baby

When my daughter was an infant, she was small. I breastfed her on demand, and she was thriving in all developmental areas, but with a birth weight of just over 2600g (under 6 pounds), she was sticking to the lower percentiles of the growth curve. I remember going to her pediatrician when she was a little over 6 months old. She had recently started eating complimentary foods. The doctor's comments were something along the lines that my baby was small, so I should be adding oil to her cereal and feeding her more. As a new mom, it hit all my insecurities. Was I not making enough milk? Was I not nourishing my baby adequately? I allowed the doctor to put me into a state of worry.

In retrospect, I realize that I was worrying for nothing. My daughter was perfectly healthy, and was just following her growth curve. Since those days, many moms have told me about similar experiences. They worry that their baby is too small, or too big. And being moms, what is the first thing we often do? We wonder what we are doing wrong. Very often, we are doing everything right, and our child is just growing the way she is supposed to.

Dietitians of Canada (DC) has a wonderful handout entitled: "Is my Child Growing Well? Questions and answers for parents."

They point out that "Children come in different sizes and shapes. Though your child may be taller or shorter, heavier or lighter than other children the same age, changes in height and weight generally follow a regular pattern that is right for your child."

Yes, the growth of our babies and children is important, because it can give us an indication of their overall health. A big change on the growth curve - growing too fast or too slowly - can be a red flag, a possible sign of something gone astray with health or nutrition. But it's also important to remember that growth is affected by many factors, including eating and physical activity habits, environment, and parents' height. And that growth is one indicator of a possible problem, but it does not mean that there is automatically a problem.

As Dietitian's of Canada recommends:

"Your child should be weighed and measured at all regularly scheduled well-child visits and/or at visits when your child is ill. Typical well-child visits may occur: within one to two weeks of birth; at two, four, six, nine, 12, 18 and 24 months; once per year for children over two years and for adolescents." The recommendations are similar in the USA.

It's important to know which growth curves are being used to monitor growth. Babies grow at different rates. For example, breastfed babies tend to grow more quickly than non-breastfed babies in the first six months and tend to grow more slowly in the second six months of life. Non-breastfed babies tend to grow faster in the second six months of life. The World Health Association (WHO) growth charts reflect this. They are the standards: they identify how children may grow when provided optimal conditions.

In Canada, the WHO growth charts are used to monitor growth for all ages. In the USA, Centers for Disease Control (CDC) recommends that health care providers use them to monitor growth for infants and children ages 0 to 2 years of age, and use the CDC growth charts to monitor growth for children age 2 years and older. The WHO charts reflect growth patterns among children who were predominantly breastfed for at least 4 months and still breastfeeding at 12 months and therefore may not apply to all children.

So how do you know if your child is growing well?

DC says "his head circumference, weight and length/height will follow (or "track") along the same growth lines over time." And they remind us that "all children have a pattern of growth that is natural for them. Regular weight and length/height measurements over time will show your child's special growth pattern. Talk to your health care provider if you have concerns about your child's growth."

Image: Joeannenah