I wonder if the mother of this baby could go for a second opinion, perhaps
with a more experienced or more breastfeeding-friendly doctor. This baby's
weight gain does not seem unusually low to me, if the baby is otherwise
healthy and developing well. Some babies do "drop down through the
percentiles" during their first year. It is worth investigation, yes, but it
does not automatically mean the baby should be fed more to make it gain
faster. Remember that birthweight does not correlate with adult size, but
weight at one year does. That means some babies who are born very small
(perhaps prematurely) will gain weight quickly during their first year,
while other babies who were born big will (say at the 80th percentile,
perhaps because their mothers had gestational diabetes, or for unknown
reasons) may drop to the 30th percentile by the time they are a year old.
This is appropriate for them. Those nice smooth curves on the graph are made
by looking at averages and certainly do not apply for every baby.

Nobody worries about babies who go "up" - from the 20th percentile to the
50th percentile. Yet there is some research now suggesting that too-rapid
weight gain in the early months is strongly linked to childhood obesity (a
serious problem in North America). The research has been done almost
exclusively on bottlefed babies, but this seems to suggest that many of
these babies are actually overfed. (Let me say that I do not believe this
applies to breastfed babies, who are able to regulate how much milk they get
and who gain at the rate appropriate for them.)

The rush to "feed the baby MORE" may be risking the future health of the
child through obesity. Let's first check to see if a real problem exists,
rule out illness or other problems, then OFFER (not force) the baby more
food to see if the baby will WILLINGLY take more if it is available. If the
baby is not interested, and is otherwise healthy and developing normally -
then maybe this baby is doing just fine.

Teresa Pitman
Guelph, Ontario

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