"Just feed him butter..."

[NSmomtobe]

I don't know if this is a vent or rant or what, but I wanted to post about my son's 9 month well baby visit today. I was going to post in the breastfeeding forum, but breastfeeding was barely mentioned so I'll just put it here.

I wasn't sure what to expect for the 9-montIh check-up because there are no vaccines recommended at 9 months here, so I just decided to relax and go with the flow.

My son was weighed 19lbs, 3.5oz according to the doctor's scale. I made a comment that he seemed to be following the 50th percentile on the WHO growth charts, but the doctor pulled up his chart and said, "Actually, he has fallen from the 60th percentile at 4 months to the 40th at 6 months and now he has dropped to the 25th percentile, so that is quite a big drop."
I said again that I had not looked at the WHO chart lately, but I was pretty sure that he has been (and is still) following the 50th percentile curve for breastfed babies.
The doctor then said, "Well, we don't use worldwide standards in Canada--we use Canadian standards."
I said, "You told me at his first visit, when I asked, that the chart you used came from inner city Detroit."
He looked again at his source and said, "Yes. These numbers came from the CDC in the US, but they were Canadianized."
"How?" I asked, confused.
"Well... I guess it is conceivable that American babies are bigger, on average, than Canadian babies..."
I said, "I guess... since a higher percentage are formula fed..."
He said, "But you are missing the point. It doesn't matter which growth chart is used because we are comparing him to himself--not the other babies on the chart--and according to the chart, he has dropped from 60th to 25th percentile and that's reason to be concerned." (Um... who is missing the point re: growth charts?)
I said, "So are you concerned then?"
He said that my son seemed healthy in every other way, but he would be concerned if he continued to drop by his next visit (which is at 12 months unless I want to make an earlier appointment to a) get him his flu shot, or b) get him weighed again). So I asked what he would recommend I do to get his weight up, since he is so concerned. His reply: "Start putting butter on all his food."
"Uh, what?"
"Put butter on all his food to get his calories up and make his food more palatable. You can buy organic butter if you want--salted or unsalted."
"And which would you recommend? Salted or unsalted."
"Well, I'd get the salted because it tastes better so he is more likely to eat it, and that is the point."
"Are you serious?"
"Well, you don't want to do it forever--just until he gets his weight up. We actually had to do it for my daughter. We had trouble getting her weight up too, so her pediatrician recommended the butter and it worked like a charm. Of course she's still addicted to butter today." (she's 8.)

I said I would keep that in mind and I smiled and nodded and came home and looked up the WHO charts, which are--as it turns out--recommended by the Dietititions of Canada, the Canadian Pediatric Society and the College of Family Physicians (our doctor is a family physician). As I suspected, my son is hovering around the 50th percentile. I have printed off the charts, along with the health professional's guide for using them. I plan to bring them to my son's 12-month appointment (and I don't plan to go back before that). Wish me luck and break out the butter.

[Spiralshell]

SALTED butter? on everything? ::boggle!!::
My little guy is now 11 months, and he was 18lbs and change at 9 months. I forget what percentile this is, but it's perfectly fine and normal. He had been off the bottom of the breastfed (WHO) charts at his earlier appointments, so I was thrilled to see him up a bit higher.
If you are concerned about weight, which I'm not convinced you really need to be, you could add more calories, but butter might not be the only way to do that. You can focus on foods that are rich in and of themselves, like avocado.
I added olive oil and coconut oil to my babe's food for extra calories, but SALTED butter seems wrong to me. Baby doesn't need extra salt! Butter is fine, but I'd mix it up with other healthy fats. And moreover, I'd start with encouraging lots of nursing, nursing longer on each breast to get the good fatty hindmilk, etc.

[LadyCatherine185]

Wow, sorry you had that experience, but good for you for standing up for yourself! I would send him the WHO charts with a letter of some sort saying your son is growing perfectly according to the WHO charts based on breast-fed babies. The reason he "dropped" in percentiles on the other charts is because breastfed babies tend to gain a lot in the beginning and then slowly taper off during the second 6 months. (though my DS didn't start "tapering off" until after a year old )

I did want to add, though, that if weight gain WAS a real concern, things like adding butter to his food, or olive oil/coconut oil, feeding him foods rich in nutrients and high in good fats like avocado are good ideas.

[NSmomtobe]

Yeah, I was actively avoiding any foods with added salt. I was thinking that avocado would be a better choice, but he didn't mention that. He did push egg yolks as well (but not egg whites because they are allergenic). He told me to boil an egg and then give him the yolk, with butter, while I eat the white myself (because they are high in protein and low in fat--I wondered if he was trying to tell me I needed to lose weight). He then said to put butter on anything he wouldn't eat, or anything to add extra calories.

DS does like mashed potatoes though. Butter would be good on that.

[sg784]

I think that if your baby is meeting all his milestones, gaining every visit, and is otherwise healthy, then there's no need for alarm. Somebody has to make up that 25th percentile right?!


However, Butter is awesome and great for babes, kids and even grown ups.

[NSmomtobe]

Originally Posted by LadyCatherine185

Wow, sorry you had that experience, but good for you for standing up for yourself! I would send him the WHO charts with a letter of some sort saying your son is growing perfectly according to the WHO charts based on breast-fed babies. The reason he "dropped" in percentiles on the other charts is because breastfed babies tend to gain a lot in the beginning and then slowly taper off during the second 6 months.

Yes, this information is in the "Health Professional's Guide for using the new WHO Growth Charts" that I printed off.

The good news is I don't have a problem standing up to this doctor. He sometimes catches me off guard though.

[Adaline'sMama]

WTF? I cannot belive a DOCTOR told you this.

[lach]

Originally Posted by sg784

I think that if your baby is meeting all his milestones, gaining every visit, and is otherwise healthy, then there's no need for alarm. Somebody has to make up that 25th percentile right?!


However, Butter is awesome and great for babes, kids and even grown ups.

Including salted butter.

[NSmomtobe]

Originally Posted by sg784

I think that if your baby is meeting all his milestones, gaining every visit, and is otherwise healthy, then there's no need for alarm. Somebody has to make up that 25th percentile right?!

The problem wasn't that he was in the 25th percentile, but that he dropped from the 60th, according to his chart.

I guess the butter wasn't that bad an idea, according to the responses here. I will start using it where I feel it is appropriate (i.e., mashed potato, sweet potato, squash... all DS's favourite foods already).

[lach]

Originally Posted by NSmomtobe

The problem wasn't that he was in the 25th percentile, but that he dropped from the 60th, according to his chart.

I guess the butter wasn't that bad an idea, according to the responses here. I will start using it where I feel it is appropriate (i.e., mashed potato, sweet potato, squash... all DS's favourite foods already).

Fat and cholesterol is what makes baby brains develop You want to make sure that they're getting plenty. Fats also make other foods easier to digest, particularly green veggies (but other veggies as well).

[MCatLvrMom2A&X]

butter

[NSmomtobe]

Originally Posted by lach

Fat and cholesterol is what makes baby brains develop You want to make sure that they're getting plenty. Fats also make other foods easier to digest, particularly green veggies (but other veggies as well).

Good to know. Thanks!

[chattyprincess]

Originally Posted by lach

Fat and cholesterol is what makes baby brains develop You want to make sure that they're getting plenty. Fats also make other foods easier to digest, particularly green veggies (but other veggies as well).

Just quickly wanted to add an eye roll to your docs comments...my dd has always been 50th percentile and was 19lbs and change at her 12mth checkup...odd considering that 20lbs by 1 is about "average"
also wanted to say after my dd2 was just born we were talking to a nurse about nutrition and the dangers of not giving whole fat milk to children and she brought up a great point that the coating around our nerves develops from 0-about 2 and the coating is made/uses almost all fat to be developed. If you do not a have a fatty enough diet during this time then the coating over the nerves can grow with holes in it and cause all sorts of long term problems. You cannot really regrow these coatings so fat is HIGHLY essential during these formative years. Plus there are lots of vitamins contained in fats that you cannot get other places and also as pp said adding fat to veggies/carbs makes them easier to digest and the vitamins in that food more easily accesible to your body .

[CrunchyChristianMama]

Originally Posted by sg784

However, Butter is awesome and great for babes, kids and even grown ups.

My DD actually likes to eat plain butter. She gets really excited when I give it to her on a spoon. It's usually raw butter from a local farmer though, so I feel really good about her eating plenty of it.

[an_aurora]

Originally Posted by Adaline'sMama

WTF? I cannot belive a DOCTOR told you this.

Me neither. My son was born at the 50th percentile, and by 6 months my son was in the 3rd percentile. My pediatrician never said a word about such nonsense! This is my second tiny baby, so nobody is concerned. At almost 15 months he is just shy of 17 pounds! I can't believe a doctor would recommend butter.

ETA: Of course everything is fine in moderation, but there is NO reason to start unhealthy eating habits at 9 months of age! This baby is eating and growing and meeting milestones just fine.

[CookAMH]

That is annoying! My DS was very similar in size (17 mo now) and has always been very healthy. Started out at like 90% at birth and is probably 30% now, but was 25% around your babe's age. He was always solid though, just not huge OR lean.

Now, butter isn't a bad idea anyway, but not because of fear of poor growth. Good sourced butter (pastured) is something I try to have DS have everyday, just because it's nutritious!

I would have been so annoyed at the doc though...ugh.

[nettlesoup]

Originally Posted by Evie's Mama

My DD actually likes to eat plain butter. She gets really excited when I give it to her on a spoon. It's usually raw butter from a local farmer though, so I feel really good about her eating plenty of it.

My daughter loves eating plain butter too. She often licks it off whatever she's eating that has butter spread on it.

Butter is very good for them, and make sure it's decent butter; the more yellow the better. And preferably without salt of course!

[wanderinggypsy]

Um, breastfed babies quite unanimously "fall off the growth charts" if the charts are not the WHO ones. Any lactation consultant will tell you!

They grow like little weeds for the first three or four months and then they decelerate their growth. It's NORMAL.

Skip the butter. Keep on doing what you are doing. You sound like a smart mama. Just find a different doctor. In fact, if you aren't concerned about anything, skip those yucky visits altogether. Being in Canada (like me), you don't have to worry about finding a doctor in the event that you ever need one.

Enjoy that lovely babe. You're doing just fine.

[Llyra]

I agree that it sounds like your LO is just fine, and the doctor is an idiot. I don't see what's wrong with butter, though, or with salt. Sodium is an essential mineral. And there's no evidence that there's any health benefit to restricting salt in childhood. And butter is a good whole food. Fat and cholesterol are essential to proper development-- that's why human milk is full of them. I don't think buttering everything is the way to go-- but I also wouldn't discount the advice that possibly adding in dietary fats might be a good plan.

[hakeber]

Originally Posted by wanderinggypsy

Um, breastfed babies quite unanimously "fall off the growth charts" if the charts are not the WHO ones. Any lactation consultant will tell you!

They grow like little weeds for the first three or four months and then they decelerate their growth. It's NORMAL.

Skip the butter. Keep on doing what you are doing. You sound like a smart mama. Just find a different doctor. In fact, if you aren't concerned about anything, skip those yucky visits altogether. Being in Canada (like me), you don't have to worry about finding a doctor in the event that you ever need one.

Enjoy that lovely babe. You're doing just fine.

Unanimously is a bit strong. My exclusively Bfed babes have always been in the 90-95 percentiles, DS still is at 5 yo (bfed until 3yo), and DD still is at 9 mo with no signs of plateauing.

But OP, it sounds like your babe is pretty healthy, and you know what you're doing. Fats are good for growing brains, and good for nursing moms, but salted butter on everything does sound like overkill.