On 14/02/2007, at 9:03, Diana Graham wrote:

> My 13 month old, who still gets a lot of her calories from nursing  
> and isn't very
> interested in cow's milk, recently stalled in weight gain after  
> several weeks of
> ear infections and colds.  She fell off her already tiny 3%ile  
> growth curve (she
> weighs about 16 lb 12 oz), and the pediatrician recommended (basically
> instructed) Pediasure in lieu of pumped milk in her day care bottles.

An artificial supplementation recommendation would tend to correlate  
with older growth charts being used, wouldn't it?

The way I look at growth charts, however, is not that any deviation  
from a line means an instant move from breastmilk to formula - that  
is a simplistic (being charitable, here) interpretation of what  
growth charts are for. Growth curves are for an "early warning  
system" for a child who has a medical problem. If a child is meant to  
be on the third centile and falls off it, that should be a trigger to  
look for a treatable cause. You have a very readily identifiable  
cause - a child can easily drop half a kilo in the course of one  
acute minor illness, and this generally bounces back without  
intervention.

I don't see a problem with adding olive oil for a 13 month old baby,  
though I'd probably tend to add it to solids more than to milk for  
largely aesthetic reasons. A slosh of EVOO can be added to just about  
any food. In addition, lots of calorie-dense foods can help (adjust  
depending on your particular dietary needs and individual allergy  
risk): avocados, cheese, legumes, meats, sweet potato with butter,  
seeds/tahini, dried fruits, egg and so on. Cook with milk/breastmilk  
rather than water.

If there is plenty of breastmilk available, it could be left to  
settled and some of the less fatty bottom part drawn off and used  
elsewhere (in cooking, perhaps).

Lara Hopkins

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