I wanted to write about my experiences with “underweight” (according to the CDC’s growth charts) kids, in hopes that it may help another mom. Lots of disclaimers are necessary!
First, I’m not a doctor, nor do I play one on the internet. My experiences and opinions should not be taken as medical advice. The closest to medical advice that I will offer is this: if a doctor suggests that you should supplement/discontinue breastfeeding solely based on your child’s place on the growth chart, in the absence of any symptoms or medical conditions…seek help from a lactation consultant (or three) and get a second opinion.
Second, this post talks about babies not on the growth charts and how it can affect a breastfeeding relationship. I realize that formula fed babies aren’t necessarily “big” and can have growth chart issues too. However, this post is about my personal experiences.
Last, there’s no judgement from me if you switched to formula at your doctor’s advice (or for any reason.) Just like some c-sections are necessary, there are situations where formula is necessary too. (Hypoplastic breasts, prior breast surgery, chemotherapy etc.) However, so many women are “booby trapped” by being given inaccurate information by the medical providers they are supposed to be able to trust. The rate of women who are told “you’re not making enough milk, your milk isn’t enough, your milk isn’t fatty enough, your pelvis isn’t big enough” and so forth is far higher than the number of women for whom this is true! Finding out that your switch to formula wasn’t necessary is about as hard a pill to swallow as finding out your “emergency c-section” was because your OB wanted to go home. Just like I don’t assume all c-sections are unnecessary, I’m not assuming that all formula use is unnecessary. That said, I also respect a woman’s right to choose, even if that choice isn’t one I’d make. So if you had a scheduled c-section or formula fed from day 1 by choice, I am not judging you (not my biz-ness!), and that’s not what this post is about, ok?
I’ve remarked before that I don’t know how our mothers did it without the internet. I don’t mean listening to what some schmuck (me) says, but having actual medical journals and details of studies right at your fingertips. It’s amazing and I don’t know what I’d do without it! Back in 2005 when I had my daughter, I was a member of a breastfeeding group on Parents.com. I credit those women (along with my stubbornness) for my breastfeeding success. Without them, I would have failed, as I was set up to by pediatricians and hospital staff.
This story begins with my miserable first birth experience, which culminated in an epidural, and me so swollen, I was sure I would pop. IV fluids given during labor can artificially inflate baby’s birth weight, leading to “alarming” weight loss in the first 24 hours. A loss of 5-7% of birth weight is physiologically appropriate for a newborn, sometimes up to 10%. When my daughter had lost about 5% in that first day, I was immediately bullied to give formula. I was even told by a nurse that “the doctor would make” me if I didn’t. We tried, she wasn’t interested. The only photo I have of my husband with her in the hospital is the one where he is trying to feed her formula. I can’t stand to look at that picture to this day, 7 years later. Not because I think formula is “evil,” but because it represents my complete failure to stand up for myself and our daughter during that entire experience.
Whether the baby loses 1% or 10%, it’s important to use the lowest weight when assessing subsequent weight gain. Depending on the source, it’s expected that a breastfed baby will gain between 4 and 8 ounces per week in the first few months.
Dr. Jay Gordon urges parents and Doctors to “look at the baby, not the scale,” which I will talk about more in a bit. Even if your baby is gaining “enough” weight per week, he or she may not be on the CDC’s growth charts, as mine weren’t. Interestingly enough, even the CDC recommends that health care providers use the WHO growth standards for children up to age 2.
The WHO standards establish growth of the breastfed infant as the norm for growth.
Breastfeeding is the recommended standard for infant feeding. The WHO charts reflect growth patterns among children who were predominantly breastfed for at least 4 months and still breastfeeding at 12 months.
The WHO standards provide a better description of physiological growth in infancy.
Clinicians often use the CDC growth charts as standards on how young children should grow. However the CDC growth charts are references; they identify how typical children in the US did grow during a specific time period. Typical growth patterns may not be ideal growth patterns. The WHO growth charts are standards; they identify how children should grow when provided optimal conditions. [Emphasis mine. Imagine using the “typical” American as the benchmark for health.]
The WHO standards are based on a high-quality study designed explicitly for creating growth charts.
The WHO standards were constructed using longitudinal length and weight data measured at frequent intervals. For the CDC growth charts, weight data were not available between birth and 3 months of age and the sample sizes were small for sex and age groups during the first 6 months of age.
Imagine that.
Edit: about a week after I posted this, the AAP came out with a new, more strongly worded statement about breastfeeding, in which they say “infant growth should be monitored with the World Health Organization (WHO) Growth Curve Standards to avoid mislabeling infants as underweight or failing to thrive.” YAY!
So what happened to us was what happens to so many other families. My daughter was meeting all expected milestones, was healthy, nursing well, having tons of wet and dirty diapers, but fell off the CDC’s growth charts. We were going to one of those offices where a dozen or more pediatricians practiced, and you saw whomever was available, for the most part. If you needed a last minute appointment, you usually got the most rotten doctor, since they were the only one not booked solid. We saw a doctor who graduated med school in 1972 (I looked it up) and probably hasn’t read a study or paid attention at a seminar since then. He immediately told us to stop breastfeeding, give formula and oh, put some cereal in the bottle too. Believe it or not, DH & I both went to this same practice as kids & saw this doctor!
What did I do? Smile, nod and get the heck out of there. Over the next several months, though she had no symptoms aside from being genetically small (her dad is around 5′ 7″ max and I am not quite 5′ tall, hovering around 100 lbs or less when not pregnant/postpartum) she was put through a battery of blood and urine tests. All are normal. Surprise.
We eventually got an appointment with the doctor who is now our current pediatrician (he left the practice & we followed him…cue creepy stalker music.) Though he graduated med school in 1980, just 8 years after jerk-o/idiot doc, he has kept up on AAP guidelines (which are unfortunately usually behind) and reads studies and attends seminars regularly. He is pro-breastfeeding & conservative in treating patients.
With his help, we did additional testing for things that may have been causing slow weight gain, without showing symptoms, and fortunately she was fine. We did some extra weight checks and tracked her individual growth curve (you can do this too by creating an interactive growth chart.) Aside from one visit where she appeared to “dip,” she rode her own curve just under the growth chart. The doctor wasn’t too concerned about the dip, since a few ounces makes a big difference, and a few ounces is easy to gain or lose with drinking/urination.
All along, he told me he had the feeling it was simply genetic, but of course, he doesn’t want to miss something, hence the testing.
Finally, at age 2 1/2 she barely got on the growth chart & has been hanging around the 3% ever since. He has told me that he’d “take IQ over weight any day,” referring to my daughter’s impressive verbal/reading/writing skills. (Proud mama here.)
When my son was born around 8 pounds, we were hopeful that he would stay “big”, and we could avoid all the weight checks. Unfortunately, he followed exactly the same patterns. Fortunately the doctor was quite conservative in tests & weight checks and he finally got on the chart at age 2!
When I was still expecting baby #3, we discussed the issue and he said that at this point, with the history, he’s convinced it’s genetic. As nice as it would be to have a baby “on the chart,” he wasn’t expecting it. My son was born at 6 lb 12 oz, down to 6 lb 5 oz at 3 days old (we’re not completely sure on all this because of some scale issues!) then up to 7 lbs at a week, 8 lbs at a month and 9 lb 10 oz at 2 months, or…the 25%, yay! He told me that he doesn’t necessarily expect him to be a big baby, and I don’t think he’d be surprised if he started falling down on the charts, but for now it’s a victory.
Even though I eventually found a supportive doctor, the doubt always crept in, and as great as he is, he said several things that contributed to that. First, he often asked an open ended question along the lines of “how do you feel about your milk supply.” Uh, well I felt fine until you asked, now I’m paranoid! He mentioned pumping output (a baby extracts milk much more efficiently than a pump, and some women simply can’t let down for a pump at all.) He also asked about feeling letdown. Not all women feel their letdown, and it often becomes less pronounced as baby gets older. Even questions of “does baby seem satisfied” can be a slippery slope, since a baby may nurse constantly and get a bit fussy while working on increasing supply during a growth spurt.
So what should be asked? Initially, make sure the baby is latched well. Is there pain? Has the mother seen a lactation consultant? Once milk has come in, can you hear the baby swallowing? Is the baby having wet and dirty diapers appropriate for his/her age? Is baby alert (as appropriate for age) and meeting milestones?
I knew my daughter (and son too) was fine, but I was still paranoid and wanted to get her on those gosh darned charts!! We tried Pediasure when she was a toddler (just filled her belly so she didn’t want to eat and whew, made nasty diapers.) We tried high fat foods like avocado, cream cheese etc. It didn’t help. Dr. Sears says “Active babies with persistent, motor-driven personalities who always seem to be revved up usually burn more calories and tend to be leaner.” We have videos of our daughter at just a few weeks old, constantly moving as if she were swimming in an invisible pool. Even now at age 7, she does.not.stay.still.
He also says “Various studies have shown that breastfed infants consume fewer calories and a lower volume of milk than formula-fed infants. This doesn’t mean that their mothers aren’t producing enough milk. Instead, it’s an indication that breastfed infants have an amazing ability to self-regulate their calorie intake according to their individual needs. This ability to determine for themselves how much they eat is probably one of the reasons that infants who are breastfed are less likely to have problems with obesity later in childhood.” (Emphasis mine.)
She weighs the perfect amount for her. She looks an awful lot like my husband did at that age; all knees and elbows! She has always been “tall for her weight,” which made her look even more slender. My son is more proportionate, so he looks chubbier.
For some reason, people think it’s OK, or appropriate to make rude remarks about a baby’s size. I’ve had strangers ask how much they weighed at birth, asked if they were preemies, implied that I was starving them and so forth. It’s so fun to hear “she’s so small” said with a look of disgust (not.) People still make remarks about my daughter being “so skinny” which infuriates me. It wouldn’t be OK to say something like that if she were overweight, so why is it OK to damage her self-esteem and body image with “too skinny” comments? She has always been a great eater, except when there was something more interesting going on. Therefore, any time we would have visitors (or visit someone) she would want to play, not eat. That meant more lovely comments about “no wonder she’s so skinny, she doesn’t eat.” I’d try to explain that she ate great at home blah, blah but no one believed me! (We also eat a diet that’s far healthier and more balanced than the average American diet. I’m sure I could fatten my kids up if I overfed them fatty ground beef, fast food, potato chips and Tastycakes instead of fruit, veggies, beans & lean meat!)
Though I’ve never had a “big” baby, I imagine people are similarly rude in that case. My daughter has been friends with a little girl since they were in 3-year preschool together. When I met her, she was a perfectly normal looking little girl, but her mom showed me a picture of her as a baby. No lie, she looked like the Michelin man. I have never seen a chubbier, more roly poly baby in my life. She was 100% breastfed, and slimmed down when she became mobile. She got equally rude comments when her daughter was “too big” and her milk must be “no good.” My BFF has “top of the charts” babies, but they look totally healthy & are proportionately tall. I thought it was ironic that she was stressing about her 90 whatever-th percentile breastfed baby gaining “too much”, while I was worrying about my <3% breastfed baby!
In conclusion, before you turn to formula, look at the whole picture, not just the chart. I wish I could clone my pediatrician and send him to all of you. He isn’t perfect, but he is fantastic. When he told us he was leaving the big practice, I was terrified that he was going to tell me he was retiring! (He’s not allowed until all my kids are grown up.) He is fairly supportive of breastfeeding (I keep extended bf’ing and night nursings to myself, LOL) and has made comments about how great breastfeeding is, that it’s the best thing I can do, keeps them healthy etc. He’s open to alternative vaccination schedules, was wonderful about my home birth, and continues to educate himself. When we were concerned about my son’s verbal skills, he suggested a baby sign language class, adding that 10 years ago, he would have told me that signing would hinder his verbal development, but recent studies show the opposite! He was even telling me about a seminar he attended about how they do the PKU testing.
At the same time, he’s very diplomatic. If you formula feed by choice, he won’t make you feel inferior. We didn’t even know his stance on circumcision until we asked. (We’d already researched & made our choice, but thought it was important to have a doctor on the same page.) He passed along the AAP’s stance on vitamin D supplementation in breastfed babies, but tells us not to sweat it if we choose not to. He doesn’t think babies or children with balanced diets need multivitamins, but will support you if you decide to use them.
So, phew. This ended up a mile long but I sincerely help it helps someone! I’m not a “militant” lactivist, but I do wish that women had all the information about breastfeeding and formula and had the support to succeed.
Has anyone else dealt with a top or bottom of the charts baby? How did your doctor handle it?
Maria wants to live in a world where cloth diapers are the norm and moms can make parenting choices without judgement. When she’s not chasing her 18, 14 and 11-year old kids around, you might find her checking out the latest gadgets, organizing something (again) or exercising in the fresh air. 
Omg just FEED YOUR BABY BETTER. They look underweight. They don’t look fed enough. My mother did the same crap to my siblings and I and we all gained 30-50 lb (not overweight) after we moved out because we could eat nutrient and caloric sufficient diets. Don’t fight the doctors being wrong doesn’t mean you’re a bad mom. But continuing to excuse it is just going to make your kids resent you later, like my siblings and I do our mom. My twins who were 2 months early were 21 lb. by their first birthday. They’re 4’5 and 75 lb each now. My genetics aren’t small. But at their age I was several pounds lighter than them, at the same build. The worst you can do is make your kids suffer for your need to be right.
I’m so glad I found your post–we have so much in common! I was bound and determined to breastfeed exclusively for a year (even if it meant pumping and bottle feeding). My son was born at 6 lbs 7 oz and tell exactly 10% to 5 lbs 12 oz in the hospital. The lactation consultant warned me the 2nd night, “Do not let the nurses bully you into formula!” I was prepared to fight and fight I did that night. They had me breastfeeding AND pumping and bottle feeding the pumped milk and they still wanted me to give formula, which I tearfully refused. The poor baby was puking all the extra milk and I was EXTREMELY, painfully engorged. He did go up to 6 lbs (4 oz gain) in one night. We were discharged from the hospital with strict orders to see our Pediatrician within 48 hours. She gave us the advice to wake him every 3 hours. He weighed 9 lbs 3 oz by 1 month, but he is so long his height to weight ratio was always 1%. We breastfed for 19.5 months and he’s now 4 years old. 75% for height & 40% for weight (10% BMI). My daughter was born two years after him and similarly to your story, she was bigger than him, so we hoped we would have less worry with her. She was 7 lbs 8 oz and took to nursing like a champ. She barely lost weight in the hospital and I was able to nurse her on demand (she sas more demanding than him :-)). She ended up quickly moving to the bottom 1-2% for weight and off-the charts low for height to weight ratio. She was breastfed for 12.5 months. Now she is 2 and is 90% for height and 1% off weight. The doctor is very understanding and laid-back. She is a great eater and he said most kids catch up in puberty. He doesn’t want to create unhealthy habits. As s heads-up, he said the school sends letters home for BMIs under 5% (she is at 1%). He did ask her and my son at their last two visits what they ate for breakfast, which I get a sneaky suspicion might be checking to mind sure I feed them breakfast! I never got any questions about my milk supply, surprisingly. I had a huge over-supply with both kids and ended up donating over 60 gallons to Mother’s Milk Bank of North Texas. Part of me wonders if the fat content of my milk is low, due to the over-supply. Although, now the kids are drinking organic while milk and table food and they’re still thin. My husband and I are healthy, normal weight adults, but we were both really skinny kids. I’m sure genetics play a huge roll. We also have obesity on both sides of the family, so we’re thankful they got “skinny” genes 🙂
Thanks again for share your story!
So happy to find this post- in the midst of worrying about my 6-month-old who keeps falling down the CDC chart for weight (currently under the 5th %ile). His ped is at worst-case-scenario level of treatment plan (which included no lactation consultant) of course. And I just keep trying to remind myself that he’s happy all day long and most likely just fine. My oldest was similar– always at the VERY bottom of the charts– she’s 6 yrs old now and we’ve had NO concern about her weight for about 4 years straight! Thanks for writing about your experience. 🙂
Maria, thank you for writing a post that was the absolute perfect thing for me to read this morning! My little one is four months and has fluctuated between the first and fifth percentiles since birth. I’m constantly hearing things like, “Do you feed that baby?” and “There’s no way she’s {insert date here}. She’s sooo small!” And my personal favorite, “She looks like she’s starving, you really should give her some formula.” My pediatrician has been really supportive; it’s everyone else that is stressing me out! She’s meeting all milestones (even rolling from back to belly consistently), her length/head measurements are good, and most importantly, SHE’S HAPPY! I’ve shed so many tears over this and decided this morning that I’m doing the best that I can and until my baby shows a sign of a medical issue other than just being a cute, little person I’m going to stop stressing. In the middle of this epiphany I read your post, and it solidified my stance. So, from one mom of an underweight baby to another, thank you for your words; this mama really needed to hear them today!
It’s hard not to take those comments to heart, even WITH a supportive doctor. 🙁
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[…] the same pediatrician for years, and respected him immensely. He supported all 3 of our “not on the growth charts” children and our son’s F.P.I.E.S. We went to whatever office we needed in order to see […]
I was in labor with my son for 12 hours, and during the whole ordeal they were pumping the max amount of fluids into me….I am convinced those fluids were the cause of his high birthweight, and the subsequent weight loss, as well as terrible engorgement and breast feeding difficulties. He started in the 50% and dwindled down to the bottom of the charts by about 6 months. He was still developing right on track, he was just smaller. He looked healthy, he had plenty of energy, he was pleasantly chunky for his age, he was proportionate. My husband and I weren’t surprised by how small he was, since we are both small people, and I was very small as a child too. His doctor got me all worried though about his size and weight even though he was either right where he needed to be or advanced in all aspects besides height/weight! And he looked very vibrant and healthy, and he is still growing as much as he should be, he’s just on a lower curve than what’s “normal” my motherly instinct has begun to prevail though, and I’m not worried about him at all!
I’m so glad! I wish they’d just ditch the scale entirely & look at the kiddo instead! 🙂
The children look Perfect to me!
Recently my little girl fell off the growth chart. I had been so stress out about it. I have been writing down what she eats and obsessing over it and I think it may be making matters worse because I think she is now not eating sometimes because I want her to. It seems like some days she eats a lot and some days she will hardly eat anything. I have found myself crying over this! I don’t know what to do!
I did the same thing! I stressed myself so much. Try to go with the flow because she will pick up on your stress. What does your doctor say?
Thank you. After my EBF daughter’s two-month appointment yesterday, I needed to read this. I had no idea that all that fluid they pump into you during labor could affect the baby’s weight so much, but it makes perfect sense! I’m feeling less stressed about my little lady being <3% !
thanks for this post! it’s really encouraging and making me rethink switching to formula after my daughter’s surgery next week. i’m 4’10” and my husband is 5’7″. my daughter is 7 months old. she was born at 17.25″ and 7 lbs. At 6 months she was only 23″ and barely 13 lbs. i’m still EBF but was considering switching to formula since i can only maintain my supply with fenugreek and hate taking those pills bc they always get stuck in my throat. i am trying mother’s milk tea as an alternative. my goal was to EBF until her surgery and then begin to wean in hopes that she would grow bigger and “catch up”. she doesn’t look malnourished at all and meeting all her developmental milestones. i know that she is probably small bc my husband and i are small. it’s been a learning experience to try and not project my own insecurities of being small/short onto my kids. and i know that plays a big part in how i deal with my kids’ small size. i guess i’m also trying to minimize the potential for teasing when they get older especially since their last name is Small. i also have a soon-to-be 4 year old son who has been under 3% for weight and height since he was 9 months old. currently, he weighs 30lbs and is about 37 or 38 inches (both stats are 3% or below). i’m thankful that he sees himself as “big” and doesn’t like it if i say he’s small. i know that the most important thing is that they are growing on their own curve and are healthy. i am constantly reminding myself of that.
My son was only 14 lb 2 oz at 6 mos a few weeks ago & he was actually on the charts. My daughter weighed even less than yours. *hugs* to you!!
Thank you so much for posting this. You helped ease my mind tremendously. My daughter was an IUGR baby and I was induced at 37.5 weeks. She weighed 5# 8oz. We had bouts with jaundice and getting her to gain weight. Now at about 9.5 weeks she’s not on the charts but she seems to be growing on her own curve, making lots of diapers, and meeting all her milestones. I’ve gone back and forth considering stopping BF’ing. However, hearing your story, other comments from your readers, and support from other BF moms at my local La Leche League, I will continue at BF! Thank you again for sharing!!!
I love that you posted this. I ‘almost’ exclusively breastfed my daughter until she decided she was done at 13mos (some pump problems and work conflicts left us having to give some formula when she was 9mos). She was never underweight and she started at a healthy 8lbs, but she slowly shifted from the 50% curve in weight to the 10-15% in the first 6mos. My ped was equally supportive of my decision to continue breastfeeding exclusively though and commented how she was ahead of the curve developmentally, looked like a happy baby, and that was really what mattered.
What struck me the most was what other people would say about your daughter — I got similar comments. My daughter is like yours — very active and would prefer to move than eat most of the time. I swear if she couldn’t eat snacks on the go she would miss out on half her daily nutrition. We had a close friend of ours watch her 40hrs a week for a few months when she was a toddler. After a couple weeks my friend commented to me that she originally had thought we weren’t providing our daughter with the proper nutrition out of ignorance, but now she realized our daughter ate like a horse but was very active and it wasn’t our fault she was skinny. I laughed it off, but it kind of startled me that she thought our daughter looked malnourished.
Even when my daughter was an infant though we got all kinds of comments about how skinny she looked. I thought nothing of it at the time because I knew she was healthy and the comments weren’t obviously malicious, but now I contrast those comments with comments we have been receiving about our son and I see the meaning behind them. Our son started at the same weight as our daughter, but gained weight quicker than he grew in length and is solidly in the middle of the weight chart. He has always been chunky. And he is also exclusively breastfed. Everywhere we go we’ve gotten comments about his ‘cute chubby rolls’ and how ‘healthy’ and ‘chunky’ he is. Everyone wants to pinch his thighs. Its bitter sweet because now I realize how I was being silently criticized.
As a society we really put too much emphasis on appearance and everyone knows that, but I think it is under-emphasized how we silently pass judgement on children and even babies based on a glance. The comments we make that follow can be very hurtful to self-image. Instead we need to focus on what really matters, what is on the inside from nutrition to their personality. I’m probably the only one that praises my kids for eating their fruits and veggies. Everyone else is busy sneaking them chicken nuggets and chocolate. How about we change that?
You get a round of applause from me! Isn’t it interesting though that the tide somewhere turns from “chubby” being desirable, to fears about obesity!
DS was born on 10/19 weighing 7 lbs 14 oz. Within a week he dropped down to 7 lbs 2 oz. At 2 weeks, the pediatrician (who had wowed us w/ his Breast is Best speech) was telling us to supplement. He didn’t ask me how I thought breastfeeding was going and he didn’t encourage me to seek the help of a lactation consultant. He also told me that in order to increase supply, I should STOP pumping. We fired that pediatrician and today met with a new one. Our son has been consistently in the 5-10% range on the growth chart. The first and second doctors both say that he is perfectly healthy and hitting his milestones, but the 1st nit-picked on the weight issue time and again. We are going back in 2 weeks for a weight check with our new doctor. He dropped off of the chart entirely, only gaining 1/2 lb a month rather than the 1 lb he had been averaging. He weighed 10 lbs 6 oz today. I’m full of mama guilt but I’m glad the new doctor didn’t start telling us to supplement.
Of course, my lactation consultant is in Nigeria for the next two weeks so I can’t talk to her about this! 😛
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First of all, I had to laugh about all the disclaimer before you started. Having read breastfeeding articles before I know how touchy (and catty) some women can be about issues like this. I’m so impressed and grateful for all the work you put into this article. After a number of months trying I wasn’t able to continue breastfeeding either of my boys (multiple food sensitivity/allergy issues). Even though this wouldn’t have helped in my particular situation, I’m sure there are a lot of women out there that this article would do wonders for. I really appreciate articles that really try to get at the root of breastfeeding concerns and issues, and you did this in a very tactful way.
Thanks Maria!
Oh no! Were you able to find a standard formula they tolerated or did you get stuck w/the expensive hypoallergenic stuff?
I had one baby in the 95th percentile or above and one in the 10th percentile or below. I nursed them both exclusively and didn’t feed them any differently. The bigger one was 8 pounds when born and the other was 6 pounds. My doctor has never said one word except that the smaller than average probably needed vitamins because she has a delayed interested in solid foods – she is 13 months. . My husband and I were small children, I was a 9 pound baby though. Neither of us are big or small. Oh and my doctor said as long as she didn’t lose she was doing ok.
When my first was about 4 months and huge, I had people telling me to stop feeding her because she was overweight, total strangers! And now my other child is 13 months and walking and doing what 13 months do, I am told she walks very well for her age – I realize they think she is only 9 months old!
Thank you, thank you, thank you for this! I don’t want to get into my story but lets just say we get lots of remarks about her size (she was IUGR, born at 35 weeks 4 days because I had pre-eclampsia). She was 3lbs 4 oz and is now almost 6 pounds at 7 weeks, and everything points to genetics… I’ve always been small, I was a tiny kid, and I’m definitely getting tired of giving our whole medical history to every person who sees her and thinks she must be days old (she certainly doesn’t act like it… she could lift her head while still in hospital and can roll from tummy to back already… I think she just burned tons of energy in utero). Anyway, it’s good to read this, there’s not much to read as support for people with just plain underweight babies with nothing seemingly wrong with them.
But that’s about 6 oz/week and nearly double in 7 weeks! What more do people expect? I’d just tell them to STFU (F stands for fudge ;-))
I have 3 children.
My first is 10 yrs old now, but when she was born and I knew little about common un-needed procedures done, my biggest gripe is that they gave me an episiotomy. Now, I realize it was probably because the hospital was literally over capacity in labor and delivery that day. I was also constipated until 2 weeks after I gave birth to my daughter. I literally only had a small bm on day 3 after birth, and a large bm 2 weeks after birth. I don’t know if it was because of hormones or the episiotomy. As far as breastfeeding goes, I planned on “doing it” but I was young (19 yrs old) and once my nipples became cracked I gave into a formula a bottle at a time. I had bought a battery powered pump in the 3rd day or so after birth and the most I could ever get out of it was 1/2 oz. after 30 minutes. So I gave in to more and more bottles and by 2 weeks old, I was dry and feeding her formula only.
My second child 5 years later, I did a lot of reading and decided I wanted to breastfeed and succeed at it because I felt breast milk would be the most natural milk for her to drink. I had lanolin cream from the hospital and used it all the time. I had many lactation appointments. Her latch was great, but for the first 3 months after my daughter being born I was misearably constipated and I was losing hair down in my private area. It could have been a pituitary or hormonal issue- I never found out. At birth my daughter was 8 1bs 14 oz. and at 2 weeks old was not back to birth weight. I was comped a hospital grade pump and I tried to pump. In the mornings I would make about 2 oz, and it seemed like I was making about 2 oz every 3 hours on average no matter what stage of development my baby was at. I breastfed her for 13 months but at 4 weeks old she did look skinny and was completely thinned out compared to her at birth weight, and she also was cranky unless on a breast, so the doctor ordered formula. I felt like I did my research when I was pregnant and believed that litterally any mother who didn’t have hypoplastic breasts could breastfeed and would make enough milk if she offered her breasts whenever the baby wanted, and baby had a great latch. I also drank large mug glasses of fenugreek tea, but my supply never increased more than 18 oz. per day. I felt bad I didn’t realize the reason for her crankiness until it was in retrospective thought. But even with this, I breastfed her at least 18 oz. a day until she was 13 months old. And, she had formula up until she was 12 oz. to fill out her hunger. When I think in retrospect, I feel I may have been able to breastfeed her without introducing formula at weeks old if I had known about other breastfeeding herbs besides for fenugreek.
When I was pregnant with my 3rd daughter, I did a lot more research on breastfeeding. When she was born she was a 7 lb baby just like my first daughter was, but this was the best birth experience for me. It was a 4 hr labor total from the very first mild contraction. I got to the hospital and I walked into the hospital and by the time I got in my hospital room I was dialated and ready to push. The nurses had to deliver my 3rd daughter. Out of all my babies, she had the smallest head and when I was giving birth I literally couldn’t stop pushing. She was like a bullet and I felt no resistance with her birth and my water broke popped really, while delivering her. I didn’t tear and I had no constipation issues. The only thing I can think of is that there wasn’t a tear like in my 2nd daughter’s birth and there wasn’t an episiotomy like in my 1st daughter, so maybe that helped with the constipation issues but also from day 1 I was taking herbs, so I think the herbs also helped with that issue. For breastfeeding, I had more milk plus packed in my hospital bag. My daughter had explosive poop in the first week unlike my 2nd daughter. My more milk plus tincture was a small bottle and it lasted me 2 weeks I believe. After that I started making my own teas with as many herbs I knew were in the more milk plus tinctures but my daughter’s weight would stay between the 2 % and 17% after her first week of life. We never introduced formula and she seemed fine but I did have to drink a lot of herbal teas and I breastfed until she was maybe 16 months old. And now my youngest is 2 years old and she’s in the 75th-80th percentile for weight and over 100% for height. My 2nd daughter is 99% for weight and over 100% for height. And my 1st born who is 10 yrs. is over the 100% for weight and 85th percentile for height.
I’m so glad things went better with your third & it sounds like all are very healthy kids!!
Hi Maria,
This post really hits home for me! I’ve had 6 children and the last 3 have all been my “3% babies” as I like to call them because they consistently hover in that percentile. All 3 weighed around eight pounds at birth but by six months none had doubled their weight as I was told they should.
And the trend continues as they grow. My 4 year old son is small and thin, only 32 pounds. My 2 year old son is 26 pounds, also small but with a little chubbiness. And my 6 month old daughter just turned 6 months and still is hovering around 15 pounds.
As you can imagine, I’ve had many days of anxious worrying but I keep telling myself these FOUR important things:
1. They are growing. Weight and height gains may be agonizingly slow, but the numbers ARE going up.
2. They are meeting all milestones – in some cases, very early.
3. They are happy and healthy in all respects
4. They eat when hungry and I can’t force them to do otherwise!
Our pediatrician is great, but did worry me a couple of times when he suggested I might want to test them for possible abnormalities, just in case it was something that could be fixed. But then again, he also said it could very possibly be genetic and absolutely nothing to worry about. He sort of just left it up to us.
Know what has helped me tremendously? Talking to other mothers, especially those with grown kids who can give you reassurance that all is well. Some children grow slowly and then have growth spurts later in life. And still others start off HUGE and then fall way behind. I’ll never forget when my husband was a Sergeant in the Army, one of his soldiers was a Cuban fellow who was just barely 5 feet 2 inches. I was shocked one day when he told me his birth weight was over 13 POUNDS!
You’re doing a great job, Maria! Great post!
Thanks for sharing your experience! When I went through this the first time, it was really hard. I kept questioning myself & felt like I was failing. I really hope this post helps other moms!
Great post.
My duahgter was born at 36 weeks weighing 4 pounds 12 ounces and dropped to 4.4 by the time we left the hospital. the doctors decided to take her early because she was not gaining weight in the womb. She was formula feed and was little and the bottom of the charts for most of her life. When she hit 2 she was at 50%, before that she was at 10% or lower.
My son was born last year at 36 weeks also weighing 5 pounds 12 ounces and dropped to 5.4 by the time we left. The doctors elected to take him early also for the same reasons. My son has never had an ounce of formula and was breast feed only. At 13 months he still breastfeeds along with eating a ton of food and whole milk. At his 1 year check up he was 19 pounds (the bottom 3%) in a month he gained 2 ounces.
We have a new doctor and he has not asked for a food journal, saw how healthy my son is and just said he is suppose to be were he is. As long as he’s gaining weight and still eating 3 full meals plus snacks we will let him be. Both my kids are happy and have met all the milestones plus some.
I’ve had numerous comments about my small babies and was put on bed rest for a total of 23 weeks (with both of my pregnancies) for my babies so small. I hate the attitutdes that I must be doing something wrong since my babies have been born so small and stop growing.
That’s such a shame. 🙁
Same here! I’m 5’2″, 95-100 lbs. My first was born 6 lbs 12 oz and second is 7 lbs 7 oz. first girl was always at the bottom of the charts, still is, but I stopped paying attention to that. She’s healthy and full of life! What else does a baby need?
They need to be giant infants that miraculously turn into slender children at some magical age?? LOL
My son was born in the 95% and around four months started declining. By seven months he was under the 10th%. I was under so much pressure to push formula and solids even though my son had no interest in solids until 10 months. Eventually we figured out he was just taking on his normal body type. Now he eats twice the recommended calories for his age and size and it keeps his weight barely hovering near 25%. This time around I am more confident and know to just ignore people. I suspect my daughter is going to be a dainty little bit and I’m sure i’ll get comments again.
I can’t believe how much my son eats! If DS#2 eats as much, I’ll need a second mortgage to feed them as teenagers. 😉
My daughter has consistently followed between the 10th and 25th percentile. She’s just now at 4 around 50% for her weight. Dr has always said that she was following a curve so it was nothing to worry about.
My son was 7lb 6oz at birth and went down to 7lb 4oz, now at 7 weeks he’s almost 12.5 pounds!!!! He’s in between the 50th and 75 percentile. I’m not sure how my dr. will handle it. I think as long as he follows a curve there will be no big deal! We know he’s chunky. At 2.5 weeks he was 9lb 3oz! Almost 2 pounds in 2.5 weeks!!!
Wow!! Our friends had a baby in November. He was 12 lbs at 2 months & he looked huge next to ours, LOL!
Thank you for this. My daughter although born on the big side, quickly moved to the small side within a few weeks. As she reached that 6 month mark when breastfed babies slim down, she quickly went off the CDC chart. Unfortunately, I had to do all the work and find out that the CDC chart is totally wrong for breastfed babies and so I started comparing her on the WHO chart..which even then she’s still tiny. My doctor, was never thrilled about her size and never even bothered taking into account that we should be using the WHO chart on her. However, they didn’t really make a fuss either as my daughter has and does meet her milestones and is happy and healthy; just itty bitty. 🙂
I’m glad you wrote this post. More people need to know the truth about “underweight” babies/toddlers/kids.
Well at least your doc hasn’t been pushy! 🙂
LOVE this!! BOTH of my babies are off the charts too!! But in the other direction!They were both BF too.I have gotten big babies make big adults comment from doctors and it makes me so mad! My daughter is 4 moths and 20lbs as was my son who is now 2 yrs and 42lbs and as tall as a 3yr old. I love my Doctor because she does NOT think he is fat!!He is just a big boy and now I have a big girl too. Thanks for writing this 🙂
Love big BF’ed babies! 😀
I went through this a bit with my daughter. She was 7 10 at birth and 6 8 when we left the hospital. The doctor told me I needed to offer her formula as well as breastfeed. I was devastated! She was eating and seemed happy. She was growing, just not as fast as they would like. My MIL was the worst, she kept telling John that I was doing something wrong or she would have doubled her weight by the time she was 2 months old. Um….sorry, I don’t have a big baby, she’s a peanut. At first, I worried when she said this, but then I realized that our doctor told us at her 4 month checkup that she was perfect. So why should I be worried. The doctors main concern was whether she was eating and growing at her curve. She has pretty much always been around the 5 % curve. At her 15 month checkup, she was 19.5 pounds and in the 2.5%. Doctor said as long as she keeps growing, she isn’t worried. It’s normal for their growth to taper off when they start walking around and her biggest factor was consistent growth. As long as she didn’t just stop growing, we had no worries. She gave us ideas of how to help fatten her up, and it’s stuff she was already eating anyways. I was glad for her honesty and openness to talk to us about it. I wasn’t worried, and neither was she. It is very obvious that her little brain is learning so much, you can practically see the wheels turning and her doctor said, that’s what I love to see 🙂
Yay for your doc!
My second child (my son) started slowly falling on the growth chart around 6 months. By then he was eating table foods along with breast milk, and he would eat just about anything with alfredo sauce on it. Yeah, I know, not the healthiest thing, but he’d eat it on veggies, and he had really low weight. Anyway, his weight dropped again the next time (mind you he was eating more food then his sister who is 4 yrs older then him) and the Dr. went through this long speech about him needing to eat more, and how if his weight kept going down on the chart then he’d have to be tested. Seriously, I usually only saw her for MAYBE 5 minutes, and this time it was 20 minutes of how
“serious” this situation was. So, I went home crying, and freaking out, and scared to go back. Luckily, my husband was starting med school, so we were switching to the Dr.’s at the Clinic attached to the school (gotta love free medical care… well, it wasn’t so free when you see the tuition, but it was included, so we were going to use it) and we got matched up with a FANTASTIC Dr. He did my son’s next check up, and my son had gone even lower on the chart, and I quickly started explaining the large amount of food my son ate, and all the things the last Dr had told me. The new Dr. looked at me, and asked me if I wanted some medication to calm down my stress level, then he went on to say that I wasn’t very large, and therefore it would be ridiculous of him to assume that my son would be large. He told me that he wasn’t expecting my son to be a basketball player, but that he was healthy, and that he was hitting all his other milestones and there was no reason to worry, as long as my son was growing then he was going to grow at his own pace and there was nothing anyone could really do or needed to do. Thank heaven we had switched when we did, otherwise my son would have been put through crazy amounts of tests, only to find out that he’s perfectly healthy. He’s now on the growth chart, last time he was even in the 17th percent, but yeah, if you don’t feel comfortable with what your Dr. is saying, find a second opinion (a Dr.’s opinion, not just any random person)
Thank goodness you found a new doc!
Thanks for this mama! I’m dealing withthe same situation now! My youngest is 5 1/2 months old and at her last check up was only in the 20% percentile for weight. And just barely! And about the same for her height~ I actually had a nurse ask me if she was a PREEMIE!
We have struggled with her weight and feedings since she was born. She weighed 8#1 oz at birth! But had dropped to 7#5oz by 1 week. So…the verdict came that I had to supplement! I didnt know any better, and was concerned..the doctors seemed concerned….
At 3 weeks SHE chose to not take the bottle anymore. Her weight seemed ok so I thought….then came her 4 month checkup. Reflux….slow weight gain(only 8 oz. in a month)….supplement again! The rice formula does seem to help her spit less…but I wonder if she’s still going to be small.
My first baby in 2005 had the same issue with size..he’s 7 now and 25% for height and between 60-75% for weight. My youngest son (4) is very small for his age too. At his 4 year well check he was 35 lbs and I think 37inches???? Still like the 10th% for weight and height! But he’s healthy! He hasnt even been sick since March! And he eats veggies all the time! He eats better than I do! He’s just tiny! I’ve even considered Pediasure for him, and talked tothe dr about testing. We’re reevaluating him at his 5 yr well check this summer.
I think genetics does play a role. I’m 5’3, hubby is 5’10, but my mom is 5’1 and my mother is law is only 4’11!!!!! We arent TALL people! I have a brother who’s 5’8(short for a full grown man by US standards).
Thanks for the reminder that sometimes CHARTS can be an inaccurate measure of our kids!
I wonder if she has a milk allergy if the reflux got better w/rice? I would have thrown a party for 10% and 20%, LOL. Not everyone can be at the 50%, it doesn’t work that way docs, LOL.
Thanks for posting this! I especially enjoyed the links about IV fluids and weight loss in newborns – My daughter was born at 9 lbs 6 oz and has always been “off the charts” on the high side, but I had a nurse force formula on us while in the hospital because my daughter lost so much weight in the first 24 hours. Honestly, I knew better, but it’s hard to refuse the formula when you have someone calling you a “bad mother”. The sad part is that my OB told me that DD swallowed a lot of fluid during my c-section and I should have gone with my gut to refuse the formula…I was also on IV fluids before she was born. I feel that because of the “Early intervention” we were never able to breastfeed in the way I wish we could have…I ended up pumping for 8 months and only getting 2-4 oz per day.
That’s what it was like for me. I was exhausted after being kept awake for days & I just wanted to go home. They were acting like i was an abuser for not wanting to give formula. I’m lucky she didn’t take it or it would have been the beginning of the end for bf’ing.
With my 1st, my ped suggested I supplement at 3 days old because of her weight loss. Man! If I could go back in time. Lets just say that was the beginning of the end of BF. At 3 wks we went back to the same doc and she asked me how much baby was drinking via formula. I was still trying to BF but supplementing. And of course because I was supplementing, my DD would chug a bottle. Doc says she shouldnt be drinking that much. WTH? Want me to tell her no? Take the bottle out of her mouth? I’m sure you tell BF moms to put the boob away too. So I worried about my daughter getting fat. Really? At 3wks old? I got a new ped and stopped worrying about it all. Now she’s 3.5 and above the 100%, as is her 6ft tall mama. 😉
Sounds like you couldn’t make that ped happy no matter what.
My son is thin, and luckily, our pediatrician has always said, “It’s just genetics. You could probably feed him anything and everything and he’d still be thin.” He’s smart and a great talker and has met all his milestones “on time” or even ahead. The only worry I have is that he’s not getting the nutrients he needs because he’s SUCH a picky eater. He won’t eat vegetables and I have the hardest time getting him to try anything new. I’m hoping when we move (we’ve lived with my parents since before my son was born and are in the process of trying to buy our first home) that I’ll have more control over what foods are in the house, and that may help with getting my son to eat a little healthier. I’ll do my best! I’m hoping with baby #2 (due in July) to do some things a little differently when it comes to eating. I’m going to offer way more fresh vegetables and make my own baby food, which I did not do the first time around. I’m also going to give baby #2 far fewer sweets and treats, and not have soda in the house. My husband and I have some regrets as far as our son goes, for having introduced him to too many things that aren’t good for him!
We never had junk when my daughter was little, but since she & my son are over 4 years apart, he had stuff sooner than she did & more of it. 🙁 It’s hard to say no, you can’t have candy when she comes home from school with it *sigh*
Our son was 8lbs 2 oz when he was born. At 2 months, he was 9lbs 4 oz. At 4 months he was 11 lbs 4 oz. The pattern seemed to be right on for the CDC charts for that period of time. Then when I went to his 6 month appointment, he was 12 lbs even and the pediatrician seemed concerned. I didn’t think anything of it. A few weeks later, he spiked a fever of 104 and it stayed that way for 3 days. She had him tested for everything she could (normally a very conservative Dr.) including catheterizing him (because he’s uncircumcised) in order to collect a urine sample. The urine test came back positive for bacteria. She contributed the infection to his lack of weight gain. From there, we met with a urologist who said that we had done a terrible thing by not circumcising him and he would have to have major surgery now to correct what we had done. They hospitalized him in order to do further tests, but they all came back normal. It was completely useless! I decided to get another opinion, but never went through with it. At his 9 month appointment, he still only weighted 12 lbs 4 oz. We did weekly weight checks from there until 12 months, but he only gained about 2 oz per month. It was just him. He weighted exactly 13 lbs and was 32 inches at 1 year.
Around 14 months, he went through a growth spurt and gained A TON of weight. He was still nearly exclusively breastfed, but that didn’t matter. At 15 months, he weighted 22 lbs. He was finally on the charts! I wanted to throw a party because now people would stop asking “Is he sick?”, “Was he premature?”, “Are you sure he’s eating enough?”. Then around 18 months, I weighted him at Nicki’s Diapers and found that he was still 22 lbs. Today, at 27 months, he weights 25 lbs. I figure that he grows in his own pattern.
I haven’t actually taken him to his pediatrician since he was 13 months, and that was to “confirm chicken pox” from what she told me. He’s been perfectly healthy, so I haven’t found a need. I still like his pediatrician, but we only need to see her if something is wrong, in my opinion. With future children, we are planning to birth at home and do the same thing, only take them in when they are in need.
Thank you for your post! I’m glad I’m not the only mom out there who thought “what if I’m doing something wrong that is harming my child?”!
Also, I noticed on the CDC’s website that they are recommending the use of the WHO growth charts from birth to age 2 now!
http://www.cdc.gov/growthcharts/
I know my post was long & boring (LOL) but I did include that, along with why. 🙂
Oh my, you’ve been through the wringer! Those are some crazy growth patterns!
My second son was born at 4# 8oz (full term), and has been small ever since. At 25mos now, he weighs 22 1/2 lbs. He was born off the chart, by 6mos had crawled up to around the 10%, and stayed there until he started walking at 15mos. Once he started walking, he slimmed down instantly because he never stops moving. I joke that he never actually walks – he trots everywhere. We switched Peds at 18mos, and while the doctors at the first office never pushed formula supplementation, they did encourage us to give him rice cereal at 4mos (I didn’t) and push the solid foods early (I started trying to feed him a larger amount of solids at 9mos b/c my pumping output had decreased). His new ped isn’t at all concerned that he is off the charts because he maintained the same curve from 15mos-24mos. She also made an interesting comment that his tooth eruption is delayed (he only has 10 teeth at 2yrs, and only the two middle on the bottom; not four), which means he can still have a larger statute as he gets older. If his tooth development was on-track and he was small, it would most likely mean he would always be small.
My older son was consistently 90% height and 50% weight, so this small peanut has been a learning experience for me. It did work out though, because DS1 was born in Aug and DS2 in Jan. I didn’t think they’d be able to share clothes, but with DS2 being so small, he’s 6mos behind on all his sizes and things have worked out beautifully! 😉
Huh, that’s interesting about the teeth!
my son is at the top of the chart and the doctor told me not to breastfed him so much!!! its not like he eats that much maybe 5 times a day and he eats on one side for about 10 mins.
Ugh, I’m sure he’s just where he needs to be. No slimfast for babies needed, LOL.
Great post. My son “dropped” on the CDC charts but looked fine on the WHO charts. We’re a fairly tall family so his weight percentile was much much lower than his height as well. I had a doctor tell me at his 1 year appointment that “cow’s milk has the fat that kids need to grow” (breast milk actually has more fat) and a bunch of other polite but completely off-base advice. He didn’t have significant amounts of cow’s milk for another 10 months or so (when I had an actual supply drop due to pregnancy) and nursed until he was over 2 years old. I did write the clinic and got an apology call from the head pediatrician, so I hope the issue has been corrected and other moms won’t have the same bad advice.
I just can’t trust doctors anymore (as in, I always need to double-check and get a second opinion…I’m not saying they’re never needed or right, just the majority of my experiences have been negative). As a teacher, I take lots of continuing education (a lot at my own expense) and I’m willing to tell a student “Hmm, I don’t know very much about that, let’s look for the answer for that”, but I’ve had SEVERAL doctors, when faced with a situation that is unusual to them (nursing during pregnancy, nursing past 1 year, passing on hormonal birth control) simply spout off their own opinion as medical advice (and sometimes not in a very polite way) instead of saying “Hmm, I don’t know very much about that. I will look for some more information.”
I am the same way. I don’t want to make myself look crazy, but I would never take what a single doctor took as fact without doing my own research. On my home birth post I said something to the effect of even if you trust your midwife, do your own research too etc. and a midwife commented seemingly reaming me saying why bother hiring her etc. You seem to feel like I do!
Your kids are adorable! Great post.
🙂
My son’s always been at the bottom of the charts, ranging anywhere from 1-10%. He’s currently 20 months old and is 3%. I worried at first, but then realized, like you, that he was healthy and developing right on track. I was lucky to have a great LC and Pediatrician. Both told me not to worry about “the number” but to look at him instead. I did get lots of comments from well meaning family and friends, who just didn’t know enough about breastfeeding, suggest that I didn’t have enough milk, it wasn’t fatty enough, the “Are you sure he’s satisfied” ?’s. I’ve learned to tune them all out, and at 20 months I still get comments about his size! I have no idea why it’s so important to people. I’m currently pregnant with my second baby, and now I get comments FROM STRANGERS about how I”m going to have my hands full, they’ll be so close in age, etc! Good thing they don’t know I’m still nursing him! 🙂
People are so dumb, I swear. LOL Get a filter people! Yeah I can only imagine the looks on people’s faces if they knew I had nursed my son at 2, or that he only weaned (at his own choice) because my milk disappeared. I nursed during my pregnancy for several weeks & had every intention of continuing.
I’ve only just recently gone anywhere (to the park & to the grocery store) and got the hands full comments already. Really? It’s only three and the oldest is 7, jeez! I had the baby in the sling too, so my hands were literally not full, ha ha!!