Mellanie, your post doesn't mention what, if any, other foods this child is
getting, and we need to know that to assess growth.  The ounce-a-day gain is
about what we expect to see in the first few months, not after 6 months.
There seems to be some newer evidence that excessively rapid growth in the
first year of life is not beneficial either; the goal is not always to get
as big as possible as quickly as possible!  It may have long term negative
consequences for insulin sensitivity to grow too fast.

Is the child developmentally on schedule, and happy and well?  Or are there
other concerns you haven't mentioned, or maybe haven't been informed of
yourself?

Most weaning foods (defined as the foods we give instead of breastmilk when
breastfeeding is tapering off) have lower nutrient density than breastmilk.
A look at the rest of the child's diet would tell whether some adjustments
should be made there to increase energy intake.  If the child is exclusively
breastfed, what is the the reason for this?

When my first child went from 50th to 5th percentile in her second 6 months
of life, I read up on growth patterns and learned that the vast majority of
children change trajectories in the first year of life, either up or down.
Children born very large or very small often approach average.  In my
daughter's case, she followed my own growth curve almost to the gram, and is
my height, if you can call 5 feet a 'height', now at age 22.  In
weight-for-length I am still 25 years ahead of her :-(  My son was the other
extreme and followed his artificially fed father's growth curve quite
closely in infancy, looking like the Michelin Man at 4 months, has the same
build though has been more slender throughout childhood than father was, and
seems to be approaching father in height now in adolescence.

I agree that when growth rate deviates from the expected, it should be
investigated.  However, the health professionals have a duty to know what is
normal weight gain so the expectations are not out of line.  "The
pediatrician says that if the baby still doesn't gain more weight they will
need to use human milk fortifier.  She has threatened mom with hospitalizing
the baby if she does not comply."  If I had such an adversarial relationship
with a health professional I would not waste my time trying to comply with
anything.  I would be checking the yellow pages and asking around in my
community to find a pediatrician who would treat me as an adult, and if I
were really feeling offended I might send a complaint to the local
professional body too.  What could be the reason for the pediatrician's
seemingly extreme concern?

Rachel Myr
Kristiansand, Norway

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