Keep on nursing! Keep on doing what you’re doing!
I would not worry if I were you. It sounds like you are doing everything right! The same thing happened with my son at 18 months, and i was still nursing him. He was otherwise happy, healthy and developing normally. My solution? I just stopped taking the kids to the doctor all together. My eight month old has never been. We are under the protection of the Lord, and are healthier and healthier than ever.
Absolutely don’t worry about this, it’s so ridiculous!
First of all, think about the math behind the percentiles. They’re based on a bell curve. SOMEBODY has to be on the bottom, and somebody has to be on the top. A lot of somebody’s. It doesn’t make them unhealthy, just part of the equation. If he’s holding steady in his pattern, he’s PERFECT. *Especially* since, as you say, you’ve got a certain body type that runs in your family, *and* he’s been active from a younger than average age.
Breastmilk is THE highest calorie/fat substance you can feed him. So keep on nursing! He’s meeting his milestones (fantastically, right!??), he’s acting healthy, and he’s not dramatically dropping percentiles. Your doctor is being pretty irrational and should be ignored on this point, in my (not so humble, in this case) opinion.
Want to know a story? My 2nd child hated solids. Wouldn’t eat them. I kept offering food, constantly, he kept refusing. We kept on nursing, he kept on meeting (and exceeding) milestones, growing great, and acting like a happy, healthy child. He didn’t start eating solids until 15 months. FIFTEEN MONTHS (as an aside, once he reached that point, he was eating meals as if he had been doing it for the past year, you know?). What kept him growing so well through then (and it really was *well*, because he was still always on the chunky/solid side)? Yup, it was breastmilk. God designed it as the perfect food for babies, and if that experience didn’t solidify my belief in that, nothing will.
I think you should definitely NOT be concerned. It sounds to me like he’s been growing steadily (minus the one spike which may have been a fluke). Joshua was at the 10% level up until he hit 3 years old. And our doc never seemed concerned, because he was continually growing, but just staying within the smaller range.
I think it’s just a matter of genetics, healthy eating, activity level, metabolism, yada yada yada. I say keep doing what you’re doing. It would be different if he acted starving all the time or something. Maybe if he started dropping weight it would be different, but it sounds to me like he’s doing fine.
Nancy
As a lactation consultant, I spend a lot of time talking to parents about what is “normal” in size/weight/height for their children. I begin by explaining that, in my opinion, “normal” and “healthy” are two different things. For one thing, as a standard, “normal” will by definition tend to fluctuate where “healthy” usually will not. I encourage my clients to strive to have healthy children and then we talk about objective measures of health in the toddler and preschool years.
I am much more inclined to speak in developmental terms such as language, social/emotional, motor and adaptive skills, using the Bayley Scales of Infant and Toddler Development if it seems a child may be falling behind in any of those basic areas.
If a child seems very small and/or the parents are concerned, I’ll ask them to keep a diet diary for two weeks which we will analyze for calorie and nutrient content. I hesitate to recommend changes in a child’s diet until I have some idea of what they’re typically getting. Most commonly, I end up recommending a multivitamin and Omega-3 supplement and that’s about it. Occasionally, there will be a child whose size and weight gain aren’t commensurate with his calorie intake. There are a few metabolic and endocrine issues that can come into play here, but they are fairly rare and easily screened for if suspected.
So, to (finally) answer your question, it doesn’t seem to me that you have anything to worry about at this time. If you find that you are indeed concerned, you might want to ask a few more questions before just pushing the calories on the little dude.
And now, I will stop with the comment hijacking already. 🙂
I would not worry too much. I had to beef up Evan’s calories when he was a baby and toddler but he also had medical issues that contributed to his need for more calories. I try to let my kids eat as much as they want and not force food on them even if that means them gorging on one thing and then not having a solid dinner for several days in a row. Kids balance their food intake over a long period of time.
I am not sure that they have updated the growth charts in ages. I think that they were formed sometime in the 60s.
After my first was born a lactation consultant told me that those growth charts are based on formula fed babies so they’ll naturally and generally be heavier than babies that have been breastfed. Just something to keep in mind.
No, I don’t think you should be concerned. I hear this all the time from petite moms (or moms with petite families/husband/inlaws). Their families are small, their babies are small, and the doctors get very concerned. I know one family who was feeding their daughter the carnation instant breakfast and rolling bananas in chocolate and nuts on the recommendation of their pediatrician. He actually encouraged them to feed her more high fats, sweets, etc. Now, I am not some health nut and my son eats chocolate, but it seems to be a little backwards to feed kids junk food in order to get them to eat weight. If they need to gain weight it should be with healthy fats like avocados and breastmilk (and breastmilk is the highest calorie/fat food you can give him, plus it is so nutritious). And in the end all that junk food they gave her didn’t seem to make a difference.
Then you have my son on the other end of the spectrum. He’s 2 1/2 and has always been above the 90th percentile. I’m 5′ but his daddy is 6’3″ and a football player. You know what my son eats all day? Crackers, rice cakes, and bananas. Ok, there are a few other things he’ll eat too, but his diet is pretty limited. Sure I am concerned because he should be eating more veggies and a wider variety, but weight wise a doctor would never be concerned about him. I am still nursing so I’m not too worried, just trying to give him time to accept new foods at his own pace and offering him lots of variety. But I just don’t understand why a doctor would look at your son and be worried and then assume mine is fine because he happens to have that burly body type.
Also, I think the walking early probably contributes a lot. My son didn’t start walking until after a year and he slimmed down a lot after that.
There are just so many factors and I don’t think there is any reason to feed your son things that you don’t think are healthy or to substitute anything over breastmilk. If he was on formula or whole milk, maybe…but if he’s nursing he doesn’t need chocolately breakfast drinks to gain weight! And even if he was on formula or whole milk, I am sure there are better alternatives to carnation instant breakfast.
Did you know that those growth carts are based on formula-fed babies, who are generally “chunkier” than their breast-fed counterparts? My daughter is in the 25% for weight and height…I can’t imagine how chubby a baby her is would be if he/she were in the 90th percentile!
Miss Meg has always been on the “low end” of those charts, but I’ve never really been too worried about it. Here’s why: (1) it’s been steady and consistently following the same pattern (2) she breastfed 2.5 years (3) I was small (4) she’s my best eater – 3 square meals plus snacks (5) the kid will choose more peas or carrots over cookies ANY TIME. (6) She’s HEALTHY.
Don’t sweat it. Go with your gut.
My doc wanted the same thing for my kiddo at his one year appt. (a weight check) and I totally blew it off! 🙂 Such a rebel! At two, my son is still on the small end and at one year was only in the 5th percentile. He wasn’t losing weight, he just hadn’t had his major growth spurt yet. Plus, when I look at my own baby book he’s following very closely along with what I weighed at any given time. When I brought these to the doc at his 15 month appt, he seemed very relieved and never brought it up again. Sometimes it’s just genetics.
Personally, I totally wouldn’t worry about it as long as you know he’s eating enough good healthy food.
Oh, just another thought for you. My younger sis was teeny when she was little! I mean TEENY! The docs were so concerned they had my parents force feeding her ice cream and any high fat junk for meals to get her to gain weight. (she was maybe a year old) That did very little at the time other than give her a taste for sweets and junk food. She’s now (unfortunately) quite heavy as she’s never been able to give all that stuff up. Why is it that doctors think junk food FAT on a baby is healthy?
You know your children. I don’t do well checks after the first month or two. I only take them in if I feel there is a problem. And I have. My last child went through a time of not eating that worried me dearly. It took lots of prayer to get through that.
He is still under the 10th percentile, but he is growing and eating a ton now!
You have to know your child, and if you know he is eating healthy and well and growing at his own rate, but you KNOW he is growing, then don’t worry about it.
My gut reaction is the same as yours. He’s ON the charts. He’s consistently growing, it’s not like he was at the 90th and keeps dropping, he’s just a small guy. And I bet that 50th percentile spike was, as you say, human error. I’ve seen how they measure and weigh babies, it’s not always perfect.
Go with your gut. Keep feeding your baby some of that wholesome full fat dairy and I bet he’ll be just fine.
Beth, at that age Ashton was ABOVE 80th percentile! As long as Benjamin is happy, eating well and progressing in all of his other mile stones I wouldn’t get too worried.
I wouldn’t be concerned at all. First reason – all 100 of the percentiles are normal. That expresses the full range of a normal growth curve. He’s a smaller child – but is still within a normal range.
Growth charts are also out of date. In the UK they are based on data between 30-40 years old – not reflecting lifestyles of parents and child in today’s world.
Much better to stick with a health – not low fat diet – and to follow your instincts.
short answer? No… don’t worry about it. BOTH of my children were super-duper skinny as babies. One almost fell off the chart for weight (50th for height) and the DID fall of the chart (also 50th for height). I was ALSO like this as a baby. My older one is now 7, is on the very highest line for height (97th?) and around 50-75th for weight. Average is average… not a “goal” for all children to reach. Good luck!
I’m in the “the growth charts are a bunch of crap” camp. 🙂
I think that a breastfed child who lives on less-processed, REAL foods is naturally going to be much slimmer than his McD’s, soda drinking and sweets munching counterparts. And if that doesn’t make us “average” isn’t that a good thing? With the childhood obesity as it is in this country, I think the AAP needs to seriously reconsider their approach.
We went through something similar when my DS started getting more active around 9mo old. Except he was always in the 90’s and slipped down into the 20’s for awhile. But by 18months he was back up over 50 again. If your child is growing and continuing to reach developmental milestones there is nothing to worry about. If he’s consistanly been growing he is doing what is normal for him.
BTW, have you checked out the WHO charts? They are normed on breastfed babies around the world and do not have as many flaws as the CDC charts the Drs use IMO. (CDC charts are “descriptive” and normed on children regardless of nutrition. The WHO charts are “prescriptive” and normed on children who follow the WHO guidlines for infant nutrition.)
Here’s the link to the boys’ charts:
http://www.who.int/childgrowth/standards/chts_lhfa_boys_p/en/index.html
No, don’t worry too much. So much is based on family genes.
Our 14 month dd is just the opposite. She’s been off the growth charts (both height and weight) since 4 mos. I even journaled her food for a month so that the doc could see that I wasn’t over feeding her or feeding her junk.
Just because I’m big (but healthy) doesn’t mean that I don’t care about my daughter’s health.
And we’re still breastfeeding as well, although the doc has “suggested” that I cut back on that. umm, yeah. I’ll the kiddo decide on that. She eats mostly fruits, veggies, and whole grains.
Don’t worry. Healthy is better than “normal.”
I think you just turned a lightbulb on over my head! My 2-year-old (known online as Bluebonnet) is tiny for her age- wearing 12month clothes. The pediatrician was getting all over me at the 18 month checkup because Bluebonnet wasn’t gaining weight fast enough. Bluebonnet runs around a lot, burns everything, we don’t eat out very much, I nursed her until about 17 months, and while she eats a wide variety, I do have to prompt her to eat and when she’s done, she’s done.
I just wish I could be articulate or let the pediatrician’s commentary bounce off of me. Or have her seen by my old dr.
My son is ridiculously skinny, too. (He’s 20 months.) He’s 10% weight and 75% height. Our pedi was concerned, but has finally realized, that he’s just going to be tall and skinny like his dad. My son eats fine, his his milestones and is generally a cheerful little guy. So what if he’s a little skinny?
I agree with the above that healthy is better than “normal.”
Crazy the advice some dr’s give. I heard the other day from someone that the dr recommended giving the kid more butter to fatten them up! Nuts, I have a friend who has three kids. If you compared them all before 6-9 mos when they started solids, one was way below average, one way above and one average. It’s all the same milk they were drinking from momma. Kids grow and become different shapes and sizes. Someone has to be at the low end just like someone has to be at the high end. Keep up the good work keeping your kids healthy. I wouldn’t change a thing.
I have a child who is below the 5%. I think I have been more concerned then the Doctor is. Which actually puts my mind at ease. My DD had really bad allergies which caused her to be small. But I’d say keep doing what you are doing and pray. I, personally, would stay away from the carnation instant breakfast. That stuff is mostly HFC and other unnatural stuff. If you child is having a high calorie, high fat diet everything will be fine. My DD just finally reached the 5% and she’ll be 3 in October. Stay the course and it will be fine. You’re doing great.
I also agree about what you were saying about the stats and genetics. It all has to be taken into account. And I wonder if they’ve skewed the high/ weight thing because more kids are obese. Because by definition, if more kids are getting heavier that would make the median go up, right?
I would not worry about it. You are all smaller, and that’s fine. Besides, I was really tall as a little kid and was predicted to be 6’3″. I turned out 5’10”. There is just a lot of unknown when it comes to growth. He may end up tall and fine, or short and fine, but I would focus on the fact that he otherwise is healthy. Especially if you look on a worldwide scale, that is rare and a tremendous blessing!
What I think the doctor was telling you is he is not concerned, but if you are, you can do this.
I’d maybe do a food diary and consult with a dietition, but as long as he isn’t dropping percentiles, he’s probably just fine. 🙂 I gave both of my skinny kids more butter and also carnation instant breakfast as per my doctor’s orders, and you know what? it didn’t help. They are still ridiculously skinny. I was too, so was my husband, It’s just how we are built.
How much genetic information does the doctor know? Does he know that your family tends to be short? He might be less concerned then.
Growth at this age isn’t about size as much as it is about nutrition and brain growth. Keep nursing, mom, it’s the best food there is.
Now, my son is not “small”, so the doctor hasn’t been the problem for us. Rather, our little toddler is asserting control by rejecting food about 75% of the time.
And he’s losing weight.
We have started using Carnation Instant Breakfast and he knows something’s up and doesn’t like it. We’ve also made our own sorbet that uses coconut milk instead of simple syrup.
That has been a hit. The kid LOVES coconut milk.
Mango, banana, berries….it is a good compliment to them all.
Plus it’s high fat, high calorie, has nutritional value, AND gets him to eat fruit on days where he simply won’t out of nothing but stubbornness.
Something you may want to try if you decide you want to increase the calories…or just want to try a different desert for yourself.
Can you say “mixed signals”??? What is up with that? I don’t get what goes through Dr.s heads most of the time. I did formula feed my boys and they were very high in the percentiles. But the pictures of your boy do not lead me to believe he is lacking in the weight area. In my opinion, you have very healthy looking children. I would probably agree that if YOU are concerned, get a dietician’s opinion. Other than that, I would trust your mommy instincts and keep doing what you have been doing.
Don’t give what they said a second thought! I wouldn’t say that other than this situation. My kids never could live up to that stupid growth chart, and while my son is really skinny he is very healthy, on the other hand my two girls are just a little more than they should be and so they give me a hard time about that when all they used to preach was they are all too skinny. So go figure! LOL Just make sure your kids are eating good high quality healthy foods and don’t worry about all the other!