Falling of the growth chart

[chase_mommy]

Watered down story... little guy was born at 32 weeks at 3.3lb.  Came off vent, oxygen and IVs pretty quickly and grew via my milk that a supplement was added to for a month or so.  He is now 10.5 months old, 8.5 corrected, and just weighed in at 12 lbs 15 ounces before nursing and 13 after.  At this point he is now below the 3rd percentile.  We delay solids, skip purees, skip cereals and only nurse... I have been introducing him to solids but he has no interest in them and seems to not like any textures- hes just not ready.  I will continue to offer them though.

Dr has now ordered weekly weight checks and requested that I get him back in with the neonate team for an eval.  This can go 2 ways. 1) he will gain weight get above 3 percentile and they will get off of my back or 2) do all the tests they feel necessary and make a huge deal about not force feeding him.

I, personally, am not worried about him.  He IS growing and meeting mild stones, just not as quickly as they would like.  He is small BUT he was 3 weeks smaller in utero AND was born 8 weeks early- he is bound to be a little guy.  I don't have any milk supply issues other than having more than enough.  In a 2.5 ounces of expressed breastmilk, if let to set, will have over 1/2 ounce of fatty cream that settles on top.  He nurses ALL the time, on demand- day and night.  Has plenty wet/dirty diaper... I see no need for concern.  PLUS the growth charts are based on formula babies- this he is not.

I plan on try avocado next and hope he gets some other fats in him but once again, I am not forcing it.  Anyone have an advice, BTDT or words of wisdom?  We just started to all get settled from all the issues that he had and I am not up for an more drama, especially the kind they will put us through. 

[FiveLittleMonkeys]

Our DS - also born at 32 weeks - hovered around the 5th percentile of the standard charts for a LONG time as well.  But when you plot him on the Breastfed Baby Chart from the WHO - here's the link - and also corrected for his appropriate age, all of a sudden, he looked a lot better.

http://www.kellymom.com/babyconcerns/growth/growthcharts.html

I'd ask your doctor to use charts for breastfed babies, and make sure that he is charting your DS with his gestational age, not his actual age.  There were a few times that we'd see a different ped who forgot that DS was born early and they would plot him wrong.  That made for some tense minutes on all  of our parts until we realized the mistake!

Our DS wasn't very interested in solids until he was more towards 9-10 months old, and even then, it was a lot of playing.  Avocado was his first love!  He did do much better sucking food off my finger than a spoon - I really think that being on the vent made him a little oral averse for a time.

DS is now almost 2.  He's still a little guy compared to other 2 year olds, but he's catching up.  It does seem to even out the older they get.

[chase_mommy]

She did adjust his age but I am pretty sure it wasn't a chart for breastfeed babies... I checked out your link.  He is below the 3rd on that one too.  The Dr called me back last night and expressed how concerned she is.  She has ordered some blood test, iron and doubled checked that I was going to get an apt with the neonatal team for another eval.  Ugh, I am feeling so yuckie today.

[FiveLittleMonkeys]

:(  I'm sorry!  I remember at DS's 9 month appointment, he had lost weight, and I cried all the way home.  Hopefully the neonatal team will pronounce him just fine and it will be the end of it.

I know it helped our ped calm down on the weight thing that DS saw the developmental ped each month at the Synagis clinic - the babies would see the Dev. Ped, who would do a quick eval and then get their shot.  It was kind of nice to be able to tell her each month, "Dr. So and So says he's just fine!"

  I know how stressful this is, Mama.  Your DS is developing on his own curve, and you're doing a great job!

[~bookcase~]

my dd has grown slowly all the way through, kind of stalling sometimes and then picking up again. she started to be interested in food at 12 months but we had been giving her bits of sweet potato etc from a much earlier age as per guidelines, because i was so worried they might take her away otherwise a horrible, horrible fear going back to early discharge when i was told she may have to be readmitted.

and all i can say is hang in there and stay with your convictions. we got dd tested at 2 for iron, thyroid, celiacs, etc i breastfed her while they took the blood from her hand behind my back, so if you can get the nurses to do that i hope it will be easier for you both. all her results came back normal and the dr is convinced it's a calorie intake issue, despite the fact she eats well and her twin and 5 older sibs not having any issues with the diet they are all fed (they are all petite like my dh and myself, but not quite as much as she is)

she's proportionate, met all her milestones and has a character to make up for her size so we think she's fine...but only time will tell if she's perfectly petite or there is some missing link that no one has been able to pick up yet (btw, she's under 0.2 centile so teeny beautiful tiny and adorable )

[CGsMom]

Our DD (27 weeker, 2 lbs, 2oz at birth) is now 17 months actual and is not "on the charts" currently.  She has been back and forth, at one point she was up to 25th percentile corrected.  Our doctor is actually one of the neonatologists (read: not a regular peds doc) that rounded on her when she was in the NICU and I have a supreme amount of confidence in her.  She has always told me not to worry about her weight, to ensure that DD gets as much food as she wants, perhaps try more calorie/fat dense foods, but don't stress.  She is small, but she will catch up, just as I am sure your little one will.

IMO, go ahead with an evaluation.  It will make everyone feel better knowing if there are really challenges or if your doc is just being hypersensitive.  They may also have suggestions your regular doctor wouldn't think about.

I know how frustrating it can be to be doing EVERYTHING you can to make sure he is healthy and strong and then have someone essentially tell you your not doing a good job.  Listen to your instincts.  Hang in there.

[Sweetpea09]

Hi, saw this thread and thought I'd share that my 40.2 weeker was born at just 5lbs 2oz due to IUGR.  He is now 17+ months and is just 21lbs on a good day.  He's less than the 1st percentile I think, and has never been more than the 8th percentile (in maybe the 1st month).  He's hit all his milestones just fine (except now he refuses to talk and grunts for what he wants because he's waited on like a little king by grandma).  Anyway, my peed has never been concerned, he started little and may always be little, that's just the way it goes.  He eats when he's hungry and at times I feel like binge eats and then binge fasts.  He's so busy and food is his last priority.  Anyway, I'd say as long as you don't see any other reasons for concerns, size alone means nothing.  Babies/toddlers know when they're hungry and unlike most adults, stop when they are full and don't eat just because the clock says it's a meal time!  I wish I could go back to being that way.  :-)