My 20 month old weighs 20lbs. and Ped yelled at me to wean. Please help!!!

[Toposlonoshlep]

(x-posted in breast feeding beyond infancy)

I spent the day crying yesterday after our well-toddler visit. My ped, who BFed her own kids to 18 months and was always supportive of me, raised her voice at me and said "I always told you he was MALNOURISHED!" She told me I need to stop nursing him during the day. She yelled that, "He is almost 2 years old and nurses like a 2 month old!" And the thing is, it's true. My kid eats, but he is super-picky. He doesn't eat any snack foods that other kids eat, like cereals, for example. He eats a lot of chicken soup with egg noodles, organic chicken sausage, avocado, sprouted grain bread, some beans, hummus, potato, and some coconut yogurt. The biggest issue is that he has a dairy allergy, so cow's milk products are out for us. I always thought I was doing a good thing by nursing him om demand because of the calcium, but now I am doubting everything...

He is in the 30%-45% for height, so no concerns there. But he is only 20 lbs. and his head is at 4.7% at 18 inches.

But he is brilliant! Ahead on all his milestones (started walking at 9 months and is now talking up a storm), super-active, happy...Could he really be MALNOURISHED?!? That word just freaks me out.  

My biggest point of contention is that he was born small (just under 7lbs. with a (lol) small head at 13.5 inches). So, his head circumference, for one, seems to be growing fine on his own curve. Not to mention that my DH is 5'9", only 135 lbs, and was always really really really petite, even in childhood.

Why did she yell at me?!? Do I really need to step it up by nursing less and thereby forcing him to eat more?!? 

I am doubting everything, even more after the same ped told me she lets her kids have McDonald's once a week to "maintain their weight".

Sorry this is so long. I am really distressed. Thanks ahead of time for any advice on whether to wean or not, and the like...

[CallMeMommy]

Originally Posted by Toposlonoshlep 

(x-posted in breast feeding beyond infancy)

I spent the day crying yesterday after our well-toddler visit. My ped, who BFed her own kids to 18 months and was always supportive of me, raised her voice at me and said "I always told you he was MALNOURISHED!" She told me I need to stop nursing him during the day. She yelled that, "He is almost 2 years old and nurses like a 2 month old!" And the thing is, it's true. My kid eats, but he is super-picky.  He doesn't eat any snack foods that other kids eat, like cereals, for example. He eats a lot of chicken soup with egg noodles, organic chicken sausage, avocado, sprouted grain bread, some beans, hummus, potato, and some coconut yogurt. The biggest issue is that he has a dairy allergy, so cow's milk products are out for us. I always thought I was doing a good thing by nursing him om demand because of the calcium, but now I am doubting everything...

He is in the 30%-45% for height, so no concerns there. But he is only 20 lbs. and his head is at 4.7% at 18 inches.

But he is brilliant! Ahead on all his milestones (started walking at 9 months and is now talking up a storm), super-active, happy...Could he really be MALNOURISHED?!? That word just freaks me out.  

My biggest point of contention is that he was born small (just under 7lbs. with a (lol) small head at 13.5 inches). So, his head circumference, for one, seems to be growing fine on his own curve. Not to mention that my DH is 5'9", only 135 lbs, and was always really really really petite, even in childhood.

Why did she yell at me?!? Do I really need to step it up by nursing less and thereby forcing him to eat more?!? 

I am doubting everything, even more after the same ped told me she lets her kids have McDonald's once a week to "maintain their weight".

Sorry this is so long. I am really distressed. Thanks ahead of time for any advice on whether to wean or not, and the like...

So his weight is the only thing she's concerned about?  Is he falling off the curve or maintaining?  You said he's meeting or exceeding all his milestones, so if weight is the only concern then IMO it's not a concern.  My son, on the other hand, was very low on the weight curve but also had developmental delays, so we knew it wasn't just a weight issue.  I never understand the logic of "he's super picky, so let's take away the only food he'll actually eat" to make kids gain weight.  I wouldn't even consider weaning.  If anything, keep nursing but try to sneak more good-fat foods into him. 

I'd also plot his weight on the WHO growth charts, the ones most doctors use are based on formula-fed kids from the '70s and it's a known fact that breast-fed kids gain weight at different rates than formula-fed kids.  He's probably not as low on the curve as you think he is.

[myfairbabies]

My 19 month old nephew is 19 lbs. My sister just has small babies, but they went ahead and did some blood tests just to rule out thyroid issues and such because he eats like a horse (he was getting blood drawn anyway for allergies). I would get a new Ped, if that's an option. It really doesn't sound like you have a problem, especially with your small husband and the fact that his milestones are all great. I would absolutely not stop nursing, I have a friend that recently did that for the same reasons (doc said toddler was too small and she needed to stop) and totally regrets it. Guess what? He's still small. Your sons sounds perfectly healthy to me!

[Toposlonoshlep]

Originally Posted by CallMeMommy 

So his weight is the only thing she's concerned about?  Is he falling off the curve or maintaining?  

Yep, he fell off...He was hanging in there at 5% for  a while, but hasn't gained more than a pound since 12 months...

He has become a pickier eater and RUNS everywhere, even when walking is in order...

As for why take away the mama milk, according to the ped, "He is getting nothing but comfort and extra hydration" from it...She thinks that the reason he will not eat more is because he prefers the milk and defers to it.

[CallMeMommy]

Originally Posted by Toposlonoshlep 

Originally Posted by CallMeMommy 

So his weight is the only thing she's concerned about?  Is he falling off the curve or maintaining?  

As for why take away the mama milk, according to the ped, "He is getting nothing but comfort and extra hydration" from it...She thinks that the reason he will not eat more is because he prefers the milk and defers to it.

Except it's not WATER, it has nutrients and fat in it!  Gah!

[Toposlonoshlep]

Originally Posted by myfairbabies 

My 19 month old nephew is 19 lbs. My sister just has small babies, but they went ahead and did some blood tests just to rule out thyroid issues and such because he eats like a horse (he was getting blood drawn anyway for allergies). I would get a new Ped, if that's an option. It really doesn't sound like you have a problem, especially with your small husband and the fact that his milestones are all great. I would absolutely not stop nursing, I have a friend that recently did that for the same reasons (doc said toddler was too small and she needed to stop) and totally regrets it. Guess what? He's still small. Your sons sounds perfectly healthy to me!

Thank you. This is what my gut says. The ped says I am getting defensive, but I am just so surprised by her approach...The reason I picked her (after MUCH research) was because she was the only one in this whole city supportive of delayed/selective vaxes and extended BFing. Now I don't know. I am seriously considering whether to search again for another one.

Thanks for your words of reassurance!

[crunchy_mommy]

It seems like so many people I know have this same discussion with their docs -- even with super-crunchy 'breastfeeding-supportive' docs. I don't understand it.

My DS has also only gained about a pound since he turned 1 year. He's 22 mos & 23lbs so a little bigger than your guy but not a ton. He doesn't eat a ton of solids & he nurses more than a newborn as well. We try hard to make sure when he does eat table food that it's nutrient-packed & lots of fat (so we make a lot of calorie-dense sauces, put olive oil on everything, etc.)

I wouldn't worry if he's meeting all his milestones and there don't seem to be any other problems (sensory issues etc.)

However, I do want to point out that weaning & not weaning are not your only options. :) If you feel something needs to change, you could just cut back on nursing or only nurse at certain times or not nurse X hours before a meal... some people seem to have some luck with that in terms of better solids intake. I cut DS back some around 18mos because I just couldn't take nursing 20+ times a day. But I did this for sanity, and I felt he was ready (but reluctant) to try eating more solids, not specifically to gain weight -- because unless you have low supply or something, breastmilk would be more nutrient dense than any other food you give him.

I would be nervous with a doc who intentionally feeds & encourages others to feed kids McDonald's on a regular basis for the purpose of improving health.

[CherryBomb]

Mama, if it makes you feel better, my 33 month old dd weights 26 pounds.  She was nursing constantly and I weaned her shortly after her 2nd birthday (due to pregnancy) and it did NOT make one bit of difference in her weight.  She is just tiny and always has been.  It sounds like your kiddo is doing just fine.  If he were not meeting milestones and was sickly, I'd worry, but he sounds healthy and small.

[shanniesue2]

I don't think the issue is one of whether or not to wean.  I think the real issue here is a doctor who does not treat her clients with respect.  Did she actually YELL at you?!?!  I'd say it's time for a new pediatrician. 

I "fired" our family doc for a much smaller infraction.  We switched to a new doc when DS was 17 months old b/c I was tired of getting vax lectures at every visit (even though the doc had agreed to a delayed schedule before DS was even born).  The doc was always spoke respectfully to me, though... he would say, "I'm okay with you delaying, as long as he does get his vax's because some baby he knew was hospitalized with whooping cough one time."  He never yelled at me, though.  I think I would take serious issue with yelling.

[MrsBone]

Originally Posted by Toposlonoshlep 

(x-posted in breast feeding beyond infancy)

I spent the day crying yesterday after our well-toddler visit. My ped, who BFed her own kids to 18 months and was always supportive of me, raised her voice at me and said "I always told you he was MALNOURISHED!" She told me I need to stop nursing him during the day. She yelled that, "He is almost 2 years old and nurses like a 2 month old!" And the thing is, it's true. My kid eats, but he is super-picky. He doesn't eat any snack foods that other kids eat, like cereals, for example. He eats a lot of chicken soup with egg noodles, organic chicken sausage, avocado, sprouted grain bread, some beans, hummus, potato, and some coconut yogurt. The biggest issue is that he has a dairy allergy, so cow's milk products are out for us. I always thought I was doing a good thing by nursing him om demand because of the calcium, but now I am doubting everything...

He is in the 30%-45% for height, so no concerns there. But he is only 20 lbs. and his head is at 4.7% at 18 inches.

But he is brilliant! Ahead on all his milestones (started walking at 9 months and is now talking up a storm), super-active, happy...Could he really be MALNOURISHED?!? That word just freaks me out.  

My biggest point of contention is that he was born small (just under 7lbs. with a (lol) small head at 13.5 inches). So, his head circumference, for one, seems to be growing fine on his own curve. Not to mention that my DH is 5'9", only 135 lbs, and was always really really really petite, even in childhood.

Why did she yell at me?!? Do I really need to step it up by nursing less and thereby forcing him to eat more?!? 

I am doubting everything, even more after the same ped told me she lets her kids have McDonald's once a week to "maintain their weight".

Sorry this is so long. I am really distressed. Thanks ahead of time for any advice on whether to wean or not, and the like...

Are you vaxing at all? If not I just wouldn't go back for well visits. I haven't taken my DS since he was 16 months old. he'll be a year this month. Why sit there and listen to criticism? You're the one paying her, so you shouldn't take it. You're the mama, you know best. If you feel like he's doing okay, he probably is. I wouldn't worry about it! As far as food intake, you could give him toast with some coconut oil on it, instead of butter.  It  will add some good fat and calories to his diet. Will he eat eggs? The fat and cholesterol in the yolks will him help put on some weight too. As for chicken soup, add some fat to that.. do you make it? If so, you could make chicken stock out of bones, and he'd be getting tons of minerals, vitamins and calories from the chicken fat. I'd use pastured chickens though if you're going to give him that much chicken fat:) I'm sorry, but taking kiddo to mcdonalds to put on weight is just not a good answer! Oh..one other thing.. does he like bread and crackers? I have some yummy recipes for bread and crackers made from almond flour..full of protein and fat, and calories!

[crunchy_mommy]

Originally Posted by MrsBone View Post

I have some yummy recipes for bread and crackers made from almond flour..full of protein and fat, and calories!

I know I would love the recipes!

[geekgolightly]

How about smoothies made with coconut milk, banana and his favorite fruits?

[motherhendoula]

Not to mention that my DH is 5'9", only 135 lbs  -( i think if i met your husband i might say he was underweight   )

It doesnt sound like your children are destined to be gigantic people to start with - i think the other posters are correct, breast feeding is not encouraging malnourishment - (i dont think malnourished children  have the energy to run everywhere)

You sound like you are fine with how often he nurses and have a good handle on non-dairy foods (speaking of which i want to mention Hemp Milk ...i have been dairy free for nearly 10 years and i LOVE this stuff!) 

I agree with Mrs Bone - you can easily dodge 'well visits' and downplay how much the child nurses and list all the great foods he is eating.  

[mamaofthree]

i think sometimes doctors forget to look at the whole patient and focus on one thing. if you and your dh are small people then why would your child be a bigger person.

it sounds like what he does eat is really good. i would also second adding a bit of fat to what he does eat if it is worrisome to you. but taking him to eat crap fast food seems like the most silly thing i have ever heard. lol like why not get him eating stuff that is healthy? i would look around and see if you can find someone else. maybe some into alternative medicine. 

good luck.

we had a tall skinny baby with my dd and that is because dh and i are both tall skinny people. (dh is 5 11 and until the last two years never weighed more then 145. he always looked good, he just wasn't a hulking guy) she would be 95% in height and 10% in weight. our ped just said nurse her as much as she needs and add butter to her food. so we did. now she is 16 and tall and thin. and that girl can pack away the food. lol

h

[Toposlonoshlep]

Originally Posted by shanniesue2 

I don't think the issue is one of whether or not to wean.  I think the real issue here is a doctor who does not treat her clients with respect.  Did she actually YELL at you?!?!  I'd say it's time for a new pediatrician. 

I "fired" our family doc for a much smaller infraction.  We switched to a new doc when DS was 17 months old b/c I was tired of getting vax lectures at every visit (even though the doc had agreed to a delayed schedule before DS was even born).  The doc was always spoke respectfully to me, though... he would say, "I'm okay with you delaying, as long as he does get his vax's because some baby he knew was hospitalized with whooping cough one time."  He never yelled at me, though.  I think I would take serious issue with yelling.

I really think the only reason that we haven't "fired" her is because she is totally and completely ok with delayed/selective vaxes and I broke my back trying to find a ped who was in the city...

She did YELL, and she often seems insecure to me. She actually told me once that she feels "intimidated" by DH and I because we are so opinionated...She once also said to me that she sees it as a problem that so many parents these days are doing their own research and think they know it all. My DH asked her, "Isn't it a GOOD thing that people are becoming educated about their kids' health?" and she said, "Well, no, not if they're going to not bring their kid in when they don't know what they're looking for."

I am ped shopping just in case, but what a pain it would be to switch. But she says now that she wants to see him every month because he is "malnourished", and she came down hard on me when I skipped 2 well-visits...She said she will "not condone it."

[AFWife]

Originally Posted by mamaofthree 

i think sometimes doctors forget to look at the whole patient and focus on one thing. if you and your dh are small people then why would your child be a bigger person.

Exactly this. A friend's oldest daughter is TINY (she's 7 and her sister is 4-5 and they weight about the same and are similar in height) She's always been teeny tiny...like, barely shows up on the charts tiny. Her mom is a little person (she's 5ft-nothin' and can't be more than 100lbs soaking wet) and her bio-father was apparently a small guy (shorter and about as thin as mom) so the ped has always said, "As long as she's eating and not showing signs of malnourishment there's no reason to worry."

[LauraN]

Tell her you "will not condone" being yelled at and will not continue to bring him in if she insists on yelling about something she has not solid facts about. His weight alone is not an indication of malnourishment, so tell her to stop trying to intimidate you.

Stopping breastfeeding will not change his eating patterns, nor will it have much effect on his weight, except perhaps a negative one when he stops getting those extra calories.

But your ped sounds like a piece of work. My old ped (we're no longer in the US) always *liked* having parents who did their research and had ideas and opinions and loved talking with us and explaining his point of view when our ideas differed from his. But he also always deferred to the parents' wishes.

[pbjmama]

If my employee yelled at me I would reply with "you're fired".

You are paying her for her medical advice. She is your consultant. The way she treated you is absolutely unacceptable. I realize you may not have the option for other care but if you do I would not go back to her and I would write a letter explaining your reasoning.

Beyond that, IMO you should not wean. Wouldn't hurt to get a second opinion and see what kind of problems may explain low weight even if it seems the norm in your family.

[Toposlonoshlep]

Originally Posted by motherhendoula 

Not to mention that my DH is 5'9", only 135 lbs  -( i think if i met your husband i might say he was underweight   )

It doesnt sound like your children are destined to be gigantic people to start with - i think the other posters are correct, breast feeding is not encouraging malnourishment - (i dont think malnourished children  have the energy to run everywhere)

You sound like you are fine with how often he nurses and have a good handle on non-dairy foods (speaking of which i want to mention Hemp Milk ...i have been dairy free for nearly 10 years and i LOVE this stuff!) 

I agree with Mrs Bone - you can easily dodge 'well visits' and downplay how much the child nurses and list all the great foods he is eating.  

Ha ha. Yeah, my husband has always had issues with people judging his health and strength based on his physique. But he is a hardcore yogi and has the immune system of a superhero, so big ain't always strong. I can't downplay the well visits because she came down HARD on me for skipping a couple. Said she would not condone it and that she cannot track my child's growth  if I don't bring him in....*sigh*

[Toposlonoshlep]

Originally Posted by LauraN 

Tell her you "will not condone" being yelled at and will not continue to bring him in if she insists on yelling about something she has not solid facts about. His weight alone is not an indication of malnourishment, so tell her to stop trying to intimidate you.

Stopping breastfeeding will not change his eating patterns, nor will it have much effect on his weight, except perhaps a negative one when he stops getting those extra calories.

But your ped sounds like a piece of work. My old ped (we're no longer in the US) always *liked* having parents who did their research and had ideas and opinions and loved talking with us and explaining his point of view when our ideas differed from his. But he also always deferred to the parents' wishes.

Ha. I wish I had the cojones to tell her that. maybe I'll grow some if she keeps this up.

I wish there were more peds like your old one. I hate that you have to experience this crud before you really know where they stand. I swear, with her, it seems personal. And unprofessional.