I was speaking with a mom recently about her petite breastfed pre-schooler, and I mentioned Lactnet to her. She gave me permission to post and would appreciate any feedback anyone might be able to provide, either from personal or from professional experience. Her daughter turned 3 years old at the beginning of May and she is very small (< 3%). Her family physician has been concerend about her size, and referred her to a pediatric endocrinologist who feels that in the absence of underlying medical conditiions that lead to short stature, a child that is not on the growth curve is *always* the result of lack of nutrition, inappropriate nutrition of a combination of both. The endocrinologist informed the mother that she considers her daughter "definitely undernourished, not malnourished to the point of abuse or neglect, but definitely undernourished". She added that she was by no means telling the mother to stop breastfeeding, that is not at all what she was telling this mother, however, if she continued to do so it was at her own risk of jeaordizing her daughter's longterm health. The mother is herself knowledgeable about breastfeeding (she is an RN colleague of mine who teaches prenatal, including the breastfeeding class) and presenting the endocrinologist with research based arguments, the endocrinologist then added to the mother that she "appears to be very informed, but surely as a mother she wouldn't do anything to purposely harm her child". The endocrinologist feels breastfeeding at age 3 is interfering with her daughter's appetite, and she should be on solids for all of her nutritional needs at this point. She is convinced this mother is not feeding her daughter at all, other than breastmilk, and when she does happen to feed her child, she feels the mother feeds her things like gummies all day long, and other equally inappropriate foods, none of which is even true. Bloodwork and bone age x-ray are normal. The pediatrician on call corroborated her assesment though, when it comes to a 3 year old breastfeeding, and filling up on 'empty' calories, interfering with appetite. This mother will be meeting with a dietician in July, at the ednocrinologist's insistance, and she is to return for a follow-up appointment with the endocrinologist in October. This mother is very scared her daughter may be removed from her care at any point breastfeeding is seen as 'abuse and neglect'... She consulted with an LC who did a pre and post feed weight, and in half an hour of nursing her daughter took in half an ounce (15 ml). The LC doesn't feel the child is nursing for nutritional needs at this point, but for immune factors, etc. Her daughter is apparently the healthiest member of the family; she rarely, if ever gets sick, and when she does she bounces back very quickly. The LC doesn't feel the child's nursing could possibly be interfering with her appetite, which is normal for a pre-schooler, who does eat a variety of nutitious foods. Apart from being small (there are very petite women on both parents' sides of the family), the LC found the daughter to be healthy, active, developmentally right on track, appropriately verbal, with good skin colour, muscle tone, hair sheen and sparkly eyes - none of which would be possible if she were indeed undernouished. This is the first health care professional who can see beyond the chart and look at the whole child, as part of her assesment. This particular LC has previously worked in a hospital and has seen undernourished/malnourished pediatric cases, and she feels the daughter is fine, just a small person, very similar to the mother's build. The mother has just today found a new family physician who concurs with the LC's findings. This doctor is not prone to unnecessary intervention and is supportive of normal duration breastfeeding. Depending on the second opinions the mother can find locally, she mentioned she being prepared to bring her daughter to Toronto to see Dr. Newman for a consult, if need be. If you have any personal and/or professional experience with petite breastfed children, this mother would find any feedback most helpful. It has been a very emotionally trying time for her. Thanks. Kathleen Kathleen Bruce RN IBCLC Independent consultant: Breastfeeding Clinic of Vermont, Lactation Resources of Vermont, Medela, Inc. Listowner Lactnet listserv [log in to unmask] Archives: http://peach.ease.lsoft.com/archives/lactnet.html *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html