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I'm a first time Dad, though my wife has three kids from a previous marriage. MY wife is small, her mom is small, My step kids (Ages 6-11) are all small.
Our daughter was born 1 month premature after a horrible pregnancy where my wife had Hyperemesis Gravidarum. She lost more than 30 lbs during the pregnancy, received regular hydration therapy and eventually a picc line for nutrients. After 8 months of constant trips to the hospital she gave birth and almost lost her and the baby.
Gracie (our little girl) was born at 6lb 9oz and droped to 5lb 8oz in the next couple days. She gained that back before we left the hospital and got her jaundice under control. Since then she has been a petite girl but growing along the standard curve.
She has acid reflux which medication has had under control for the last couple months.
Monday, she weighed in at 10lb 5oz. She gained every time she's been weighed but her weight gain is low. As far as I know her length and head growth is normal, she wears the appropriate sized clothes just fine.
She's extremely active and alert and always eager to explore things around her. She smiles and laughs all the time and loves pulling the dog's and cat's ears when they get within arms reach and she's ready to take off into a crawl any day now. She's meeting all mile stones up to this point (and since our 9yo is profoundly autistic, we know developmental mile stones well).
But she's small... she got some pudge to her cheeks and her hands and legs but she's not a chubby baby.
She eats well, two jars of fruit and vegetables a day and nursing every 3-4 hours.
Her Dr wants to force formula on us and is raising all sorts of panic buttons and specialist referrals at us. But hasn't really taken any other information in account other than her weight vs the standard. And to be honest it has me fairly scared.
We currently are taking it week to week by her weight but I have absolutely no trust in the health care system these days and even less trust of Drs. And we don't have the greatest insurance so we can't even get a "real" Dr, as far as I'm concerned.
Well, in my opinion (just a mom, not a doctor, but I've been through this very thing), 10lbs5oz is not a healthy weight for a 6mo old. It sounds like she was born at a healthy weight (my son was 6lbs 15oz, induced at 37wks for issues with my health) and is growing on her own curve. She sounds just like my son (jaundice, very alert, hitting all his milestones on time or early, reflux, and no weight loss, just not *enough* weight gain each appt). For us they started with blood and urine tests, upper GI, sweat test and even an ultrasound on his kidneys. They can't find anything wrong with him except his lack of appetite and he was put on an appetite stimulant. They had to rule everything else out though before they decided to do that. Just last month we *graduated* from all his specialists and he was declared to be *just small*. He just turned 2 and is about 23.5lbs and 33in tall, smaller than most of his friends, but not abnormally so.
My SIL has a 4 mo old little girl that weighs about what your daughter does and she's already been in the hospital twice and they had her switch from breastfeeding to formula (which did make a big difference in their case) and she's had numerous tests run. At this time they are contemplating surgery and fitting her with a G tube.
My thoughts/opinions are that *I* would have tests run to make sure there isn't anything wrong with her. Testing is scary, but for me, peace of mind was more important. It doesn't necessarily mean anything is even wrong with her, she just may need some help in the calorie dept. We've met with two nutritionists and they have given us different ideas of things we can add to food to increase my son's caloric intake. Even for being a little guy (which he gets commented on all the time) he has more energy than you can even imagine. Good luck, let us know what you guys decide.
I'm actually just lurking here, cause I have some concerns about my 7 month old (will be 7 months this weekend). We are having sort of the opposite problem in that I am very concerned about my ds's weight, but no one else is including doctor and family. Lucas was born on time at 7lbs 3oz. He had a very quick birth, and we dealt with a low body temp for the first 24 hours which made him drowsy and not hungry, and didn't latch well. His lowest weight was 6lbs 7oz. Last week he was weighed at 13lbs. and he's still only 25 inches long. I keep asking the doc if there's anything wrong and the doc doesn't seem too worried. I've asked at the last 3 appointments. My family tells me that I shouldn't worry and he looks normal to them. He does have chunk to him and seems to be just a small build. Skinny and long runs in our family and also skinny and short, so it could be genetics......I just don't know. He has gained the 1lb/month which doc says is normal (1-2lbs) and is growing steadily on his own curve.
He is now still not bearing weight on legs, not sitting up on his own (starting to get better, but still nowhere near unnassisted), only rolls from tummy to back. As far as other milestones I would say he's on track or more advance in fine moter, language, and social development.
I live in a place were there are is not really a choice of doctors as there is a doctor shortage. I'm in Canada, so we don't pay for healthcare, and to see a specialist I would need a referal from my own doc who thinks that everything is fine.
Sorry if I hijacked your post, just though I would give you something to compare too (as our kiddos are almost the same age) and get some advice on my own situation as well. I don't know what to think.
I think that the point where doctors are alarmed (at least in our case) is when they stop growing on a curve. My son has never lost weight from one appt to the next, just not gained what was expected/wanted. From his 4 to 6 mo checkup his tiny weight gain made it look like almost a flat line on his chart. Even if they are not on the chart they should still be following their own growth line. One of the other ladies post a link to this: site. Here you can chart your childs weight so you can see how they fall on the chart, it was very helpful for me. As far as measuring length...I find that it's much harder to get an accurate reading at this age. I know once we went to the doctor and they had my son shrinking from one appt to the next, which was impossible, because babies wiggle so much.
For us, the doctors became concerned about Anna's weight when her curve started to flatten. She was gaining appropriately, and then just kind of stalled out until she eventually fell off the healthy range of the chart altogether, though she never actually lost weight. She showed no other signs of anything wrong with her whatsoever besides poor appetite. She was super alert, hitting all her milestones early, very energetic, etc. However, I was warned that eventually things would catch up to her and her body could not sustain her development with such few calories. We saw several doctors, nutritionists, etc., and the sentiment was consistent. There is a difference between "just small" and "TOO small." Some doctors are jumpier than others, as I've seen others moms being told by their doctors that their babies are too small when they are still several pounds bigger than my daughter. If you are unsure, I would plot her weight along a standard growth curve and see where she falls and the general shape of the curve. Falling down across percentiles is a red flag. A growth curve that is significantly flatter than the norm is a warning sign as well.
As far as the breastfeeding vs. formula recommendation, I would try to see a lactation consultant. I would want to know if the breastmilk production is adequate and rich enough. I have heard of rare cases when it isn't. For my daughter, for example, I produced far too little. Like, less than an ounce per feeding, but she has just never shown significant hunger cues. I had no choice but to switch because I was starving her. Your case is probably not that severe, but your daughter may be similar to mine in that she just doesn't care how much she eats. I was very, very big on breastfeeding, but when I saw that it was not enough to sustain her health, I had to turn to formula. Some doctors are just too formula happy, but there are some cases where it is necessary, unfortunately.
Rosalie, Mommy to Anna (05/06) and Thomas (10/08)