How would you feel??

Question

I took my baby for his 1 year check-up and shots(he turned a year on April 12th) yesterday and after they had weighed him and all(he weighed 16 pounds 2 ounces and was 28 inches long)the doctor comes in the room and starts questioning us about what we are feeding him and how much and how often and how much milk we are giving him and so on.

So I told him what we are doing--which is mostly table food now and he gets between 16-24 ounces of milk a day(it all depends on how much he eats--when he eats less he drinks more) The doctor proceeds to say well he is very small for his age and he needs to eat more and drink less.(my oldest son was small till he turned 3 and then he caught up to the charts--and my baby is the same way).

So my question really is how would you feel about this and what would you do or say? Thanks for your input

Answer 1

I would trust your "mommy instincts"! If you know your son is eating right and the same thing happened with your other son, I would say the same goes for this little guy.

Answer 2

That is small, but you say that your first born was similar. How about you and your husband? Is your son otherwise healthy? How much did he weigh when he was born?



I can understand your doctors concern, however he doesn't sound very helpful or supportive. I would think a good pediatrician would sit down with you and try and get to the bottom of his slow weight. He would offer you suggestions on feeding and not try to make you feel bad for something that could be very normal or could be medical.



So to answer your question, I would be angry. I would tell him I would appreciate his advice medically, but he can leave the parenting advice to himself. I would also ask him why he has been seeing my son for one year and this is the first time he has ever mentioned slow weight gain to me.



Am I reading too much in to this?



edit: I'm a mom to a preemie also, but my son was bigger than yours when he was born. We have never force fed our son in order to make him gain weight. We do offer feedings often, but if he doesn't want to eat I do not force him. So to answer your last question. I would do as your husband suggested. Most preemies catch up in all aspects by the time they are two...not one. So long as he is gaining steadily, I would not be overly concerned and I certainly would not force feed a one year old. Can you even do that??

Answer 3

He was doing his job, checking in on a child who might need some help. But I know sometimes they really come off as insulting and accusing. My son was "chunky", though no pediatrician ever told me he needed to lose weight or go on a diet, just "watch what he eats". He was 12 then. So he grew 6 inches, and worked hard (self-motivated, no less) on getting in better shape and lost 40 lbs. The pediatrician had the nerve to look at my now skinny son and say he still had some to lose around the middle. My goodness, he went from a men's 38 waist at age 12 to size 32's falling off of him! Take heart and follow your instincts about your son's growth. Is he playful, energetic, learning well, keeping up with his peers as far as fine and gross motor skills, etc.? I knew my son would grow and stretch out like his father, grandfather and uncles and sure enough he did. Being small isn't the same thing and not thriving! My 2-year old has only gained 2 lbs in the past 18 months and everyone says she's fine! Take heart!

Answer 4

That is very small for his age. I have a preemie and he is 4 months 3 months adjusted and he weighs 14lbs. And he is underweight. When we went to the dr. she was questioning me as well. Asking me how much he was drinking. I told her 4oz every 2-4 hours and she told me to up it to 6oz, well he doesnt want it. I do know a couple of people who's children are under weight and the pediatrician has actually called Social Services on them!! Which is totally wrong. The reason is because they said the children werent gaining enough weight. Well personally if I was neglecting my child I would not bring him to the Dr.'s. I think all pedi's ask these questions. Did he give you any suggestions at least to put weight on? I wouldnt worry about it if you know your first child was like that and then had a growth spurt. I would not take it as them being mean, just concerned.

Answer 5

I would feel bad. As if I were an unfit mother. But the doctor is just doing his job. He's just trying to make sure your son is growing well and on target for his age. My son weighed 16 lbs at his 4 month checkup, which is in the 75th percentile. Do as the doctor says...cut out the drinks and give that kid more food!

Answer 6

If in doubt, there is nothing wrong with getting a second opinion. When you do, DO NOT tell the first doctor what the second one said. That way you will know that they didn't conference together and decide the same outcome for each other's sake. (your own piece of mind) If the second doctor has the same opinion then, you will know that your baby could be underweight. Then you can pursue that situation with a better outlook.

Answer 7

I wouldn't be offended, if thats what your asking. I would take his suggestion and try to get my child to eat more and drink less. Both of my little girls were below average in the weight chart too, and they also grew out of it, or caught up I guess I should say. But, like I said I would just try his suggestion and see how it goes!

Answer 8

I would try what the doctor says. I would not be offended by what he asked or said. He is just looking out for your child's growth. I am sure that there is nothing that you have done wrong thus far as far as being a good parent.

Answer 9

My son is tiny, too. You know if your son is healthy or not. You know if he's hungry or not. You can't force food down his throat if he doesn't want it. Some people (children and adults) metabolize faster than others. It's natural.



If he's happy and healthy, there's nothing to worry about.



Also, all babies are different. Some babies will hit 16lbs before they're a month old, others will wait until they're a year. You can't gauge your baby's growth by the growth of others, only by their health and happiness.

Answer 10

omg i am going threw the same thing my daughter is almost 6 months and her doctor always questions me about how i feed my girl. and i tell her i can't force her to eat. she eats baby cereal and drinks formula but she is still skinny. she is very long though so she is growing but just not getting chubby. and my doctor makes me feel like i am neglecting my baby girl which i am not. in my family my brother, and my 2 nephews were very skinny till the edge of 4 yrs old and it's normal cuz they are very healthy. and i have been thinking of changing doctors cuz she makes me feel like i am neglecting her and i am not. my daughter eats how much she can and just some babies are skinny and don't gain weight that doesn't mean ur not feeding them.

Answer 11

Don't worry or feel anyway, he is just trying to help you keep your son healthy. He probably already is but he is just concered about his weight and lenght. My son turns 1 on May 2 and he weights 23lbs and is 29 inches. Has long has you know you are feeding him right and he is getting enough you are okay. Just do what you been doing.

Answer 12

hes doing his job.

my son is almost 6 months and at his 4 month well baby check weighed 16lbs and was 26 inches.

im guessing he is now 18-19lbs, and probably 27-28 inches.

so id have to agree that your son seems very small for his age.

just wondering what size clothing he wears since my son just started wearing 6-9 month clothes.

Answer 13

I would say politly to my Doctor, thank you for your concern, but however this is his daily routine, Baby is happy and content with this routine, and if baby wants to eat more he will, if baby wants to drink more milk he will..

You as babys mummy will know what your baby wants, Doctors however go by weight and height charts, through yearly data inputs, whixh i think is bolloxs as each baby is different......

Answer 14

You may be right. His development maybe similar to your first son. Did he take iron supplement when he was born? Premature babies get their iron from mother in last 6 weeks of the pregnancy. Sometimes children grow slower because they have iron deficiency. Your doctor should recommend blood test to rule out iron and B12 deficiency.

Answer 15

my niece is very small for her age too. Babies are people so their sizes will vary. Don't listen to people who compare their children to yours. There are very specific signs of malnutrition if the doctor does not see any of these he is probably just covering all his bases by counseling you on your child's weight.

Answer 16

the growth of your baby depends on the parents height and weight too.



however if the height or weight is lesser than normal, the doctor would fear of delayed growth, which is not good for the baby development. so i think you should follow the doctor's advice.

Answer 17

The doctor is just doing his job, so as long as you know that your baby is happy and healthy then there isn't any need to worry. just keep doing what your doing.

Answer 18

Did you tell him what you just told us about your youngest? It does seem rather small but not alarmingly small. I would give him healthy snacks between meals (my son's favorite is fresh blueberries, cheese and pepperidge farm cheese fishies) and continue to feed him as usual.

Answer 19

i would just listen to what he is saying. both my children weighed that much before they even turned 6 months old so it is a concern. your dr's intentions are not bad, he is concerned for your child.

Answer 20

I don't understand why the doctor would say less formula(?breastmilk?) and more non-milk feeds?



NOTHING is as calorie, fat, and nutrient dense as breastmilk/formula. At 1 year no more than 25% of a babies caloric needs should come from non-milk feeds.



Also between 6-12 months taking less than 20oz per day is considered a concern.



Keep in mind your doctor is NOT a nutritionist. If you want better nutritional advice I would consult someone with some actual training in infant nutrition -which does not include most doctors or pediatricians.



http://kellymom.com/nutrition/solids/solids-how.html

Watch baby's cues - this is particularly easy if baby nurses beforehand and most/all of the solids are offered to baby to self-feed. Increase solids gradually if baby is interested. Aim for baby getting no more than 25% of her calories from solids by the age of 12 months (some babies eat less than this at 12 months and that's also normal).



http://www.kellymom.com/bf/bfextended/ebf-benefits.html

* It's not uncommon for weaning to be recommended for toddlers who are eating few solids. However, this recommendation is not supported by research. According to Sally Kneidel in "Nursing Beyond One Year" (New Beginnings, Vol. 6 No. 4, July-August 1990, pp. 99-103.):



Some doctors may feel that nursing will interfere with a child's appetite for other foods. Yet there has been no documentation that nursing children are more likely than weaned children to refuse supplementary foods. In fact, most researchers in Third World countries, where a malnourished toddler's appetite may be of critical importance, recommend continued nursing for even the severely malnourished (Briend et al, 1988; Rhode, 1988; Shattock and Stephens, 1975; Whitehead, 1985). Most suggest helping the malnourished older nursing child not by weaning but by supplementing the mother's diet to improve the nutritional quality of her milk (Ahn and MacLean. 1980; Jelliffe and Jelliffe, 1978) and by offering the child more varied and more palatable foods to improve his or her appetite (Rohde, 1988; Tangermann, 1988; Underwood, 1985).





http://www.kellymom.com/babyconcerns/growth/weight-gain_increase.html

There are several simple things that have been proven to help with weight gain:



* Stop or decrease solid foods, particularly if baby is younger than 6 months. Most solids foods have fewer calories and nutrients than breastmilk, plus they tend to replace (rather than add to) the higher-calorie, more nutritious breastmilk.

* Sleep with your baby (this increases prolactin and frequency of nursing).

* Learn baby massage -- this has been proven to improve digestion and weight gain.

* Carry baby throughout the day in a carrier/sling; get as much skin to skin contact as you can. Both of these things have been shown to improve weight gain.



* Nurse often - at least every 2 hours during the day and at least once at night. Frequent nursing increases baby's milk intake.

* Make sure you're allowing your baby to completely finish one side before you offer the other by waiting upon her cues that she is finished; i.e. pulling off herself and looking satisfied, going to sleep, changing from an active suck/swallow to more of a pacifier suck, etc. Always OFFER the second side, but don't worry if she doesn't seem to need it. It's much more important that she be allowed to completely finish one side than that she nurse both sides. By doing so she will be assured of reaching enough of the richer, more caloric hindmilk that helps her to go longer between feedings.

* Use breast massage and breast compression during nursing.

* Pump or hand express for a couple of minutes before nursing. This will remove some of the foremilk so that your baby receives more of the richer, higher calorie hindmilk.

* If supplements are medically indicated, breastmilk is preferred over formula as a supplement (exceptions to this are rare), and the average fat/calorie content of mom's milk is higher than that of formula. Mom can pump for 5-10 minutes after nursing (don't interrupt or shorten the nursing session to do this), and offer this higher-fat hindmilk to baby as needed. This is also an option for moms who normally offer expressed milk when they are separated from baby.



See also What affects the amount of fat or calories in mom's milk?





http://www.drgreene.org/body.cfm?id=21&action=detail&ref=857

A baby can have up to 32 ounces of formula per day. In addition, he can have as much in the way of solids, water, or juice as he wants to supplement this. The mealtime formula is usually given at the end of the meals, to top off the solids in a comfortable and easy way. Even though the solids are now playing a larger role, the breast milk or formula still provides the core of the nutritional needs. If a baby begins to regularly take less than about 20 ounces per day, you might want to offer the bottle first and then solids.



http://askdrsears.com/html/0/T000100.asp#T031014

I've been feeding my baby iron-fortified formula. When is it okay to switch to whole cow's milk? Research comparing cow's milk and formula-fed infants during the first year of life has shown that cow's milk is irritating to the intestines of a tiny infant, causing infants to lose a tiny bit of blood in their stools, contributing to iron deficiency anemia. There is very little iron in cow's milk anyway, and the iron that is there is poorly absorbed. Concern about iron-deficiency anemia has led the American Academy of Pediatrics, backed by solid research, to discourage the use of cow's milk in children under one year of age. One of America's top pediatric hematologists (blood specialist), the late Dr. Frank Oski , Professor and Chairman of the Department of Pediatrics at Johns Hopkin University (and co-author of a book entitled: Don't Drink Your Milk) advised parents to be cautious and not rush into the use of cow's milk, even during the second year of life. At present it would seem prudent to continue giving your baby iron-fortified formula during the second year of life and very gradually wean him to dairy products, beginning with yogurt. If your toddler generally has a balanced diet and routine hemoglobin tests show that he is not even close to being anemic, then switch from formula to whole milk sometime during the second year, but don't be in a hurry.