Is My Son Undernurished???

Get a different pediatrician. She sounds like a nut. Don't forget to get copies of his file.

Good luck.

The rule of thumb I always heard was they generally double their birth weight by 5 months and triple their birth weight by 1 yr.
My son weighed 9 lbs 1 1/2 oz at birth, 18 lbs at 5th month and was 24 lbs at 1 yr (not quite tripled but still a good weight for him - he was an avid crawler and weight gain slows once they start moving around a lot).
I breast fed him for 5 months, then formula fed him till just over 1 yr.
You need a doctor you can trust and work with. If you are doubting her word now (and what she is saying development wise sounds like nothing I've ever heard before), how much are you going to be able to believe her if anything serious comes up? Just find another doctor. This one sounds just a bit round the bend.

Okay, you son is more than fine! My daughter just turned 6 months and is 13.9 lbs. She is meeting all of her milestones and is very healthy and active. The dr wasn't in the slightest bit worried because she is maintaining her curve. She is exclusively breast fed. We have tried solids (cereal) but she barely gets any because she just gags right now. It is recommended that they don't start solids until 6months because there gut is not ready for it yet. Then, until a year it is mostly for practice, most nutrition should still be coming from breast milk or formula. Check out kellymom.com for more info.
Of course she wants to see him back at 9 months- that is normally when the next well baby visit is- for all babies!
I'm so sorry that she made you feel this way. Bad day or not- that is unacceptable! A good relationship and rapport with your pediatrician is a must and she doesn't seem interested in establishing that rapport and trust with you- I would look for another one myself.
Hope this helps put your mind at ease that your little one is doing just fine and is in no way undernourished!

wow! I would just ignore it maybe she was having a really bad day. Breastmilk is all that's really needed for the first year and when solids are added its just to have fun with different tastes and textures its not for a nutrition source. I think your baby sounds like he is doing just fine. Don't let her get to you. I travel 45 minutes-hour (sometimes more if the traffic is real bad) to get to a good pediatrician there aren't any that I would trust with my child that are near by.

Your son is fine. Your doctor isn't. Unless she's been wonderful every other time and was just having a terrible day, I'd look for a new one.

Wow...I would seriously question your pediatricians people skills!! Your son is just fine as far as I am concerned...and you are right, your milk is the absolute BEST thing you can be feeding your child and at 6 months of age all he really needs is your breast milk!!! My own grandson just turned 9 months old...he had his 9 month appt last week..he weighs 17.5 lbs and is 29 inches long...his pediatrician ( who is more of breast feeding advocate than yours is, obviously!!) was VERY Pleased with his growth. He has been eating a few foods ( avocados, steamed carrots,green beans) for the past 2 months...but not really to "replace" breast milk but to help introduce him to the sensory delights of solid foods!!!.
I feel like I can always tell by looking at a baby if it is a bottle fed or breast fed baby...breast fed babies tend to be leaner.... so I would not be concerned about your son at all!!! I would how ever consider finding a pediatrician who is more closely aligned to the way you are choosing to raise your little one. You are going to have a relationship with this doctor for quite a few years and you might be happier with someone else.

I'm sorry you had such an experience! It definitely sounds like the pediatrician was having a bad day, especially if this is the first time she has acted like this.

First, take a deep breath. LOL. :) You are doing fine. The current recommenedation by the American Academy of Pediatrics is: No solid food until 6 months, and that solid food should not be the primary source of nutrition until the baby turns 1. This means that the baby should be getting the majority of its nutrition from breast milk or formula. This was decided after reviewing the research, and I believe this rec. has been in place for at least several years..... Solid food is all about learning and experiencing new tastes and textures, and not so much about getting nutrition.

So if the doc brings this up again, let her know you did some reading, and make reference to the guidelines of AAP. And ask her if she has different recommendations.

Regarding the baby's weight, he's not a boxer, trying to make a certain weight class so he can fight, LOL! We had an in-depth discussion with our ped. about the weight/growth charts---and she said that docs should not be looking for a child to be in a certain percentile..... What the docs should be looking for is to see how the child is progressing. So, for example, our baby was born in the 10% of weight and 50% for height. At his 1 month appt, he was 20% for weight and 65% for height. At his 3 month appt,, he was at 25% for weight and 75% for height (this is common, I guess, particularly because he's a boy, and my husband is tall, so the height increase was not surprising). He stayed at those percents until around 15 year, when his weight went down to 20%..... What they want to see is that he is consistently growing, and is not making radical changes upward or downward.

So, if your little guy has been in the 50% percentile for weight, or was lower and gradually increased, that's good. If he dropped a lot in % or gained a lot in %, that is concerning.

What I did when I started on solid food was to continue nursing at approximately the same amount (especially at first) and feed him solid food right after nursing. That way, he got all the nutrition from the milk, and he wasn't starving while trying to master the idea of using his tongue to taste and move food to the back of his mouth. 1 T = 1 serving, and at his age, 1 T is about all you'll get in him at first, (unless he really loves it or is quick to pick up on the idea! :).

If your ped. continues to act like this, maybe say, "can we stop for this exam for a moment and talk? I know you are very busy, but I'm concerned because I feel like you are treated us differently than when we first came to your office and on our first couple of visits." She may get defensive (out of guilt or whatever), but if you kindly bring it to her attention, hopefully, she will be able to take a step back and rebalance herself and calm down.

If not, I would say to start shopping around. She may have been the only one to want to take a homebirth baby, but now that he's 6 months and is healthy, and has been seen by a doc, I would think that switching wouldn't be so hard as the initial problem of finding a doc to see you & the baby.

You are a great mom! She is a terrible Doctor! ( are you sure she is really a Dr????)

Umm...that's weird to me. My youngest is 14 months and we're lucky if she tips the scale at 16 lbs. She was exclusively breastfed and actually stopped gaining weight for awhile. She was in no way malnourished. She was totally healthy in every aspect of the word. It sounds to me like your guys is perfectly fine. I might be wrong, but I believe the recommendation for beginning solid foods is 6 months. Obviously he's not blind as he was focusing on her rings. Who wants to look at a silly ol' light when there's pretty sparkly things to look at? Had she never put her hand on his leg, he probably wouldn't have noticed it. I know if someone touches me, I focus on that.
I have no idea why she would act that way. I guess you can just shrug it off as a bad day. See what her demeanor is at your next visit. If she's still hostile toward you, I would look at different pediatricians.
I went through several before I found one that fit our needs. Don't be afraid to stand up for what you think and believe.
In the meantime, take to heart that you are doing just fine and so is your little guy.

My daughter was breastfed exclusively for the first ten months. She refused solids until that time. The doctor tested her for anemia (she thought for sure she would be anemic since I wasn't giving her iron supplements and she was refusing solids), but she came back fine! She is now 17 months eats just about everything and still only weighs 20 lbs. But, the doctor isn't concerned. She is just petite like her momma!
Also, I thought you weren't even supposed to try solids until they turn six months and then you start out slow with just one meal a day? At least that is how it was with my boys who did show an interest in solids at six months. Also, normally the next visit would be at nine months anyways. So, I think the doctor was just having a bad day too! Your son seems right on track to me!
I have a friend who swears by raw milk. I take blackstrap molasses for iron too!

Our son was exclusively breastfed for 9 months with NO other food or supplements! He is now an extremely healthy, happy, and bright 3 year old!

My best advice is to take him back in 3 months to a different pediatrician.
Really, unless you have a great reason for giving her another chance, go to someone different, if for nothing else than another opinion.
You know your child best first of all and know if he can see you, his spoon, his bottle, his toys. Starting him on solid food at 6+ months is more than fine. I would do things differently now than I did with my just turning 6 year old in that I started him on rice cereal like everyone else. I would start him on starchy veggies right off the bat, or purreed spinach. They are much less inflammatory to the gut (bonus: you get then used to alkaline tastes and they grow up loving veggies.)
You and your baby sound like your doing fine. Keep breast feeding. Another thing to consider is how tall or big are you and your husband? If you are both on the petite side, you're not likely to have gigantic kids. That's why there are percentiles, because we are all different.

Hi B.,
You are doing nothing wrong. I have 2 happy, healthy boys. My first I did not give solids to until he was almost 7 months. He just wouldn't eat from a spoon. My second, the eater, was doing it at 3 months. Go with your mommy instinct. I would switch doctors and file a complaint with the practice. It's hard enough being a mom and they should be there to hepl you.
L.

Hi B.,

The m.d. sounds a bit hysterical. I'd look into getting a different doc for your son. Not only for her attitude, but also for her heavily ringed hands. Rings hold germs. Yuck. I'm sure she washes but those rings have grooves.
I can't remember when I started my children on solids.

Good luck,
M.D.

as long as you're feeding him on his demand schedule he's fine.

I say find a new pediatrician. That blind comment was totally inappropriate - even if she truly thought he was blind (which it sounds like he isn't). She should know better than that. I also wouldn't worry about whether or not he's nourished because he sounds like he is. A lot of pediatrician don't want you to start solids until 6 months!

You know, I hate to be a breastfeeding nazi, but your peds comments are WHY there are bm nazis!

Your milk (since you are taking your vits, eating and drinking well) is all your 6 MO needs, you are doing everything exactly right! Especially when you say you will soon be starting solids since you've noticed he is taking an interest in when YOU eat. His growth sounds perfectly normal to me, you sound like an excellent mamma.

I would just shake it off (maybe a stressful day, maybe interpreted what she said incorrectly), we ALL have them, even docs are Mammas too! See how it is on his next check up

Meanwhile, you're doing everything right! Keep it up!

(did she REALLY say, 'i think he might be blind?' honestly, what kind of thing is THAT to say to a new mom, gee wiz she must've been having the MOTHER of all bad days!!)

well, is your son following other milestones? sitting up on his own? starting to crawl? holding his head up on his own? I would say if he is doing everything that is "normal" and still very active, then he's fine. However, I also think that if he is very active, it's probably time ot start him on sloids to help sustain a very active baby. 17.5 lb sounds pretty good. my daughter was 19-20 lb at a year and she started on solids at 4.5 months. Good luck and all babies are different.

That definitely sounds like a crazy visit and a crazy doctor. And um you would normally have a 9-month check-up anyway, so that's weird that she said it like that?

Anyway the only thing that really concerns me about your son's diet is the lack of iron...babies can't absorb any iron from breastmilk and it doesn't matter if your diet is iron-rich. My pediatrician asked me to give my son an iron supplement, since he was exclusively breastfed too, until he was either on 3 meals of solids a day or on cow's milk after 12 months of age. Otherwise, sounds like you're doing an awesome job.

When my baby was 6 months old was also almost 18 lbs with almost the exact growth you mentioned! He is also 75th for height and 50th for weight. I also had just started him on solids. She said everything looked great and that he was perfect!!

The only cause for concern would be if his charting isn't consistant growth. Maybe that's what she meant? Was his percentile's higher at his 4 month checkup?

Your pedi made it sound like she needed to see him in three months because of something wrong but in reality he was supposed to be seen then again anyway! That's the baby schedule. Don't worry, I really think you are fine.

B.,
Sorry you had such a difficult experience with this doctor. IF you truly think it was a bad day than I could see returning to the doctor but I would try to bring it up at the next visit. A check-up at 9 months is typical so I wouldn't worry about her rushing you back.
Our little guy is in the same size/percentile as yours. Our doctor was a little concerned because he had fallen off the growth curve (he was 9lbs. 2 ozs. at birth) but she wasn't ready to say that we were doing anything wrong. She said we would see where he was at the next visit and if it seemed like his weight was plateuing than we would run some tests to see if there was an underlying issue that was preventing him from gaining. We all think he is fine and growing but at a slightly slower pace that the typical babies his age.
Our doctor thought he MAY be on 3-meals by 9 months but continues to encourage breastmilk as the primary source of nutrtion.

Good luck with everything and don't worry too much about the docs - - - they are doing what they are trained to do! If you have a repeat crazy visit I would definitely seek a new practice even if you have to travel a bit further.
- J. :)

Well, the 9 month visit is just to make sure they are growing and gaining properly.

Your son is fine. It sounds to me like you took offense to your Dr and she wasn't being sensitive.

Get a new Dr. Or just accept that many Dr don't have nice bedside manners.

as long as he has been steadily staying in the same percentile, he sounds fine. If he was in the 90th at last checkup, and is now in the 50th, you should be concerned. They should follow the same growing pattern at least until he starts to walk.

17lbs at 6 months sounds great, as my peanut was 19 at her first birthday LOL, but she was in the 50th percentile the full time, so no one was concerned.

I do beleive he should be trying some solid foods now, but 3 meals of it? I don't think so. My babe was on 2x day rice cereal at 5 months and then around 6, went to 2x day rice cereal/baby food, the majority of her food still coming from my BM.

The blind thing would have been the part that caused me to say what the heck is this doctor's problem? That's my red flag, that she would assume he is blind and not look into any other factors, say a distracting shiny ring?!?!?

You may need to find a new pediatrician, and trust me there are for sure others who will work with your vaccination schedule. They may not agree with it, but... they will work with you.

Good luck!

You are not a bad mom. Good for you for breastfeeding. I think your doctors bedside manner may need to be checked and what he was probably trying to relay was just breast milk is not enough. 50th percentile for weight is small. Look at all the mammals on the planet. If they are not fed well when they are young they will always be small and weak. My best friends baby at 6 months was in 50th percentile and they were checking her for mental illness. Your doctor may have overreacted or not delivered his message nicely but you could be doing permanent damage. Check with la leche even they will tell you that you need to feed him more and if he is not eating there could be an underlying problem.

Your son sounds just fine! He sounds great, actually. Personally I would use a different pediatrician next time. I like pediatricians who are more relaxed! Or if you stick with her I'd think you should have a little talk with her telling her how she made you feel.

First change doctors. This doctor sounds like a quack!

And make sure you are getting the right amount of protein and limiting sweets, caffeeine and alcohol. You may know this already but thought I would mention it.

You know in breast feeding your baby is getting what you are eating. He can only be nourished if you have a good diet. Since you didn't mention what you eat, I thought I would mention this.

Your pediatrician sounds crazy. I would find a new one asap! No reasonable doctor would say "I think he might be blind" with such a cavelier attitude. My son just turned 7 months and at his 6 month visit he was 16 pounds, and no red flags were raised. His weight sounds fine to me. Of course you will bring him back at 9 months....that is the next well child check up. It sounds like your doctor was trying to make you feel like you are a bad mom! This is not what you or your son deserve. Find a new doctor!!!!!!

I am in agreement with your doctor. Especially after what you added to your original post. While I am sure that you enjoy breastfeeding your child and that it feels great to you it is time that you start giving him some real food. And if the most "liberal" ped in your area thinks this then maybe it is true. I would definitely take him back in 3 months also.

I think you should change the doctor. Sounds like she is completely incompetent and rude, and really shouldn't be doing what she is doing. Breastfeeding your child is not only a good thing, it's an excellent thing for your little son. After all, isn't it what nature intended for us in the first place long before formulas came into existence?? So keep on breastfeeding your son! I know moms who are still breastfeeding their 12- and 14-month olds!
And what was she thinking by telling you that your son is blind - goodness! I wonder how she is still working at that office after making such awful claims (I'm sure you are not the only one to receive false statements from her). She really should quit being a child's doctor.

You don't like your doctor. Mine is even gruffer. I ignore lots of comments he makes and advice he gives. It's not important to me, and I do trust him to spot any serious problems and refer me to places which he has in the past. Don't take the comments personally. Well trained doctors who also have JUST the right personality are hard to find.

I haven't read the other responses so sorry if this is redundant. But bad day or not, I couldn't deal with a Dr that treated me that way. My daughter is 6 months as well was 16 lbs 4 oz and 27 1/2 inches long. 50th % for weight and 75th% for height. I just introduced solids for the first time when she was 6 months old and my Dr had NO problem with that. She said she looks beautiful and healthy at a very similar weight and height to your child. Absolutely not undernourished! She told me to introduce different foods and that I could move a little faster b/c I waited until she was 6 months. But she gets the majority of her calories from breastmilk still. She should NOT have scared you about your son being blind...that is CRAZY, bad day or not. And the normal schedule is to go back at 9 months, so she seemed to act like you were coming back b/c she was sooo concerned when in fact you would normally come back in 3 months. If she was THAT concerned, she would have you back in a few weeks. You know her better, but if that was me...I wouldn't be seeing that Dr again.

I'm not sure about her manner (which, as you describe it, sounds ridiculous), but coming in for a weight/height check at 9 months isn't unusual... and something I would guess that you would want to do anyway. There is a lot of confusion and disagreement on when to start solids, and everyone (even docs) have their preferences. I'd chalk it up to a bad day, but, as you've said, 2 bad experiences in a row would make me think about finding another doctor.

Everyone is entitled to a bad day. Since this is the only liberal pediatrician in your area you need to stick with her. I would however mention to her that the visit was very disturbing. I had a pediatrician I ended up leaving because of a stomach issue that was not diagnosed properly on my younger son. Beleive me, they heard me when I needed to speak up to them. Some pediatricians do "think" they know whats best for our kids those pediatricians seem to make us moms feel like we don't know what we're doing but we do. You're doing a great job breastfeeding him and he seems he's gaining weight just fine. However, at 6 months he should start stage 2 solids. At 4 months is stage 1, so I can understand her point about addressing that with you. Some pediatricians like to see chunky babies, your baby is within its normal weight and height so she's probably making sure that in those 3 months you've already started him on the solids.

I dunno... Relying solely on him being in the 50th of weight now maybe misleading because you dont say what his percentage was previously... Has he consistently been in the 50% or was he at a higher % and has been slipping downward every 3 months? Same with the height... Was he ways at the 75th % or is he trending downward? Keep in mind that usually you see loss/change in % around 12 months, the age when when their metabolism kicks in. You really don't want to see a downward trend start before that.

Her reaction may also have to do with whatever she advised at your last check-up. If she advised you to start him on cereal and baby yogurt at 4 months and you ignored that advice, then yeah, she might have been annoyed to find out he's still exclusively breastfeed at 6 months.

Lastly, I recall that exclusively breastfeeding babies may have a higher risk for iron deficiency. So I don't think its healthy to rely on breastmilk after 6 months. At 6 months, his muscles should be getting ready to be more mobile, so you want to make sure he's getting the optimum nutrition that his muscle development and skeletal system needs.

Get a new doctor. That lady is nuts.

The American Academy of Pediatrics recommends breast-feeding EXCLUSIVELY until 6 months of age, and continuing to nurse (while introducing solid foods) until a year of age... Sounds like your gut is right-on, as is your description of the visit - insane ;)

Time for a new Ped. Pronto. Like, yesterday.

And table food has a FRACTION of the nutrition breastmilk and formula does. One of the first things that's done when infants are not getting enough nutrition is to YANK them OFF of any and all table food. Sheesh.

Sometimes some people are great for a specific period of time, and then they become... less than great. I had a ped, for example, who was GREAT with infants and toddlers, but terrible with kids. So I made sure that if the appointment was with them (it was a small group of Peds, appointments could be with anyone), that all of a sudden I remembered "a conflict", and got a different day/doctor.

The mark of a good pediatrician, btw, is even if your child's arm had just been cut off... you leave feeling reassured, more knowledgeable, and sure that you can handle what's coming.

And as far as nutrition and growth... make an appointment with a nurtritionist who specializes in infant and child nutrtition... and you'll get an EAR full of how *no one* should be eating 3 meals a day. 5-6 meals a day is preferable on a bare minimum for toddlers to adults, and infants usually need to be eating every apx 2-3 hours.

3 meals a day! My mind is still reeling. What Baloney!

Yikes! I think you know that your instincts are right on about the development of your child. As far as the doctor and this "bad day," I think I would consider writing a well thought out letter explaining your frustration with the visit. Not confrontational, just some gracious constructive criticism.

Get a NEW doctor! This lady is crazy. No matter how bad her day is she should NOT behave this way.
My sister did not start solid foods with her daughter (now 1 year old) until she was 6 months old, based on her doctor's advice.
I started my boys at 3 months, which our doctors thought was too early, but they never made me feel bad about it. They just told me to make sure they were getting enough breast milk.
My boys started in the 95th percentile and eventually dropped down to the 50th & our doctors say that's normal.
I don't think you have anything to worry about, other than finding a new doctor.

Hi,

If you do believe it is a bad day, I would contact her and let her know how she made you feel.
Otherwise, I would feel safe with a doctor who is obviously not paying attention and just trying to find something wrong.
You have to be able to trust her if something wrong actually happens.

If your son is underweight at the 50th percentile, then my 2 year old daughter (at the 5th) is what??? She is healthy, very active and so incredibly smart. I've realized that Docs, no matter how liberal (and I have a semi-liberal one) seem to put the fear of God into parents. We just have to be strong and know that we are doing the best for our own children.

Hi B.,

I'm sorry to hear she is the most liberal pediatrician in your area but if this were my experience, I would be searching for another ped or limiting our well visits. Did she use a breastfeeding or formula feeding chart for his measurements?

As a mom of 4 children, all of whom were exclusively breastfed for the first 9-12 months and gradually started table food when they showed the interest(we fed them what we had and whole foods....avocado, veggies, banana for starters), I can assure you that you are doing what is best for your little man. I extended breastfed all of mine and am still breastfeeding my youngest who just turned 13 months. Your breastmilk has nourished his body up until now and it will continue to do so. Don't feel guilty about exclusively breastfeeding him and start solids when he's showing an interest and you feel it's time. Sometimes it's challenging to listen to our instinct and follow our beliefs based on what society and others tell us we should be doing. One source that I found incredibly validating for me was mothering magazine. You can find them at http://www.mothering.com if you haven't already.

Peace,
J.

OMG! Give me a break! I'm sure he's fine & your doctor was just TOTALLY over-reacting and/or having a crappy day. Jeez! That's terrible.

My kids were both breastfed & VERY tiny (but very smart & extremely healthy, which, to me, speaks much more than growth alone!). My daughter was only 16# at a year & my son is a little over 3 & only weighs 26.5#.
To me, it sounds like you have great instincts & that you are following your baby's cues. Your baby will always tell you what he needs.
Keep up the great work, mama!