Stunted growth would mean child taking insufficient calories to maintain
weight %ile.  Body prioritizes calories first to brain, next to length, last
to weight.  By the time the head circ %ile is dropping a child will have
been undernourished for some time.  It helps to (1) see (you can
reconstruct) the child's growth charts (weight and length) (2) assess
genetic potential - how tall are mom and dad and rest of family? Gives you
an idea of what is reasonable (3) support the work with nutritionist (4)
rent scale to find out how much brstmlk child is taking (gets rid of all the
guesswork)

Sadly there are some little ones out there who prefer to suck on a rather
empty brst than eat.  This is unusual but definitely happens.  They become
anorexic, adjusting intake down to whatever is avail.  Often do a lot of
sucking (fingers, thumbs, blankies, etc.) as well.  They are usually
described as content, mellow, sleeping well, meeting all milestones.  When
you meet them they don't look right - often pale, too placid, and taking
quick nips of brst with little swallowing and no complaint.  Head may look
big for body.

It is possible to underfeed to point that child will not meet genetic
potential.  There's a point of no return but have no idea when this is.
Usually length turns around promptly as soon as adequate intake - have seen
startling response to increase in calories.

Very rarely I have seen a mom have to wean completely in order for her child
to start to eat enough.  Sad, I know.  Complex and sensitive issue.  But am
reminded of Coach Smith's Rule No. One - Feed The Baby.

Good luck - a very hard situation.
Joanna Koch, IBCLC, N Ca




Got a call from a mom who wanted information to support her continued =
breastfeeding of her 14mo daughter.  Although her daughter is only 15 =
pounds, she is healthy and reaching appropriate developmental = milestones.
The daughter does eat nutritious foods, but also snack = breastfeeds (as the
nutritionist told the mom).  Daughter has received = some medical tests and
there is nothing apparently wrong, but the mom = has to return to a
Children's Hospital in another state for a follow-up = visit.  I guess the
only thing they could pick on in the previous visit = was the breastfeeding
and the mom is afraid they will tell her when she = returns (if there is not
sufficient weight gain)  to wean and since she = is in the "system", mom is
afraid of what will happen if she does not =
wean.    I'm not sure what the daughter's length is, but they are =
throwing the "stunted" word at the mom and the mom has no idea of how = that
is diagnosed.
 =20
  Need help!
  Terriann Shell
  Big Lake, AK

 

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