Anh,
I do not have expertise in this area, but I won't let
that prevent me from having an opinion.
I do not have a medical background, so I didn't understand
all of the very thorough account you presented, but a couple
of things come to mind:
1. I think that failure to thrive is a tough one to
diagnose accurately because it has many factors, centering
around physical and developmental growth. From what I could
tell your baby is normal in most of those measures. She is
small in the weight department (but normal in length and
head circumfrence) and developmentally normal except that
she is not yet sitting. She's not really good at taking
solids yet, and is not happy with pediasure to help her
get some more calories. Seems to me a second opinion from
another pediatrician may be in order, preferably one who
has a lot of experience with FTT and a good sense of when
to worry and when to follow carefully, but not worry yet.

2. As far as the problem of the baby not sitting up yet,
I would recommend an evaluation by Early Intervention. My
experience in Boston is that this is a wonderful program
with competent professionals (in a wide variety of areas) who
will evaluate your daughter and give you a sense of whether
her not sitting yet is a sign of a more serious problem, or
just that she's not interested yet. They will also suggest
some games and exercises to do with your daughter to encourage
her to sit up.

3. I would be very reluctant to change the nursing routine. It's
the easiest thing for doctors to suggest giving up in exchange for
something more concretely measurable. If she is iffy about other foods,
I think that the breastfeeding is giving her much needed nutrition rather
than the other way around i.e. preventing her from getting the
calories from other foods.

It is so important to remember that average and normal are not the same
thing. Average is a statistical statement that is MEANINGLESS when applied
to an individual. There is a VERY WIDE range of normal development. In
the absence of something concrete to be concerned about, be very cautious
about dramatically changing your routine and feeding patterns with your
daughter.

I hope this is helpful. Please keep us posted.

 Naomi Bar-Yam

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