Georgeanne asked for input regarding a slow-gaining 11-month old whose
doctor advised mom to wean because baby needs to be eating more:

>Mom of an 11 mo old called today(her dtr had slowed weight gaining prev when
>ill, regained well when feeling better) whose child was ill and only BF,
>concerned because the last episode prompted Dr. to say "maybe you should stop
>breastfeeding, she needs to eat more." <snip>
>
> we would like some input if the same comment is repeated
>at the ear-check folloup visit when he weighs her again.


I got the same advice about my son. He was diagnosed with failure to thrive
at 15 months because of very slow weight gain for the previous 6 months. He
was still not interested in solids at that time.

Ped's opinion was that my son had developed a preference for bf and that
this was a developmental problem. The nurse told me that if he didn't start
to gain weight then "of course the next step will be to put him in the
hospital."

Ped referred us to a health dept. team and a nutritionist began making home
visits. Her advice was to be very regular about mealtimes, put food out but
only in a matter-of-fact way, and not bf within 30 minutes of a meal. She
also wanted me to count/measure how much he ate at each meal. Our reports
went something like, "5 grains of oatmeal," or "2 nibbles of a bagel, but
he spit it back out." But surprisingly (because it didn't seem as if he was
eating anything), we saw some weight gain over the next month.

At that point the nutritionist recommended that I increase the time between
bf and meals to 1.5 hours, and not bf for at least 30 minutes after a meal
(i.e., don't nurse for 1.5 hours before a meal or for 30 min. after a
meal). Between 3 meals and 2 snacks a day, this strategy doesn't allow for
much bf. She wanted me to pretty much limit bf to early morning and before
bed.

I never followed this advice and yet my son started eating more and
continued to gain. In fact, he started gaining at well over the "average"
rate for his age.

BUT: at next ped. visit, despite all this improvement, the doctor said, "we
need to get him off the breast." His opinion was that I must think it was
easier to bf and so was not willing to put my son on solids.

I think Jack just started gaining when he got ready. For a long time he
chewed food but didn't swallow it -- it came back out of his mouth. When
the nurse threatened us with putting him in the hospital, I started doing
some research and realized that maybe there was a swallowing disorder
involved. But right about that time Jack started gaining some weight. He
slowly figured out how to swallow food, and now no longer has a problem
with the mechanics of eating. (Though he is still a very picky eater,
doesn't eat much even of the food he likes, and still nurses a lot.)

We were thrilled when he finally hit 20 pounds, and most recently, when he
gained 15 ounces in about 6 weeks, putting him at a whopping
almost-21-pounds.

The one good thing that did come from all this was that we got a free
developmental assessment. The assessment team had a great ped. who took a
much broader view of things.

He said basically: you're small, your husband's small, your son is going to
be small. (Jack is under 5th percentile for ht and wt when plotted
separately, but in 25-50 range when ht/wt are plotted as a ratio). He said
Jack is "well-nourished for his height."

He also said that once a child turns 2, they look to see a 2-inch gain in
height per year. He said it Jack doesn't make THAT mark (at 3 years), then
it will be time to look into it. But for now, he wasn't concerned at all
about his size, or about the fact that he plateaued (sp?) with his weight
for a while.

In the meantime, the nutritionist continues to visit every 6 weeks to do
weight checks and to talk about how things are going with Jack's eating.
She comes again tomorrow...

Hope all this is helpful. We are switching ped's, by the way.


    Betty Meeler
    Durham, NC
    [log in to unmask]