Getting my 15 month old preemie to grow

[sbrinton]

So our pediatrician is freaking out. And I'm a little worried. Zephan is 15 months (13 months adjusted) and weighs about 17 pounds and is 30 inches long.

This puts his height at the 50th percentile if we adjust, or between the 25th and 50th if we don't. But his weight is way below the chart - the 5th percentile for his age would be 20.5 pounds. The 5th percentile for his adjusted age is 19.5 pounds. If we look at the WHO charts, the 3rd percentile is around 18.5 pounds.

The doctor doesn't expect him to be a big kid as all of our boys are lean, but she's very concerned. She wants us to butter everything, to mix formula into everything, to feed him junk like Carnation Instant Breakfast. She also wants us to go have lab work done at Children's Hospital to test for allergies, cystic fibrosis, and who knows what else.

Any thoughts on what we should do?

[Lousli]

First of all, is there any chance that your son is just small because he's small (not a nutritional or preemie issue?) I got a similar lecture at the pediatrician's office when my daughter was about 15 months. The doc I saw (not our regular one) wanted me to quit nursing or at least quit night nursing and give her Pediasure. She ordered a blood and a urine test on my daughter. Nothing turned out to be wrong.

Not once did she take genetics into account. I'm 5 feet tall and weigh just over 100 pounds. My grandmother was 4'10'' or 11." We're small people. I looked in my baby book and it turned out that I was almost exactly the same size as my daughter was at that age, and I wasn't a preemie. Even now she's only about 31 or 32 pounds at 5 years old.

I think if you can speak to your pediatrician about it, I'd ask what would be the benefit in getting the tests done immediately (especially if they are at all invasive) versus getting them done in 3 or 6 months after you've tried a high calorie diet. if there is a compelling reason for testing right away, then sure, do it. Otherwise, why not try to be aware of the calories he is getting and see if that helps?

We still feed Hazel the full-fat baby yogurt and whole milk, and put butter on pretty much everything. It is funny though because on the other end of the spectrum, I'm pretty sure they are going to give me grief when I go in with my 8 year old that she is bordering on too heavy. You can't win unless they fall right into the middle of their perfect little chart.

[Kailey's mom]

Besides being premature, did you ds have any medical issues? reflux issues? Are his stools greasy? I know, sounds gross. Did he fall off his own curve? If you answered yes to any of the above, I would go ahead and get the testing done. IDK, I mean, if he appears healthy, and eats like a typical 13 month old, I wouldn't be freaking though. ((hugs))

[aris99]

Unless your little one has stopped growing I would not worry just yet. My dd (born 26 weeks, 1lb 10.5oz) was about that size at Zephan's age and her weight was being micro managed by a truckload of well meaning specialists. Then suddenly my middle child started having health issues and I took my eyes off my dd's growth chart for awhile. She was small (barely on the charts)but she kept on growing and now at 4 she is very slim but she's wearing 5T clothes...go figure! I didn't push high calorie formula beyond 18 mos (I wasn't able to bf beyond about 6 mos due to lack of supply) and though I think she still has reflux from time to time it hasn't put her off her food and I think she's doing great!

Trust your instincts. You know if Zephan is outgrowing his clothes, whether he has enough energy, if he's generally looking healthy...he might just need another yr or 2 to "catch up".

[LaughingHyena]

That sounds similar to DD, I know she was under 16lb at a year.

She was not big on solids till closer to 20 months (around about when she started walking, I always wondered if they were related)

Does he seem healthy? have lots of energy to play? Does his hair and fingernails grow? (I seem to remember this being one of the things our doctors told us to look out for)

If it's just the charts which are worrying then I would leave the testing for a few months, then think about it. If there are other things which make you worried then it may be better to do the testing and have those things ruled out (or in).

[preemiesguide]

The moms who've replied to your thread so far have asked really great questions. Aside from being small, is your son healthy? If he's showing any symptoms other than a low weight, then looking for further health problems might make sense.

Most catch up growth happens before 2 years of age, which might be why your pediatrician is starting to worry now. Also, if a child starts to slide down the scale (for example, if he was in the 50th percentile for weight at 12 months and is down to the 5th percentile now), then that's a sign that other issues might be going on. Of course, if you're little one is making the transition from mostly breastmilk to mostly solids, that could explain it.

You mentioned that your other children were small. How does Zephan compare to his brothers at 13 months?

As you consider whether or not to start trying to get extra calories into Zephan, remember that there are positive and negative consequences to catch up growth - and that there are healthier ways to get extra calories into little ones ;-)


:-)
Cheri
Visit me at preemies.about.com

[sbrinton]

He is mostly healthy, although he has had a cold or various infections with thick, gunky mucus for months. He's had ear infections over and over again and does wheeze a little with breathing. He had RSV twice this year.

The doctors expect him to be small and are fine with him cruising along the bottom of the chart. The issue is that he stopped growing, or actually lost weight, between 12 and 15 months. So he totally fell of his curve.

I wouldn't worry so much if he was a picky eater, but he eats amazing volumes of food. For example, yesterday for breakfast he had 1 cup of cheerios, 4 oz juice and a whole milk yogurt. For lunch he had sliced turkey, half a slice of toast with butter, cucumber slices and shredded cheese. last night he was at grandma's house and he ate a whole (organic, at least) hot dog, about 1/2 cup baked beans, 1/2 cup applesauce, soymilk, and an ice cream sandwich. He breastfed 3 times (I think he gets 5-6 oz per feeding). So depending how much actually landed on the floor, I think that's easily 1200-1400 calories. And that day was not unusual at all. He often eats more than is 2 or 5 year old brothers.

So...I guess that's where I am worried. The little man eats and eats and eats but he is still tiny.