JoAnn Barham writes:
>
>I have a friend with a dilemma. She has an eight month old bf baby girl.
Baby is in 25th percentile for height/weight, "Jane"
>is worried about Baby's size.
>
>The questions are:
>
>1) Should she give cow's milk and not formula to a baby this age?
>
>2) If she does give cow's milk, what kind? According to the LLL BAB, cow's
>milk should not be given until after 1 year of age, and then whole milk for
>2-3 years. Do these guidelines still exist?

IMHO (in my humble opinion), Jane first needs a new pediatrician.  Then,
Jane needs to understand that the 25th percentile of growth means that 25%
of the population is below this point, and 75% is above.  It isn't like a
test grade, where you have to get a 70 to pass, and it isn't like some other
measures where you would like to be average (50th percentile) or else you
feel bad.  A full one-quarter of the population has to be below the 25th
percentile, by definition.  Thus, the child's size is absolutely fine,
*unless* she was at the 80% from birth to six months, then fell
precipitously off the growth charts by losing weight and not growing in
height for several months.  *That* might indicate a problem.  If the child
is growing and tracking steadily along the 25th percentile, then she
*doesn't* have a growth problem, and isn't too little.
Finally, if Jane wants to give the baby something to replace her breast milk
when she is gone and the EBM is gone, she definitely should use formula
until at least one year of age (I would say longer, but then I'm no expert
on the use of formula).  After one year minimum, then she should switch to
whole milk.

Hope these ideas help.
Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology
Specialist in infant feeding and growth of children
Texas A&M University
e-mail to [log in to unmask]
(409) 845-5256
(409) 778-4513