I mentioned that Reed's doctors are concerned about his weight gain. But as Luke quite accurately pointed out, the growth charts that the doctors are using are inaccurate for breastfed babies. Most doctors in the US use growth charts that were produced by the CDC and were created from a sample of both breastfed and formula fed babies. This is an unfair comparison for breastfed babies as they don't tend to be as heavy as their formula fed counterparts. Breastfed babies eat exactly as much as they want, and mom is never concerned about baby taking the last ounce, because that's what he normally drinks. There is widespread belief that formula feeding may actually be a contributing factor in the increasing rate of obesity in the US. We are teaching our children from a very young age to ignore their fullness and continue eating becasue there is still food. (Feel free to add more here Luke!)
So, where does Reed fall on the CDC growth curve? He's somewhere below the third percentile. He misses being in the third percentile by little less than a pound (and falls short of the 50th percentile by about 5 pounds). The World Health Organization has created growth charts for babies that are exclusively breastfed (with solids after 6 months). On this growth chart, Reed is in the third percentile. So, is Reed underweight?
After our appointment with Reed's gastroenterologist and dietician, I was really worried about his weight and concerned about some recommendations the dietician had made that I felt were fairly drastic. To get a little perspective, I scheduled an appointment with our pediatrician. He had noticed Reed's weight gain dropping off, but chalked it up to his genetics (Reed will probably never be a huge fellow) and with that in mind, I hadn't been concerned about his weight (until I met with the specialists). This also made me more willing to trust that he would not want Reed to get fat, just so he fit the growth curve.
As I had hoped, our pediatrician offered some comforting information. First off, he compared Reed's weight gain with his growth in inches and the growth of his head. Of these three, only Reed's weight has been drastically dropping through the percentiles. He said that when they see this, it usually means that the baby just isn't getting enough calories. Considering the very limited diet that has been available to Reed, I would not be surprised if this was the case!
The second thing our pediatrician said was that, in the medical profession, they are trained to look for problems in anybody who falls outside the first two standard deviations (above the 97th percentile or below the 3rd). My response to this was, "somebody has to fall outside the first two standard deviations!" and he thoroughly agreed. He noted again, that Reed may always be small, but that it would certainly be worth weighing him again in a month, just to make sure he was gaining at an appropriate rate. (Have I mentioned that I love our pediatrician?)
So, I'll pose the question again; is Reed underweight? My thought is that he might be, considering the ultra-low protein (virtually no protein aside from breastmilk) low fat diet he's been on. As we are able to introduce him to higher calorie foods (that most babies would have been eating for months now) I'll be interested to see if he starts gaining more weight. But should any of us lose any sleep if he stays small? I don't think so!
And now, just because it would hardly be a blog post without them, some pictures!
1 comment:
Just so ya know, I never even reached the growth chart growing up. I followed my own little curve up until high school, I think! Heck, I was even a bottle fed baby! The doctor was never really concerned because I was hitting all of my develpmental milestones and doing just fine when I hit school age. Reed will tell you in his own way what he needs to eat and how much.
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