Doctor Referring Us to Children's Hosp. Because 1-Year-old Doesn't Weigh Enough

I'm an MD so I wanted to weigh in. If a baby drops more than a certain number of percentiles in weight, it's called "failure to thrive" and occasionally it means the child has some type of chronic disease (for instance, heart problems). That's why your pediatrician has referred you. However, you're describing a child that's clearly thriving - and there is most likely absolutely nothing wrong with him. The specialists at Children's will check him out, and they can reassure you that he's healthy. Definitely go to the appointment. They know what to look for and will make sure that everything is fine.

DO NOT stop breastfeeding your son! You're definitely doing the right thing by providing him with breast milk. For one thing, if that's the only thing he'll eat and you take it away, he'll eat even less. But you're also right that breast milk is nutritionally far superior to cow's milk or formula, not to mention the bonding that you both do through nursing.

If he's having trouble with textures, sometimes an OT (occupational therapist) can work with him on that and give you ways to help him become more tolerant of different foods. That's another reason to keep your appointment at Children's - they can refer you to an OT in your area. Sometimes the OT can come to your home and help your son in his familiar environment. Many children take a while to learn to tolerate the wide variety of foods available, so don't worry too much. He'll get there, it just may take a little time.

You have done nothing wrong. You are a fabulous mother. Your son is lucky to have a mom who cares about him so much that she worries about his health like this!

3 moms found this helpful

First, you're not alone and breastmilk really is good nutrition for him.
Second, yes, he does also need solids.

We had some weight gain issues with my oldest and I had some of the same concerns about introducing solids and my daughter weaning/low milk supply. What I learned is that my daughter wants my milk no matter what else she's eating or drinking. Her issues were when she was a little younger than yours (9months), but she's now over 2 and continues to nurse usually 4 times a day. She was nursing an average of 5-8 times a day when she was 18 months. While our situations are a little different, I've been there and know the guilt and regret that go along with hearing that your breastfed baby isn't gaining well.

A referal to Children's doesn't have to be a bad thing. They might be able to help you with the texture issues and make sure it's just that he needs more exposure to solids. If you don't want to use formula, either tell your doctor and ask for other suggestions or simply get a different doctor. When we were told my daughter had a month to prove she could gain weight our pediatrician said to start meat and suggested formula. I told her that I wasn't going to do either, so she gave us some other suggestions like yogurt, egg yolk (but you can give whites too since he's over 1), tofu, cottage cheese, butter on everything, and diluted juice.

We don't give ours much juice, but the rest we do often. For example, my daughter had about 1/2 cup veggie penne, an egg, and a plum for breakfast. For lunch she had two tofu sticks w/ketsup, an english muffin with a little butter, and some peas. Dinner will probably be a 1 tortilla cheese and salsa quesadilla, salad, and banana. We did introduce cow milk at 1 year old, but she probably drinks it twice a week or so. We mix it into fruit and yogurt smoothies, scrambled egg, and with carrot juice occasionally.

One thing I did to help us both make the transition to more solids but still nursing is that I would give her as much solids as she was willing to eat and then I would nurse her. After every meal, that was our pattern. If I can be any more help or if you want the name of our pediatrician, please just e-mail me. :) Your boy will grow and things will be okay!

2 moms found this helpful

you need a new pediatrician! Breastfeeding is best for your child. The World Health Organization even recommends breastfeeding past 1 year (I believe it is up to 3 years- can't remember right now). It sounds to me like your son has Sensory integration Disorder. i have a friend with a 26 month old who can only handle eating one bite of solid food before she gags and throws up. She has been taking her daughter to a Specialist to assist in this.

So my recommendations for you are:
1) Find a new Pediatrician who cares for you and supports you in your views on how to raise your child. Remember you are paying her for her knowledge if she is brow beating you or scaring you and not supporting you, you have the right to choose someone else who will support you.

2) See if you can find an Occupational therapist which can help your child get past the gag reflex and texture issues.

3) Follow your instincts. If your heart and mind are completely disagreeing with someone you are in the right to find other Dr's who will help support you in your efforts f raising your child.

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I wish I had more time to type..

I believe that "sensory integration disorder" is a parent induced situation. Look into BABY LED WEANING (blw) there are several websites. There's no way that so many kids would have trouble eating in the natural world. You should never used pureed foods and NEVER FEED A BABY. A baby should be able to chew and feed themselves before they ever eat solids. BLW will explain it better. Other countries that use this method simply don't have issues with eating like we do in the US. Baby food is unnatural.

Some kids aren't ready to eat solids until 12 months ++. Unless your child has suddenly become a baby cow, then you shouldn't switch from breast milk to cows milk at 12 months.

SOME BABIES ARE JUST SMALL! My friend has an 18 month old that weighs barely 19lbs. He's fine and healthy and small. You're doing great, stop worrying about this!

2 moms found this helpful

You are doing the right thing by breastfeeding, and your doctor is wrong by saying you are producing less because he's older.

BUT

You really should start feeding him more solids. While breastmilk is best for babies, that doesn't mean it should be the only thing he's ingesting at the age of one. God gave us teeth for a reason, and they come in around age 1 :p Definitely start feeding him more solids. You can still nurse him a lot, but don't deprive him of solids :)

I would feed him three meals a day of solids, and then nurse him all other times he gets hungry in between meals.

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It sounds like your doctor is trying to do the right thing and having you go to children's is not a punishment. The height and weight should be in the same percentile.

Children's can help you especially since you have so many dos and dont's. I think you should go with an open mind, have your questions and concern written out and they should be able to help make a plan that stays within your guildlines. Good Luck.

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You've had lots of responses and I didn't read them so I hope this isn't too much of a repetition.

I don't think your doctor is judging you or punishing you, I think that they are concerned for your son.

I'm sure she didn't send you to Children's earlier because your son was still showing some progress on the growth chart and staying balanced with his height and weight, but perhaps there wasn't enough growth from your last visit or he didn't gain any weight at all, and that is a reason to be concerned. Babies need fat the first two years of life for their brain development.

My suggestion would be to go to Children's Hospital so they can evaluate your son to make sure he is developing properly. If he is then no worries, if he isn't then you know and can continue to change his eating habits or whatever you need to do to help him.

My son, who was my first, I tried nursing, but when we went in for his 6 month check-up and he hadn't gained any weight since his 3 month check up we stopped breastfeeding and immediately switched him to formula. He never cried like he was hungry either, he was a very happy baby and slept well and still does. Now he is 4 and in the special-ed preschool for a speech delay- is this because his brain didn't get enough fat at that time for his speech to develop properly, I don't know and we never will. But what we do know is that after switching him to formula he caught up in his weight and has had healthy check-ups ever since and that he has the potential to catch up with other children his age developmentally.

Yes, breastmilk is good, but your son got that for the first year of his life and can now switch to whole milk until he is 2. Tell your husband he is lucky to have a wife that is willing and able to nurse as long as you have because lots of women won't. I can't nurse that long and my husband doesn't blame me for our son's developmental problem. Just tell him you have to do what is best for your son and the breast milk isn't cutting it. Honestly, as someone who feeds formula to their children, at age 1 both of my kids were getting 24 oz. of milk a day along with rice cereal for breakfast, and two large (3 stage) baby food jars for lunch AND dinner.

Good Luck, just go to the hospital to make sure everything is ok. And don't blame yourself, you did your best, now you need help, don't let pride keep you from getting the help.

P.S. Boys and girls are different in their growth and while I couldn't find my son's records from his 1 year well check, I found my daughter's and she weighed 21 lbs 9 oz (60%) and was 30" tall (80%). The records I could find for my son are from his 3 & 4 year old well checks. My son at 3 was 40 lbs. (97%) and 39.5" (95%). At 4 yo he was 43.6 lbs (90-95%) and 42" (75-90%).

1 mom found this helpful

I definitely hope that you go to a good pediatrician for a second opinion. Both of my kids weighed less than yours at 1 year and were eating about the same amount of breastmilk/regular foods as yours. They are both perfectly healthy and happy (now 4 and 2), and it sounds to me like your son is too. Ditch that doc! P.S. The response you got that said that a baby's height and weight should be in the same percentile is RIDICULOUS! My daughter is and always has been in the 10th for weight and the 90th for height, and my son is and always has been in the 15th for weight and 75th for height. That is perfectly normal and healthy!

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My daughter was also a child who had texture aversions. She was breast fed exclusively until about 10 months when she actually had a mild interest in some foods. When we started her on cows milk at age 1 she was ok with it, and it did not impact her breast feeding at all. Don't stress, you will find foods that he likes, try some finger foods, my daughter really started to enjoy eating when she had a little control over it. She also did not like baby food ever. Good luck, try a different doctor, your doctor doesn't seem to be supporting you or guiding you, just scaring you.

1 mom found this helpful

This seems ABSOLUTELY rediculous to me that your doctor did this. YOU DEFINITELY NEED TO GET A SECOND OPINION!!!! I have a friend who has a petit girl who is 16 monhs and she only weighs 17 lbs., and our doctor in Astoria, OR said that it is just fine. She doesn't really like food all that much so she breastfeeds mostly. If your baby seems happy and healthy...what is the problem? Why the worry? It just doesn't make sense to me. Before women starting going back to work, many women would breastfeed their children exclusively for 2 or more years. It is NOT a problem, it is actually what the child needs. What your doctor should be doing is praising you for the fact that you are doing one of the VERY BEST things for your child, which is breastfeeding them for this long. There is a TON of research on the benefits of breastfeeding. I would ask your doctor more questions about WHY WHY WHY the referral. Also, I would highly recommend a midwife as well to talk to. I see Dr. Sue Skinner in Astoria, OR (who the forementioned doctor of that 17 lb girl sees). All she said to my friend is to feed her more fatty foods like avocado and eggs, along with breastmilk of course. They come in all shapes and sizes. Go see someone else and please don't feel guilty...there is no need! Good luck to you!

1 mom found this helpful

Hi M.,

My #2 daughter weighed 6lbs 6oz at birth. On her 1st birthday she weighed 17 lbs with her clothes, cowboy boots, & cowgirl hat. Now, she's a 50 yr old grandma of 5 and still snacks all day, never eats a meal and weighs about 95lbs fully clothed, she is about 4'11" and just simply takes after my mother who was 5' and weighed about 100 lbs all her life.

Don't sweat the small stuff, he'll eat what he needs and grow as big as his genes tell him to.

Don't push the baby food; did you ever taste that stuff... if not try it... yuck!

Best of Luck~
C.

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There is a lot of good advice here for you so I'll try not to duplicate it.

I just hope you can feel more comfortable with going to the children's hospital. When a physician makes a referral it is not to punish you but to get you care from someone who has had extra training in a specific area. Doctors and pediatricians are good for the general population however if you have specific issues the divert from the norm it is good to find someone who has more knowledge in that area. The hospital will have more resources available to you to assist you in caring for your little one.

My first son was a preemie and required some "special" care a couple times in his early years. I appreciate that there are physicians who have that extra knowledge and can care for him at a greater level.

I wouldn't look at it as punishment to you, look at it as your Dr saying in code "I don't have enough knowledge in this area to aid in the care of your child." They just don't want to come out and say that. I think they feel if they say that it will make them look incompetent.

I hope this helps. I hope you can get the care your little one deserves.

1 mom found this helpful

Oh, how I wish I had more than a second to write-

my heart goes out to you, it is so hard when you hear something like that from a dr. But I wish you wouldn't beat yourself up- you have done nothing wrong by continuing to nurse your baby. Yes, it is important to be giving him plenty of solids, but breastmilk is still so so so good for him! And I think it's weird that the doc thinks 25th percentil requires a trip to the hospital! That sounds very strange to me. Both my kids have always been in the 15th percentile or so (my 13 mo old has just reached 18 lbs) Did he used to be higher and then suddenly drop? That could be concerning, but if he's always been small, that sounds fine. (of course I'm not a dr though)

Anyway, please stop blaming yourself- you did nothing wrong. What I did when my baby was 11 mos and not gaining much weight was really concentrate on frequent eating (and nursing)- and lots of healthy fats and proteins. (olive oil, whole milk yogurt, beans, meat, lentils,) From what you describe of your son, he sounds like he's thriving!

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Has he always been in the 25% range for weight and the 75% for height? I ask because all FOUR of my children have been in that range since they were born. As long as there's a steady progression of weight gain from birth (ie: ALWAYS been in the low weight/high height range for age) then there shouldn't be a huge worry, but you -should- seek a specialist for the texture aversion as it can be a sign of a physical issue and not something that you've caused at all.

My almost 10 y/o is -very- tall and thin for her age, but has been that way since birth. She was only 6 pounds, but was 24 inches long! We never had an issue with it since she continued to gain weight and height as she grew up.

Offer solids for breakfast, lunch, snack and dinner. Even crackers and such count as solids. After you try to feed him solids, always always always offer him the breast afterwards. The more calories he gets, the more weight he'll gain.

With him being so active, I wouldn't be seriously freaking out.

Do get him in to see a specialist, though. Just to be on the safe side and rule out any physical issues that he may be having.

~A. (Mom of four healthy, active, but skinny, kiddos)

1 mom found this helpful

I promise, M. -- you will get MUCH more parent-friendly help at Childrens' ---- your doctor needs to go back to school and retake the classes on '''how to support and guide parents'' - clearly he/she missed that one.

Now, yes, - I can understand why your doctor made the referral - the weight is low- and you sound as though the advice you got didn't help you deal with his eating issues- and you are right that the last thing to do is have him throwing up. YOU NEED BETTER HELP AND SUPPORT AND CHILDREN's is the place to get it - I promise.

Blessings,
J. - aka- old Mom ( my first was tiny, also- and is now a 5'9" 38 year old daughter with a 9 year old son-- . )

--

1 mom found this helpful

I think going to Children's will be a great learning experience, not a punishment. I, too, have a "little" child and have found that the staff at Children's has been nothing but kind and helpful. I also breastfed, but with the help of both the staff at Children's and at Evergreen we made a smooth, easy transition to solid foods while breastfeeding. You have done a great job to breastfed so long and there is no reason to stop while your son gets sold food as well.

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Well, a couple of things. To start- my son was also about 17 1/2 lbs when he turned 1, was in the 25th percentile for weight and the 75th for height. My Dr. was never concerned because if you look at his father- it is completely obvious why he is built the way he is. My son is now a very active 8 year old, still tall and very thin. That being said- he eats eveything in sight and is very healthy. All kids are different.

On the other hand, while breast milk is so important, by one- kids should be eating all kinds of fruits and veggies and other foods like oatmeal and such. This kind of food usually starts around 4 mos. old. Lots of kids have texture issues, but by starting them on the food that early- it gives them lots of time to practice and get used to things. It sounds like you meant well, but you were kind of depriving him of lots of nutrients, as well as experiences. My son also had gastric reflux problems when he was tiny- so he threw up most of the stuff I fed him. We put him on some medication to treat the reflux problem, and he got over it. We just kept trying different things until we knew what he could handle and what he couldn't- and as he got older and more experienced he got better and better at eating all kids of foods.

Lastly, as for the cows mild and not wanting to breastfeed anymore, I could be wrong, but I don't think one would interfere with the other. I mean, I don't know how long you plan to breastfeed, but usually around a year is when people are weaning them from the breast and switching them to cows milk anyway. If you do want to continue- go ahead. Giving him options isn't going to make him want to nurse any more or less. That would be like saying giving him juice or water would make him want to stop nursing. Most babies want to nurse not only for nurishment, but more so for the closeness and comfort it provides. They are not going to get that from a sippy cup of whole milk- just some of the extra calories and nutrients their bodies need to grow strong and healthy.

There is no guide on how to be the perfect parent. Just keep doing your best and don't worry so much. I think it's great you ask questions, and hopefully you can get some comforting, reassuring, and helpful tips from all of us other Moms.

Oh,and if you are uncomfortable with you childs physician, by all means- switch. You need a Dr. that understands you and supports you becoming the best parent you can be. You need to feel safe to ask questions and get the answers you need without feeling judged.

Good luck!

1 mom found this helpful

Hi M.,

It looks like you have gotten LOTS of responses, but I'm going to second, third and 50th what other people are saying. Weight is not everything. Human babies are obviously not all the same size, nor are they supposed to be. The best indicator of his health should be if he's happy, energetic and developmentally on target. Lots of 1-year-olds don't eat much food, they're still getting used to eating solid food. And nursing is still great for him.

I would not only get a second opinion, but I would think about switching doctors. She should not be making you feel like a terrible mother. You aren't. Ask around about doctors or pediatricians that people love and take him to one of those and see if you get the same opinion. Maybe even think about taking him to the Children's Hospital and see what they say there. It's my suspicion that if he went to the Children's Hospital they would be so refreshed to see a happy healthy kid and they would ask what you were doing there!

Try to relax and put it into perspective. Good luck!

1 mom found this helpful

I think you need to listen to your doctor and take him to childrens. They are your second opinion and can help you learn how to get your baby on board with solids. They are not the police and you are not being punished. My daughter didn't want solids either and it took a long time for her to try new things, but eventually she did. 17 1/2 pounds is small, but not life threatening. my daughter was 15 pounds at a year. what you have to realize is that your baby can not survive and thrive on breast milk alone. he does need other food. your breast milk is his liguid for the day at this age. he needs to learn to eat real food. just start with one meal and every 3 days add another meal/snack of solid foods. your baby won't stop breastfeeding because of it or because you give him milk. talk to the people at childrens. they are wonderful and specialize in children. if you are not happy with your doctor that you normally see then find a new one. you do not want to stay away from taking your child to the doctor because you don't feel comfortable with them. you can ask the people at childrens for a reccomendation for a new pediatrician. good luck!

1 mom found this helpful

Did you doctor reference the charts for breast fed babies? They are different. It doesn't sound like your doctor is very pro-breast feeding. I know our daughter did not gain any weight from about 9 months to 14.5 months, due in part to being so active. It sounds to me that you have done everything "right" and that it may be an overreaction on your doctor's part, but I don't have a medical degree. I would go ahead and take the referral just to be sure that there aren't any other underlying factors, but stop beating yourself up. You know your child and trust your instinct!!!! Go to la leche meetings or find a resource that is pro-breast feeding for support might be helpful as well. I hope that you get some reassurance from somewhere that you aren't doing anything bad or that you were just following your babies cues. Hope this helps in some small way!

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Don't get too worked up-- We're all human after all! That being said, I would consult a pediatrician. Explain all of it right up front, and include how guilty you already feel! I think too often docs forget that they are dealing with human beings that have feelings-- often very, very strong ones. It sounds like your little guy could really use a feeding specialist consult-- either an OT to deal with the sensory part of eating or an SLP to deal with the gagging-- or even better-- BOTH! :-) You can contact your ESD for a free evaluation (although some ESD's have feeding specialists and some don't). I would recommend really pushing for a feeding eval though-- even if your baby doesn't have feeding issues, going through the eval can really give you a chance to ask some questions and get some tips on getting a baby that doesn't like textures to eat!
Take care!!!

1 mom found this helpful

I took my daughter to Children's Hospital around that time for eating issues (that gag reflex - she ate much less than your son at that age!). The person we worked with was really excellent, and reassuring. They are competent folks who will be able to recognize if there is a problem or if there is something else you can be doing. They are also quite nice and understanding.

You can try feeding him more (just keep offering food until he says no), and you can try milk (goats milk, cows milk - either will be okay at this age - try them in a cup instead of a bottle - i really doubt it will interfere with his nursing). But, if he still nurses regularly and strongly, and he is eating some solids, i doubt there is a real problem at all. Your goal should be to expand his food list slowly from here on out.

But, honestly, why the fear of Children's? Why not bring him in, get the second opinion, and go from there? Yes, there is a chance they will recommend changes to your behavior, but, these will help your son so you can make those changes. But there is also a chance that they are just going to evaluate him to make sure there isn't a bigger problem, and send you home with some reassurance. I got a lot of ideas for how to help my daughter learn to eat without gagging that i was glad to have.

Children's isn't a punishment, its just a location of some really well educated and knowledgeable children's doctors. This is the second opinion you are looking for, from the best doctors in the business!!

(Ps. you can ask about a multivitamin supplement - the one issue that some kids who are exclusively nursed past 1 year face is sometimes an iron deficiency. As your doc or the doctor at children's about a multivitamin.)

1 mom found this helpful

don't listen to the DOc. He's just so used to seeing babies that are over weight drinking cows milk or formula, i breast feed my daughter and she is 18 months old.

Everyone thinks she looks too think for her age..but she is perfectly healthy, energetic and happy. You should not let anyone tell you what you should do with your child, you know what is best for your child.

If you are questioning the doc, its obvious that you think it is not necessary to take your child to the childrens hospital. Every child is different..kids who drink cows milk are abviously going to be heavier than the healthy children that drink breastmilk. My child does not drink milk at all, she refuses it, and that is a good thing, i myself hate the taste of milk (by itself).

My child also eats solids...rice (sticky, jasmine), veggies, raw tomatoes, fresh friuts, diluted juices, and many more.

I mainly feed her breast milk all through the night and many times during the day with some solids.

hope this helps! good luck.

1 mom found this helpful

Don't be afraid of the doctors at the Children's Hospital. They are not bad guys. They are there to help. Tell them what you have told us. My DD was very little at one, but she at everything I could feed her. It was just her activity level.

At some time you will have introduce solids--start will plain yogurts flavored to your taste with jams or fresh fruits. No honey.

Try feeding him the yogurt before for the snacks.

1 mom found this helpful

I think you need to change doctors! You are his mother, do listen to doctors but also listen to your instinct. My daughter was barley 14 lb at that age and not even on the chart. She was perfectly healthy and happy and is now a thriving 3 year old, still skinny, but that is her build. Children are all different and they do things differently as well. If you think it would be better to feed him yourself a little longer until he gets over the texture aversion then you DO THAT.
And please STOP beating yourself up. I think you are doing the right thing and I would try a different doctor. Believe me children come in all shapes and sizes. My first was tiny like your son, my second was a moose, and my third is an 8 mo old boy who weighs about 12 lb. You are doing the right thing as his mother, don't questions that.
Cynthia

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Hello M.,

Doctors have to be careful. I don't think she is punishing you. Go to Children's - listen and get some great advice to help your baby gain weight. My daughter was in a children's hospital for 6 weeks when she was first born - and was in the negative percentile for a long time. I got some great advice about adding calories to her diet - cream cheese in her scrambled eggs, whole milk, etc.

Try to see Children's as a resource not a punishment.

Positively,
M.

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What ever you do, Keep breastfeeding your child. It is still the best nutrition if he is not eating enough. I have a two year old with feeding problems and have been seeing the people at the OHSU Feeding clinic for over a year. I still breast feed her. (OHSU specialists told me to.) World Health Organization recommends breastfeeding until children are age two to get all the benefits. She is in the 4th % for weight and the 72nd % for height. She only eats solids two or three days out of the week and even then it is under 400 calories a day. Breastfeeding is the only reason it is not worse. Keep offering as much solid food as you can. Offer it often. The gag sounds a lot like what my daughter does. It is something that you should be seen for but will probably go away with time and possibly therapy.

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I would just follow through on the referral and see what the specialists at the hospital think. Learn as much as you can from them and don't take everything so personally. They are there to help you not condemn you. Just move forward from here :)

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If your little boy is healthy and active (and you would know being his mom) then the weight is not an issue!

We went through this. Our son was born 6lbs 4ozs and has always been very small. He always ate a ton though and gained weight slowly, but was odviously a healthy, happy, active little boy! Some dr freaked out because he was always low on their charts. Insisted we put him on formula (he was 100% breastfed) and basically said we were starving him! Scared the hell out of us!

Truth is that he was fine and super healthy! He is still small for his age at 4, but he is also still veru healthy and active and hits all his milestones.

You absolutly should not worry! You do need to find a new dr that doesn't base everything off of charts! And by the way, there are totally seperate charts for breastfed babies then formula fed babies! Most drs use the formula ones!

You do not need to give cows milk if you wish to keep nursing! Your husband is right. Cows milk is not as good for your little boy as breastmilk and it has a lot of bad things in it too which breastmilk doesn't.

Please don't let this dr scare you! You know your child best!

I had to reread your post and add, please go to a different dr! This dr is an idiot! How the heck would he/she know how much milk you're producing? Your breasts are good enough! Your body is good enough! Your milk is good enough! Infact, even better that anything else you could feed your son! I know of lots of kids who didn't take to eatting solids until after a year old! Breastmilk should still be their main source of nutrition! There is never a certain time or age at which your milk starts to go away or go bad unless you stop nursing as much. Then your supply can go down.

Please check out www.kellymom.com It is a wonderful breastfeeding support website that has lactation consultants.

This dr is ridiculous! Our son was right around 16lbs at 1 yr and was and is just fine! Babies/young kids do not have to be fat to be healthy!

1 mom found this helpful

Please don't listen to that doctor! There's nothing wrong with your son. Some kids are just more sensitive to what they put in their mouths. My first son weighed 19 pounds when he was one year old and his pediatrician wasn't worried about him at all. There's a reason some kids are a higher or lower percentile than others. You figure someone's got to be in the one/fifth/tenth percentile, otherwise it wouldn't exist. You also don't have to move him to cow's milk. It is encouraged to nurse as long as you are comfortable with it. There's no need to stop. I'd be glad to give you the name of my kids' pediatrician's office. They are a wonderful group!

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Hi M.,
First, I have to say you should find a pediatrician that you like for your son. This Dr. doesn't sound like a good fit for you. Pediatricians see so many children that they can offer more specialized advice. Your dr should be an encouragement and a ally to you, even if there are concerns.
I think you will find that by going to Childrens you will have a lot of you fears relieved and you will find support & encouragement. You should keep the appointment. Third, breastmilk is best. I breastfed my daughter until she was 2 and she rarely sick. The nutrition & immunities babies get from breastmilk is still best, but as someone else said, feed him solids and nurse in between meals.
You are a good mom and your son is going to be fine.

1 mom found this helpful

You are a great mom and you are doing all the right things. It is okay if he has to see a specialist at the children's hospital. It could be they are just making sure! It is okay! Children's hospitals can be such a great source of info. I wish I had more to help you with, but just know you are loved. You are a strong and good mommy and you love your family. Things will be okay!!!

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Reading your post angered me. I hate it when doctors make us mommies feel like we are doing something to hurt our kids when we are trying to do what is the very best for them. You are not the enemy & yet obviously the doctor is making you feel as if you are. First of all your doctor should know that breast feeding is the absolute best nutrition for your little guy...period! To be honest with you I really do think you need to get a 2nd opinion & perhaps a new doctor altogether. I have 4 sons the 1st two I had to stop breast feeding early due to health problems but the 2nd two I breast fed exclusively for about 2 years each. The older of the 2 breast fed boys was always chubby & average size and I never fed him baby food he breast fed only until he wanted finger foods or table food & I then allowed him to eat what he wanted with supervision & help (making sure things were cut into safe & manageable sizes to prevent choking). The 2nd breast fed son was small he was often at the 10th percentile for weight & sometimes lower. He is just a small kid. I have 2 sons that are built like linebackers & 2 sons that are small & skinny its just their build. The 2 sons I didn't breast feed as long got sick MUCH more often & even got chicken pox the 1st time they were exposed to it & yet even with their brothers in the same house with chicken pox the 2 breast fed boys still haven't had them. I just don't think its right for your doctor to discourage you from breast feeding. If you feel like you may not be producing enough milk then breast feed more often. Our bodies are made to adapt to the needs of our babies & breast feeding more often will encourage more milk production.I would NEVER replace breast milk with formula if you are able to & want to breast feed. I would suggest that you allow your son to have other foods as HE wants them but I would not push them on him. One of my sons also had the texture issue much more than the other 3, like your son has and we just had to allow him to add more foods to his diet as HE was ready. Remember that you are your sons most important advocate! Doctors don't know everything they are human and falable also. You know your child better than anyone & you love him & want what is best for him more than anyone else in this world (well maybe tied with daddy) & you will find there will be many many times before your son is grown that you need to stand for what you think is right for him in the face of adversity. No 2 people parent the same & no 2 families have the same exact priorities. Stick to what you believe in!! And remember a referral is not mandatory & is not final. If you choose not to take your son that is your right as a parent! I would most definitely seek the opinion of another doctor and not allow the current one to intimidate you simply because he is a doctor. Good luck & hang in there!! :)

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My son was 19 lbs at 1 and didn't gain much by 15 months, so our pediatrician referred us to a nutritionist. I still breastfeed him and he has been on solids since 7 months. He's a wonderful eater, just not an avid weight gainer.

One thing I didn't read in the other posts was how personal this type of referral can be for a breastfeeding mom. Since birth, I have been the feeder of my child and am still responsible for his meals by choosing what he eats. I took it very personally that our doctor thought there might be a problem. It's so hard not to, as a mom and especially as a breastfeeding mom. I've had to do a lot of thinking about what this means for me that my son is not gaining weight like my doctor would like to see. I have come to the conclusion that this really isn't about me, it is a precaution to make sure everything is going fine and there isn't something underlying the doctor is missing. This is a precaution and not a punishment. And, my job as a loving mom is to get over the anger and upset I feel that I think my doctor thinks I'm doing something wrong.

You are doing everything right for your child. Breastmilk is the best milk your child can receive and this is not your fault. Check with the wonderful folks at Children's. They are there to help your child when things don't go as expected. They are a wonderful resource and not there to punish you.

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Dear M.,
I wish I had some answers for you. All I have to offer are suggestions. I would encourage you to follow your instincts and get a second opinion, and from a pediatrician if possible. Did you know that the World Health Organization recommends breastfeeding until the age of two? That's what our doctor told us, anyway, and that the American Pediatrics Association (or some name similar to that, I may have it wrong), recommends a year as a minimum. I wish you the best of luck. It sounds like you're doing the best that you can in the best way you know how. Take care.
S.

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You did not mess up and the fact you are asking for help shows what a great mom you are! My 9 month old is 16lbs5oz. She eats solids and breastfeeds. I have never forced solids on her and she even chokes on water!! I would get a second opinion. I was still nurseing at night at least twice until her 9 month check up (last week)and her doctor told me that she would be fine if I cut her off at night. I asked about her weight and what if she lost some.. he told me that all babies have their own charts and as long as she is gaining not losing he is happy.

Does your little guy like to explore? My friend had a daughter that did not like solids so they put cherrios in a toy that she could open up and "find" them. She did this for a lond time and even now when they come to our house, we have the same toy, she still looks for the cherrios!

We have also found with our daughter that if she can feed herself she will eat or if it is off of mommys plate it tastes better. I firmly beleive that if your son was hungry he would tell you. I do not know where you live but if you want a good pediatrician i have one in silverdale!

Also stick with breatmilk if you can it sounds like your husband is supportative. All babies come in thier own size. One of newphews was 14 1/2 lbs at 1 and still in 3-6 month clothes and another nephew is 8 weeks and already 14 1/2 lbs (different sides of the family) trust your gut and your baby.

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Please stop beating yourself up! You're doing just fine - every baby is different! First, just take a look at your baby - does he look healthy? If the answer is yes, then he's getting enough food. Remember, 25th percentile means that 25 percent of all babies are around there, or *less* - that's not a dangerous place to be at all! There are lots of babies that just aren't into real food yet at his age - breast milk is just fine, and it IS still the best, most nutritious food. As long as he's getting that, the real food is more about him learning about eating, than actually getting his nutrition from it.
I'd say, get a 2nd opinion - it sounds like your doc is trying to cover their own butt, and panicking you in the process. If you feel fine about how your baby is doing, then your baby is probably fine - you know him best!!
And again - please stop beating yourself up. I've made myself feel just awful because I didn't think I made enough milk, because when I pump I barely get anything - but, when I actually look at my baby, he's totally healthy! Trust your baby - and trust yourself!

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I didn't read all of the previous responses, but just in case you need more reassuring: drop the doctor and trash the referral. Find a new doctor who knows what she is talking about.

Unless you're leaving out a big part of the story, the only problem that you're dealing with is a crappy pediatrician. A child that is in the 25% for weight and the 75% for height is not underweight. My daughter has been hovering in the 10-25 % for weight and 60-75% for height for all of her two years and our doctor never so much as blinked about it. The only comment I have gotten so far from her is..."if she's lucky she'll stay like this when she grows up".

If you feel uncomfortable throwing out your doctors recommendation by all means, go to children's... they will probably just tell you that it is an non-issue.

And seriously: find a new doctor! Any physician with that kind of attitude needs to find a new job - if you don't have a decent bedside manner don't be a doctor.

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Hi M.,

I think going to Children's is a good idea.

You are really being hard on yourself. Turn your thoughts around to look at this in a positive way. Only good will come to making sure your baby is healthy.

You are so awesome for breastfeeding your baby for so long.

Most babies have very strong texture aversions and gag reflexes at this age and it is difficult to watch this happen for your baby. But this is the way they learn how to handle textures safely. I think you are right on that this is something to look into with Children's about your baby, is this a normal texture aversion/gag or does the baby need more training.

Did your doctor want you to feed the baby high calorie, fat and protein foods like avacado, whole milk yogurt, cream cheese on cherrios, small bites of cheddar cheese, macaroni and cheese cooked really soft, cottage cheese, scrambled eggs? The type of food you are feeding baby will help him gain weight and allow you to still breast feed. You can even give your baby breast milk in a cup if you don't want to give him cow's milk.

Do you let the baby feed himself? Sometimes babies at this age are really wanting to do it themselves. Finger foods are really good and anything they can dip. Babies and toddlers tove to dip. Teach him to dip cherrios or pieces of peach in yogurt. Think of any food he can dip.

Do you have regular feeding schedule with baby in the highchair? Baby's are really in tune with timing.

Sometimes feeding your baby is like a dance and you just have to keep practicing and so do they. Baby just need lots of opportunities to learn.

It sounds like you are already doing so many good things. Only good will come from getting more expert help!

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I go along with all the others that say you know your kid best. Definitely get a second opinion. I would go to a pediatrician, or at least someone who understands breastfeeding. I think you are doing fine and so is your son. My daughter was always lower on the charts but our Dr. was very aware of what was going on with both of us.

Just stick with your gut, you know what is best.

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ARG. Stories like these make me so angry!

Please ignore all of the advice to stop, cut-down or otherwise compromise your breastfeeding relationship. Your doctor is obviously mis-educated about breast milk. Breastfeeding is a supply and demand system, if your son is still bfing every 2-3 hours, your breasts will produce the amount of milk he needs for that until he cuts back on his own. She should have encouraged you to make sure you keep it up, if she's not happy with his nutrition or weight gain, since it will fill in the gaps. I'll also ditto the posters below who recommended the Kellymom and LLL web sites, there is a lot of wonderful information and resources on both of them.

Further more, your child does not NEED or HAVE to drink cow's milk now or ever. The only reason for that recommendation is because of the calcium/fat content (it's an easy fix, basically). You can get those nutrients from other foods (including some from bm) if you don't want to give him cow's milk. Cow's milk is, after all, made for baby cows, not baby humans (that's what your breast milk is for! :)). Also, if he's got texture/food aversions at all, he may not even want to drink it. My son has never had milk because he refuses it, no matter what we do (soy, vanilla soy, cow milk with chocolate, plain etc.) and I'm fine with that.

As for his size, all kids are different, and all bets are off, especially when they become mobile!! My son is a shrimpy, but crazy active kid who started walking at 10 months and never, ever stops moving. He is 22 months and barely weighs in at 23lbs with a shirt and diaper on. He is completely fine, if not wonderful!! He was right around 18lbs at 12 months as well. He still bf's and eats lots of "regular" food some days and hardly anything other days, that's what toddlers do.

The only reason I would think about going to Children's is if you are concerned with your son's texture aversion, if he even really has one. My kid would not eat anything mushy at all, even ice cream (!!) until just this past month when he started eating yogurt out of the blue. He never ate baby food, except for the few spoonfuls here and there that we tried for months to get him to eat. Have you tried giving him small pieces of soft-ish table food instead of baby food? My son was WAY happier with that kind of food, but didn't really start regularly eating enough food to call a meal at all until he was almost a year old. It's really all practice for the first year anyway, they could never eat enough at the ages before that to get a LOT of nutrients from the food until then (ever wonder why when babies eat stuff like grapes and berries, it looks the same coming out the other end? It's because they still don't fully digest or have mature gut flora until after a year old).

My point for writing this novel is to let you know that you certainly are not a bad mother, or alone in your situation. There are plenty of us with petite children, who still bf them, who's kids don't like to eat, who don't give our kids cow's milk and are normal, developing great and won't have to worry as much about having obese older children.

Good luck to you and your family-you are doing a great job following your instincts and I'm confident that you will into the future. Don't let any doctor make you doubt yourself!!

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M.,

Stop beating yourself up. All moms have a learning curve whether it is their first or tenth child. They are all different. If you are concerned about your sons eating habits then go ahead with the referral. If nothing else it will ease your mind and you can get your questions answered by a specialist. I don't know your sons height, but I have plenty of friends whose children were that "small" at one year. As far as cows milk, if you don't want to use it then don't. Just make sure he is getting calcium and vitamin D from other sources. (I have a bone to pick with those who say it makes your children fat because it doesn't. At least not my kids.) Good luck and take it easy on yourself.

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M.,

I mean this in the kindest light, but if your doctor says your child is a failure to thrive CPS will step in and take your child. Failure to thrive includes not growing and not gaining weight.

It's great that you mean well and want to nurse him as much has possible but children his age need at least 32 oz of liquid intake daily. If he is not getting that he could be dehydrated.

Neither of my kids had any kind of "food aversion" so I can't help with that, but once your child is 12 months old you CAN and SHOULD start introducing whole milk into his diet. At this point breast milk isn't always best unless you have a high fat content in your produced milk. Until he is two he needs the extra fat in whole milk to help his brain development.

Some days the only sign I get that my kids are hungry is that they are extra whiny and the fight with each other more. Establish a feeding routine and stick with it. You all will be happier.

Kindly meant,
M.

Is he an active guy? Is he meeting developmental milestones? How big are the two of you?

http://www.drjaygordon.com/development/bf/scales.asp

You're right- your milk is the best source of nutrition for him. Keep up the good work!

My Daughter was only 18 pounds on her first birthday!! I say keep breast feeding her and she will grow at her own pace...As long as your son is reaching the milestones then no need to worry! All kids are different! My Little gilr just turned 3 and now weighs 27 pounds and my little boy is 19 months and weighs 24!

Just remember by breast feeding you are giving your son the best food in the world!

lots of good responses, just wanted to add a couple of things to encourage you in your good mothering! the growth charts most doctors use are based on formula feeding, so he's actually higher on the breastfeeding charts. you have a wonderful smart supportive husband too! cow's milk in any form is not only not necessary but is not even a good food for humans of any age and especially not for children. (see notmilk.com). and have you tried eating babyfood yourself? no wonder he won't eat it! i'd focus more on offering him real food - really nutritious and yummy things like fresh raw organic fruits, vegetables, seeds, & nuts (the latter two maybe in the form of butters or milks) - like bananas, other soft fruits, avocados, cucumbers, nut milk & fruit smoothies, and just let him choose what he wants to eat and don't make a big deal out of it (you definitely don't want to get into a power struggle). and continue to breastfeed him as often as he wants, day and night (making sure that you let him nurse on one side until he is done, so that he will get the fat-rich hind milk). if the children's hospital nutritionist really told parents to feed their child cream cheese, scrambled eggs, and whole milk, i sure wouldn't believe anything they say either! (but i think it probably wouldn't hurt to go there either, if your insurance will cover it and it won't cost you anything, and if you take their advice with a grain of salt and do your own research and don't let them talk you into anything). it sounds like your son is totally fine, and i want to congratulate you for reaching out for support, and i'm glad you got so many supportive responses. my son was always below the 3rd percentile, always the shortest kid in his class. he finally finished growing at about 22 years and is now 5'11". so try not to worry, you're a great mom! (and i agree that you might want to consider finding a different pediatrician, although i'm sure that yours means well).

I hope your doc is just concerned, not judging you or punishing you. Since the doctor doesn't specialize in pediatrics, it's reasonable for him to not have enough knowledge in this area. Your son's health is your responsibility and the docs are hired to help you in your goal.

My daughter couldn't tolerate food at all until she was a year old (starting solids at 6 months is just a general guideline). She had major gastrointestinal problems and food allergies (those remain) until then. So she was solely breastfed until one year. She was similar in build to your boy. Her pediatrician was not worried at all. She said 1) our height/weight charts in the U.S. have been modified to account for fat formula-fed babies and 2) breastmilk is all she needs for the first year; after that if she still can't eat solids then she'll suggest we do something else.

You should have a pediatrician who is a breastfeeding supporter and understands why the charts were recently changed. Also your son's doctor should be someone you're comfortable communicating with, not one who intimidates you. And one who 1) has children of their own and 2) has treated hundred of other children (experience with babies).

You may also want to seek the help of a nutritionist. They may have suggestions for foods that are smoother in texture with a nutritional punch. Things like watered down hummus, avacado, refried beans - these are all great brain foods.

All the best!

P.S. Don't let anyone talk you into giving up breastfeeding. It is still the best brain food in the world. And it's not low in calories; it increases substantially in fat content after the baby is one year old.

I also had a daughter that didn't gain well she dropped all the way to the third percentile for height and weight. Her peditrician ran some test to make certain she was absorbing her nutrients. She was and all was well. She told me feed her healthy not empty calories. She had not tripled her birth weight at a year just gaining slowly. She weighed less than your son at a year. I think by 18 months she had finally tripled her birth weight. Today she is a petite slender girl. I could feed her 24 hours a day and she still would be tiny. She can burn it as fast as she puts it in.
She was labeled failure to thrive just because she didn't gain well but we were doing everything right. It hurt because I was feeding her. My other two daughter were in the 25th for weight and 75th percentiles for height. No alarm buttons. Your son is well proportioned. I think she has a problem with you still nursing him. The gag reflex as you introduce more solids. Some have it worse than others.
Just relax . You are a good mom. It won't hurt him to hav an occasional sip of cows milk. He can still have that special nursing time with you. The doctors at Childrens will probably wonder why you were referred.
M.

It sounds like you and your husband are very pleased with having breastfed and thats great. But, I would go to Children's Hospital or go to a pediatrician and welcome formula if he isn't liking many foods very well. I'm sure its a bit emotional transitioning from being your baby's main source of nourishment to being the supplementer but that is the evolution of it...

I would definitely get a second opinion if your child is happy and active. My son dropped below the 0 percentile a few times age (he started at 7 lbs 11 oz so he wasn't a small baby), but typically stayed at the 25th%. It sounds like it's a height/weight ration that your doctor might be concerned about. However, a baby can grow up completely healthy with mostly breastmilk at that age and some babies do have a very difficult time with solids. We ended up getting an occupational therapist to work with my son since he wouldn't eat solids. Turns out he had sensory issues and he didn't eat baby food for a long time and didn't do table food until around 2. He eats everything now. It took him a while to deal with his texture aversion but now the only thing he won't eat is peanut butter. There isn't anything he won't try now.

Get another opinion and tell your doctor your concern about your child's texture aversion. Your child does need to get something besides breastmilk now, but you may need some help to get him to eat the baby food. I don't think you need to put him on formula. We never did (my son would never take a bottle. You do need to get him to start eating some solids and there are lots of tricks to get a child with taste aversions to do it. Occupational therapists can help a lot and if your child has a delay in appropriate eating for his age, they don't cost you anything.

First of all, you sound like a very good mother.

Some babies are just small. Are you and/or your husband on the small side? I have friends with tiny kids, but the parents are short/thin people too.

My sister's son had to see an occupational therapist because of texture issues. If that would help your son, then it's great to see them. It's NOT your fault. Some kids are just that way. Feeling worried is okay. You love him and you want him to be healthy. Don't feel guilty about seeing specialists. My own experience with Children's Hospital (here in Seattle) is that they are VERY nice and pay close attention to your child. Be happy about going to Children's. I hope that you can get some good answers there.

This doctor sounds like kind of a "fit every child into the same box" type person. Your husband is a smart guy to say "no formula". Your breast milk IS the best thing for him, but yes he does need to be eating 3 or 4 times a day also because his age and growth require additional nutrition. A child will let you know if they are hungry. If he is happy and active and not lethargic then he is obviously getting what he needs. Another huge thing to consider is the sizes of the parents. Are you taller and bigger boned people or are you smaller more delicate boned people? That makes a huge difference! 3 of my kids were right on track for the size charts but my older son was really small for his age and still is. He weighed 17.5 pounds as a one year old also and at 7 years old he just now was able to get out of his booster seat! Many people do look at him and think he is underfed or malnurished. Here are the reasons we know he is not (and fortunately we have a smart doctor that understands these): My side of the family is all small boned, petite, light weight people. My Grampy was exactly the same size as my son when he was a child and as an adult was still at most only 140lbs. I am small also (110 lbs). My husbands side of the family is what I would consider average size for a human being (140-210 lbs). Therefore (and you can see it in there facial features and everything) our two daughters and one son took after the stature of his family and our other son just happens to take after my families stature. I might also add that even though he is small and he eats a ton due to the fact that he also has a high metabolism.

My advice is to definitely seek a second opinion from a male doctor. Unfortunately more female doctors out there nowadays tend to think they've got it all figured out and aren't usually as open to listening to the parents. (not all, I'm just saying that it takes a lot of fortitude and self assurance for a female to make it as a doctor, but that unfortunately can make them too egotistical as well). God bless you in your plight, I think you sound like you are a wonderful mother!

And as a side note...please just ignore what Michelle S. said...she is obviously one of the ignorant one's like your doctor. It is rarely in the best interest of one's child to give up breast milk and definitely not in your situation! And no, just because a chart says that's when to feed them, doesn't mean that's how it is for every child! I have 4 of them and they all gave the feeding cues at different times and in different ways. So if 4 kids from the same two people can be that different how much more varied will children from different families be? :) duh!

First of all, don't be too offended by your doctor's concern. If my son's doctor had been more concerned his diabetes would have been diagnosed approximately four years before it was. The poor kid suffered terribly but "he was just little". Well, he was diabetic. Much better to get these things early. Diabetes in kids rears up between one and five sometimes so to appease your doctor you might want to to simply get a glucose test done to see where he is at. I think that is more likely the case with your child than him punishing you. Don't take it personally. Doctors do think they know best because they went to school for a very long time. They don't always though. If you truly feel this doctor is out of line, do get a second opinion. Sounds like you are feeding him just not like this doctor wants you too. Some doctors also are more old fashioned and believe that breast feeding is not necessary after the first year. (It's not really so while it may be a comfort and a close time for you two maybe its time to consider putting him on something else. Your husband is encouraging you to continue breastfeeding..which is interesting...probably a good thing :) (Many guys experience the whole jealousy thing after awhile so yours encouraging you is a pleasant surprise at least to me ). I had to quit breast feeding at six weeks with both of mine. (I simply ran out and I mean went completely empty in the middle of the night). Really...I do encourage you to help your doctor rule out other possibilities but if he's just being a "stick in the mud" then take him to another doctor and see what they say. Babies grow at different rates. My son was extremely small for his age from birth to age four. After he was diagnosed and we started controlling his diabetes he gained plenty of weight. We now have to make sure he doesn't get overweight. You can't please everybody all of the time it seems. SO, make a decision, and if the feeding him more is working..my mom used to tell me that even "two bites" of any given food can be enough at one time for some kids so go with that for now. Feed him "two bites" at a time here and there throughout the day and more at mealtimes. You obviously didn't mean to starve the kid so get over that and move on to better things...if that means a nicer doctor, so be it:) Good luck!

Okay, I see your frustration, and my heart goes out to the two of you!! My daughter was "underweight" also. She was breastfed also. Breastmilk naturally has less fat than formula, don't know if you knew that. There is no better way to start your babies life than to nurse him, hands down! So congratulations, you have done a wonderful job! Now I think is the time to move to more solids in a slow fashion, like you have been doing, but more times a day. I would mix up some rice cereal or oatmeal with some breastmilk to the thickness of your choice and put the bowl in front of him and let him play! Let him make a mess, eat it, whatever he wants to do..the goal is goal is to let him get more familiar with it. My daughter had a sensitive gag reflex too, make the food thinner if you need to. The food processor just doesn't produce the same texture that comes in the baby food jars- just use the jarred stuff mostly for now, then move on when he is ready, you'll know.

As for him not wanting to nurse because he has milk or formula? No way. Breastmilk is way sweeter than cows milk, and cold cows milk is nothing like the comfort he gets at the breast. What I think would be best for BOTH of you is to introduce more solids slowly like one nursed meal replaced by solids a day for a week. A great one to start off with is lunch. Good luck, e-mail me at ____@____.com if you have any more questions, I have to tend to my daughter- hope I helped so far!

Hello M.,

#1 get rid of that guilt and shame you are doing a great job. You need a new doctor. My little girl is on the small side, in fact your son is a least on the chart. My daughter is 0 for her height and 15% for her weight. She is now 2 1/2 and I kept mentioning to my doctor how small she is and my doctor told me there is nothing wrong with her. As long as she has the energy to run and play and she is not grumpy or fussy then she is doing just fine. She is going to be small and I am okay with that. I do know how you feel. She is 2 1/2 and is only 25 pounds and 31 inches long. I breastfed her too and giving them cows milk won't change them nursing. Trust me. I would give him whole milk because it has a higher fat content but don't worry he will not give up nursing. Good luck and don't worry you are doing just fine.

I think he will be fine. My son is 10 months old and he is in the 25 precintile for his age. And he eats all the time (three mealsAnd a couple snacks) and that's even on top of his bottles.he is very active to for his age and I think tha has a lot to do with how they burn their calories. Some kids are just small and the only thing you can do for that is just feed them as much as they will eat when they say they are hungry. I am sure your baby will be just fine. I have a lot of family that were small like that and were ok.

Hi M.,

That sounds like a scary and difficult situation. My son (who is now 2 and a half) was quite small at 1 year, but still weighed more than yours does. I don't think you should feel guilty about the feeding him thing. The big thing is to offer him food, but many babies and toddlers won't eat much solid food.

There are some conditions where children have trouble absorbing nutrients from the food they are getting. I'm guessing that your doctor thinks that your son needs to be tested for this since he has fallen off the growth curve. This is NOT your fault and it is wrong for the doctor to make you feel guilty about it. (You may want to look into finding a new primary care doc for your doctor since this one sounds so rude!)

Hopefully your son is healthy and just small. The fact that he is so active and happy is a very good sign. I wish you the best of luck!

I really don't think you should be feeling guilty, but I know how incredibly scary it is when your child is or may be sick. Just keep in mind that you are his number one advocate and that you know him way better than the doctor.

I hope everything is going okay with him now!

I would get a second opinion and trust your gut mothering instinct. Mother's have been breastfeeding for centuries. Sounds like maybe the Dr is the issue so try another one. Good Luck
A.

Okay,first off my daughter weighed 16 pounds at one. She was always small and turned 4 in July and weighed in at a whopping 28.5 pounds! I would take him to see a pediatrition for a second opinion. Our pediatrition told us to feed our daughter more fat in her diet. I nursed her until she was one and at about 10 months she started drinking fruit smoothies, (she wanted what her older brothers were having). We were told to add real butter to her hot cereal, bread and mashed potatoes. Some children are just not going to be large babies, my daughter takes after my when I was young. In fact whe was only in the 5-10 percentile.

There is nothing wrong with continuing to breast feed him, but at one he needs more than breast milk. They may want you to go to childrens to see a nutritionist for good choices of foods to feed him. I know people say that mom's know what's best for our kids and I do believe that we know our children better than anyone (except dad :)), but when it comes to their health we need to seek professional advise.

Don't be too hard on yourself, but it sounds like you need some assistance, you will feel better when you get a second opinion. I was always relieved to know my daughter was healthy after her check ups :)

Oh my M., I am so sorry. Pleas do not beat yourself up. You need to take your son to a pediatrician. My only gained 13 ounces in 3 months. At 10 months he weighed 16 pounds 1 oz and at his 12 month appt he weighed 16 pounds 14 ounces. He also grew 2 inches. He fell of the chart and is still only in the 3 percent, he always has been in the 3 percent for weight and head. His height he was in the 25-50% for awhile dropped down to the 25% and now he is in the 50-75%. My pediatrician was a little concerned about the weight and asked me and he started crawling at 11 months. She said that made sense. He is still being breastfeed day and night. I too was feeling a little bummed at his dr. appt and asked if I needed to do anything more and she said no. They used to recommend feeding lots of fats and junk foods to fatten up the babies and now we have a bunch of overweight 8 year olds. She said just keep feeding him healthy meals. That is exactly what I am doing and breastfeeding him. He was only 5 pounds when he was born and he has trippled his weight in a year, which is what is supposed to happen. He is just a little tyke and we are little people as well. I am hoping he now weighs 17 pounds :) My best friend has twins that just turned 2 this last weekend. At their 18 month appt her daughter only weighed 19 pounds and 4.5 ounces, she had been off the charts for awhile. All of the sudden she started eating food and now weighs 22 pounds at 2 years old. So what I am trying to say is that each baby is different and grows at their own rate. You are doing exactly what you should be doing, you know your baby best. You need to start seeing a pediatrician who is more in tuned with how babies grow. Also take into consideration height as a factor. Your son sounds like a healthy little squirt, just like my son who will be 13 months old next week and like I said I am hoping weighs 17 pounds. Keep breastfeeding! Your breastmilk changes as your baby changes. You don't need to go with cows milk. I asked the dr. about that and she said as long as I was breastfeeding him I didn't have to give him cows milk. You are being a great mom! You know your baby and you are feeding him what he needs to be fed. Some good advice my freinds husband of the twins gave me, "Somebody has to be in the 3% just like someone has to be in the 100%" Keep your chin up and don't go to Children's find a new pediatrician.
Y.

Do not worry! The referral will most likely help you! The Children's Hospital will be a good experience for you. You will get to meet with a nutritionist and other specialists that will help you learn techniques to overcome texture issues. A friend of mine went through a similar situation (her Doctor made the same referral) and ended up working with an occupational therapist to overcome her son's texture challenges. The best thing you can do right now is to continue your nursing, but also offer solids more frequently. Give your baby a chance to explore each "medium" of food freely. Touching and exploring the foods with hands is one way of how they learn to be comfortable with new textures. Good luck!

I can understand being so upset about the doctor's referral. My twins at one year old and both are small like your son. However developmentally they are right on target even though their milestones should be adjusted for them being preemies.

In my opinion I would get a second opinion for a different pediatrician. But also by going to Children's Hospital you may find that there is absolutely nothing wrong with your baby. My twins had a ped who was acting the same way and was making them come in for additional weight checks because he thought they were underweight. But after talking to a lactation consultant I came to my own conclusion that they are perfectly healthy babies.

You need to consider whether he's hitting his developmental milestones, how active he is, making sure that when he's hungry he gets food and gets full (which it sounds like you're doing imo)and what his genetics are. My husband is 120lbs and he eats like a horse so obviously the kids are the same way. Sometimes they can eat 9-12 oz of baby food at each meal and that be on top of table food that we've shared with them. But my DD is 16.14lbs and DS is 17.11lbs. Talk to a lactation consultant as well and I think you'll find some really reassuring advice.

Breastfed babies are far different than the natural average. Think about it, many babies are forced to take in food they can't process properly as early as 3 months of age, many parents give them cows milk (and some of the charts are based on the time when it was common that most milk had a ton of hormones in it), and their size and weight have jumped up in comparison to babies being raised your way. I would consider switching to another pediatrician or finding one that is breastfeeding friendly for a second opinion. My daughter was in the low 10-15 percentile for height and weight her first year. She was strictly breastfed, but her doctor said that based on her own personal chart progress, she was very stead, she was meeting or exceeding all milestone markers and her head measurement was just fine. Since there were no indications of any issues or problems, she was considered normal.

Now at 3 years old, she is very tall for her age but still much leaner (but not too skinny) than most kids. Very bright, very rarely gets sick and is incredibly intelligent, emotionally secure, physically active and healthy in every aspect.

BTW - my daughter was the same weight as your son at his age!

Breastfeeding helps a child better regulate food intake and they will not starve! He sounds like he is very content and the amount of milk you are producing is plenty! You may also want to reach out to your local LLL leader!

http://www.llli.org/

Sincerely,
A.
www.punkinbutt.com

Hi M. - You have already received some great responses. It sounds like you are learning more each day on what works for your son. I would suggest changing your doctor to a peditrician but I would also go to the referral to Children's Hospital. Request a full set of your son's medical records from the current Dr so that you can personally take with you to what ever doctor you go to. Is he reaching his developmental milestones or staying on a smooth curve of growth even though he is on the low side for one & high for the other? My youngest was that way too but it is how he is growing (his dad was skinny & tall at that same age).

I help run a support group for parents of special needs kids and one of those areas covered deals with kids who can't/won't eat food due to a physical issue or that they are more sensitive to smell, texture, etc. It is key to get assistance early to help these kids find coping strategies to help them overcome the struggles they have.

I would continue to breastfeed, yes it is much better than formula or cows milk (make sure you are eating the best too). But at his age he does need to start drinking whole milk in addition (but follow the child specific advice you can get from the specialist, as each child is different). Again, if he is having struggles with food texture I would make sure to go to the Children's Hospital as they can help do full evaluations & recommend services (nutritional, educational, occupational therapy [make sure it is pediatric OT & not general OT], physical, etc) to help all of you.

My guess is your current Dr being a "general family" and not a peditrician referred you to ones who can help better. Granted how they did it, or how it made you feel is wrong. If you do opt to officially change doctors I would suggest (after you do the specialist) write a letter to the current doctor to share how this experience has made you feel. You can then share with them what you did learn from the specialist. This doctor and others need to realize that their comments - even if they dont intend to come across negative, really do hurt.

Just remember that all of us were not "experienced" as Mamas before we had our first kid, it is a learning curve for all of us. You can and are doing it! God Bless

I didn't have time to read all 75 responses, so pardon me if I'm repeating. My niece was 13 lbs at 1 year, and they referred her to the Children's Hospital to rule out any genetic factors. (Cystic Fibrosis namely) She did fine, and all that was recommended was adding Pediasure to her diet. She was up to her normal weight within a couple months. My son was pretty skinny at one too, and one doctor told us all this worrysome stuff, and then we switched doctors and the new one said, "of course he's skinny, he just learned to walk and is burning every calorie he eats!" Keep breastfeeding, but adding milk likely won't do any harm to your nursing schedule. Try whole goats milk if you're worried (can get at Fred Meyer), since it's much more like breastmilk.

Find a pediatrician soon! They have a better understanding of babies and toddlers. Both my kids have been around the 3rd percentile at some point, and they are both happy and healthy and very active (even my 6-month old who is currently around the 2nd or 3rd percentile for weight). Our ped said as long as they are gaining weight and healthy and active, don't worry. A therapist could probably help with the texture aversions, my nephew is seeing one now (he's 2-1/2 years old). Get a pediatrician and let them tell you if a specialist is needed.

Hi, I think my brother's 2nd son only weighed about 18 lbs when he turned 1, and from what I witnessed he ate a lot of food so must just be his body type (wish I had that problem!). He was around the 0th percentile for weight but is very healthy and active. His older brother was bigger than that. Both of my sons were exactly 20 lbs when they turned 1. My kids LOVED the Gerber puffs (sweet potato especially) that just kind of melt in their mouth. You say your husband doesn't want to give him formula, but you can also just mix a little in with his food to give extra nutrition without giving it to him in a bottle. I'm sure he will be just fine, but it might not hurt to get a 2nd opinion from a pediatrition, maybe they have seen more children that are on the low end of the growth chart and will help ease your worries. Also, my pedi told me that the weight charts have been inflated over the years as more babies and kids are "over weight" or chubbier. I know people with 6 month old babies that weigh as much as my 2 1/2 year old. Good luck!

Breast milk is great but you pretty much get all the benefit from it inthe first 6 months. At one year old, the breast milk has done it's job - switch to regular milk and formula and whatever else will keep the little guy full. Don't compromise his nourishment because you are hung up on breast milk, it's not meant to be what they eat forever.

As far as the referral to Children's, don't think of it as a punishment! Our daughter has been visiting an ENT there since she was a few months old and it's a wonderful caring place - and a good place to get that second opinion you wanted.

Hi M.,
It looks like you got a ton of resonses and I only had time to read a few but thought I'd tell what I did. I also have a small boy. He's 2 years + 4 months and weighs 25 pounds now but he was around 18 lbs. at age one. We see a naturopathic pediatrician and we seemed to be more worried about his weight than she was. She suggested to put Coconut Oil (it looks like shortening) in anything it would go with (oatmeal, applesauce [melt first], smoothies, spread on toast, etc.) It has like 23 grams of fat per serving (~1 T.) and is healthy fat, plus it tastes really good! Babies need (good) fat! You can find it at health food stores (PCC, Whole Foods). She also encouraged lots of nut butters (almond, cashew) for fat/protein. I would mix both of these in his oatmeal. When he got older, she encouraged more meat (we still struggle with this).

When my son had measured in the 3rd percentile, she reminded me that SOMEONE has to be in the 3rd, the 2nd, and the 1st percentiles. These are just averages. She always refers to the World Health Organization (WHO) growth charts because Leo was breastfed until 18 months.

I'm glad you found a different doctor who isn't using scare tactics and making you feel so bad. You shouldn't at all! You are doing all the right things. ((Hugs))

Hi,

My daughter was 90% for height and 5% for weight. She was so long and lean that when she was six months old, she would wear jumpers for 18m because of length, but her onsies were still 0-3m. I remember being so scared, but the doctor insisted she was fine. She also was healthy, walked on time, and was happy. We fed her as much as she wanted - sometimes that was a lot and sometimes that was little.

She stayed at that percentile difference, no matter what I did. When she was four, she suddenly filled out. It freaked the WIC people out, cause over the course of a year she went from 90% height, 5% weight to 90% height, 95% for weight. They were super concerned about her weight gain, even though I assured them that she didn't get candy often or even juice.

Now, she's five, height/weight proportionate, healthy, and in Kindergarten. The moral is - if the child is healthy and eating and happy and growing without dropping weight... he is likely fine. You might do the Children's visit to find out about the texture issue (he should be eating more foods of different types now), but really - I would get a second doctor opinion first.

You are doing a great job! Good luck!

In regards to switching to formula, remember that formula was made to immitate breast milk and is nutritionally inferior. THey both have about 20 calories per ounce. The reason a baby poops more on formula is because they are ABSORBING LESS than they do of the breast milk. Keep nursing! One thing they do for premies to increase the calories is to pump some milk, let it stand so that the cream rises, skim off the cream and mix it in with more, unseperated milk. This greatly increases the fat content.

Good luck!

Oh, my boy weighed 17 lbs at one year and is 2 1/2 and only weighs 24 lbs. He is now on hte percentile chart. He had dropped below the line and I had to take him in every 6 weeks to 3 mos to get him weighed and even had a ton of blood work. He is thriving and talking and running. He is where he should be developmentally. Don't worry about it and you may want to change peditricians.
S.

definitely get a second opinion!! All of my kids were in the lower percentile but now my son towers over me. All healthy and happy...just small as babies.

I would go to the childrens hospital. Focus on your son getting healthier and less on what you did wrong as a parent- They don't come with manuals- take it as a learning lesson
L

Ok, first off it sounds like you need a new Dr. He should not treat you like that ever! Second I have three kids, my 10 year old was the same way, still is. Some kids are just that way. He has always been under wieght and will probably always be that way. He is very active and the problem is they burn off the calories they do get to fast. Alot of kids have issues with the texture of foods, I have nieces that were and still are that way. Not your fault!!! My dr. told me for the extra calories to give him what they called super milk. It is the carnation instant breakfast mixed with milk. A couple times a day, which I didn't really do much, but what little I did helped. And if you don't want to start him on milk, then try mixing it with breats milk when you pump. If you are not getting enough calories and stuff yourself, then you aren't passing on enough either, anything you do or donot eat thats what your baby gets. And I had kids that wouldn't eat babyfood, just didn't like it. I bought a food processor and mushed whatever we were eating and they liked it much better. You can make it the consistancy that your child can handle. But don't take the blame and don't let your dr bully you, that really is wrong of him. Mother's have instincs for a reason, listen to them and learn to trust them! I hope any of this helped. T.

My son, now 15, has weight gain issues similar to what you are describing. He was born a healthy 8 lbs 3 oz but he dropped to the 25th percentile for weight and the 75th percentile for height. The pediatrician had me track his feeding (6oz soy formula every 2 hours from 2 weeks on) and at 6 weeks had me adding rice cereal to his bottles for extra caloric intake. My son is still very skinny (now 5'7.5" and 108 lbs).
The pediatrician ran a bunch of tests on him including meningitis but all came back normal. It turns out that he is just a skinny kid. Even to this day the pediatrician is not concerned about how thin he is as he is staying on his growth pattern and is healthy otherwise.

My point in telling you all of this is that your son could just be a thin kid....of course have the tests run to rule out anything major but odds are hes just fine.

Yes...he should weigh more, particularly if he is in the 75% for length...But, ultimately, you are the parent. The doctor is the expert, but if you don't like the advice, then go to a different doctor...What is the harm in going to Childrens? What if there is actually a reason for your son to see a specialist? It does sound, however, like you are feeding him like a 6 month old, like you said. I have a 7 month old daughter, I nurse her 5-7 times a day, and give her at least 2 solid food meals (I make her food, but give her a few tablespoons of a vegetable or fruit with rice cereal). You were correct - most nutrition should come from breastmilk, but the technique that you should have been using is nursing then feeding afterward a couple of times a day.

As for cows milk, one year is a typical age for kids to switch - don't know why you and your husband are so against it...you are giving him processed baby food, so why not give him regular milk?

Hi M.,

I agree with you that breast milk is very good for your son but at one year old year old and such an extreme difference in height percentile versus weight percentile, there could be something that needs to be addressed medically or he may really need more calories. Breast milk changes over time and does become less caloric as time goes on, by how much I am not sure. Giving him "solid" food now is a good thing to try but seeing a pediatrician or someone at Children's Hospital might be a wise choice right too. It may just be that that is how your son is and nothing is really wrong. But if he does have a medical condition that can be addressed wouldn't you feel even worse later if you didn't explore this just a little at least now. I am not saying that you should go to Children's Hospital but a second opinion would be good.

Don't beat yourself up about the past, you can't change it. I know easier said than done, but you did what you thought was best given the information that you had at the time. Maybe more information for another doctor will help you in making choices now.

Now that I have said all that, those charts are based averages and won't work perfectly for everyone. If and your husband are particularly tall and thin then your child is probably just growing normally for his genetic makeup. But if you he isn't likely to have have tall and skinny in his genetic makeup then... I can see why the doctor would be concerned. Also, realize that check ups 3 months apart are pretty normal for things that doctors are concerned about.

Good Luck,
S.

I would trust your own instincts on this. Although I'm sure your doctor means well, they expect all kids to fit into what is "normal." If you feel your baby is healthy, keep doing what you're doing. Or at least get a second or third opinion from other doctors.

I am sorry you are feeling so frustrated with this experience. I feel that you should involve the care and advice of a very good pediatrician right away. I would find out the specific rational behind your doctor's referral to the children's hospital. Does he require more extensive evaluation such as lab work? You need to know, and you need to fully understand why. I worry that for whatever reason, your family is curently unable to follow the care plan recommended by your MD. I would advise a second opinion and a new medical relationship for ongoing care of your son. I also breastfed, until my son was 3 1/2 years old. I began to incorporate various other foods from 4 months on including making purees of fruit/veggies, whole grain cereals, and some supplimentation of formula (Horizon organic). Just because you are breastfeeding you need not exclude other foods. There is a lot of pseudoscience out there on the web, and i think the sound advice of a recommended pediatric doctor is a better sounding board sometimes. It could be that your son has food alergies/intolerences or a reflux condition if he is vomiting up whole foods. Does he have teeth? Teeth are for chewing food, and if he is not doing that by now, I think you really need some better advice. There is a lot of mistrust of the medical community, but I think we must be educated and aware parents who can access their advice, and make our own decisions based upon careful, logical and sound consideration. Go get a good ped md right now. Best of luck.

Our son was under the 10th percentile at his 1 year, but our pediatrician never seemed concerned. She recommended lots of butter on his foods and mashed avocado. You can also add some olive oil to his baby food. I'm sort of shocked that your doctor is concerned though there are 25% of children who weigh less than your son! Perhaps she wants to impress upon you the importance of really trying to bring up his weight. You get it! I think you should find a pediatrician for your son regardless of whether you take him to the children's hospital. You need to find someone who shares your concern for your son without making you feel guilty. It's really not warranted! By the way, our son is a healthy and happy 3-yr-old who is somewhere in the neighborhood of the 25th percentile.