Hello, Lisa and all of you,
Although I am lurking most of the time on this fabulous mailing list (compliments and thanks to all of you), I now want to contribute to this discussion. I am a dutch MD, working in a mother and baby health care setting in Germany. I see many children, both breastfed and bottle fed (fortunately the breastfed children are by far the majority). I sometimes see babys, both in the breastfed and in the bottle-fed group, who are very lean and are growing very slowly. It is even possible, that, when a mother has 3 children, all breastfed, child nr. 1 is growing very fast, child nr. 2 is very lean, and child nr 3. again is growing very fast. Since 2 years I started to ask the parents, how they were growing themselves as a child (and since this was in the seventies, they themselves were mostly bottlefed). Often I hear, that they themselves were lean as babies (and often still are). Sometimes one of the parents was growing very fast and the other was growing slowly, which explains, that one child has the growth pattern of one parent and the other child has the growth pattern of the other parent. I even have asked some parents to bring their growing curves to me, and it is astonishing to see the same patterns in both parent and child. So now I am trying to make a bigger group. I even play with the thought to publish this data, but I need to collect more data. But yes, I really believe I see a genetic pattern. Of course, we have to be very careful here, and check child, mother and breastfeeding on all of the reasons already mentioned for FTT (I have quite a list on that one), but especcially for this small, very active, happy, very good developing babies, with adequate supply, I now always ask the parents to their growth pattern, and it helps me to make a positive diagnosis: "slow growth on genetic basis". I am very interested if others also found this correlations (would make a wonderfull study!).
Thank you for your reactions in this very interesting discussion,
Elien Rouw, MD, Bühl, Germany

  
Lisa Marasco wrote:
> > Pam and all,
I may not have been clear enough in what I was searching out. When I am wondering about those low growth babies, formula or breastfed, I am not thinking of the failure to thrive infant with organic or psychological (neglect/abuse) issues. I'm pondering the concept of babies who were programmed to grow slowly as a variation of normal. My musings are to how  often low growth rate is actually a norm for the child and not related to any pathologic factors, be it lack of milk, infant depression, fear of pain, avoidance of feeding discomfort, etc. I'm wondering how often we might attribute low growth to being genetically programmed when in actuality there was an underlying cause that was never picked up. What might the true
percentage be of babies who by nature were meant to grow slowly? >> 
 

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