feedback for "Off the Charts"

1. I was so excited to see an article about this issue and so incredibly disappointed! My daughter is (and, since 2 months, has been) off the charts at the heavy end. I assumed this article would also reject the claims that children should not be over 100percentile. I am a thin, 5'4" adult and my husband is a very tall and skinny 6'2". My daughter has been ranking over 100% her whole life and is obviously quite chunky. AND she looks exactly like my own baby pictures--in a word: fat. When I was a baby there were no percentiles to worry my mom. I was fed much as my daughter is fed: breast milk until over age 1, lots of fruits and veg, no juice, no refined sugars, etc. Yet she is (and I was) "fat." I wish this article would have at least given a comparable example of a chubby baby. The only thing this article got right is that the last thing mothers need is another worry.

   posted by : chubby baby on 5/26/2008 at 11:37 PM Flag For Abuse

2. Chubby Baby: I, too, have an off-the-charts kiddo. He was exclusively breastfed for 6 months, and since then has only had a bit of fresh fruits, veggies, and grains. No formula, no rice cereal, no "puffs." He is 14 months now and dropping and still breastfeeding on cue and eating what he wants of the foods we offer. Babies are great at self regulating, so I don't push the issue, just let him eat until he's done.
   For breastfed babies it is important to note that during the first 4 months they often weigh more than their formula-fed counterparts. After that, they tend to lean out a bit, which often looks like a percentile drop on the formula-fed/early solids charts.
   www.kellymom.com has the WHO growth charts, which your babe will probably fare better on.
   
   I do rather like the issues this article raises. More important than where a baby falls on the chart are issues such as output (wet/dirty diapers), activity level, motor milestones ..... it boggles my mind why pediatricians do not take these issues into account more. I can't believe the things that come out of my pediatricians mouth in regards to nutrition and growth. Nor can I believe the mainstream ideas about infant nutrition, either. I would love to see the WHO rec.s take precedence, but agree that it will probably not happen.

   posted by : NatMama on 5/27/2008 at 12:17 AM Flag For Abuse

3. Us too! Our son was 100% breast-fed (actually, it would have been nice for my wife if he took a bottle every now and then - but no such luck! :).
   
   Anyway - his weight was very in line with what's described in this article for breast-fed children. He started OK but became VERY lean around 6-9 months. He was under 10% on the US charts.
   
   We became very concerned but fortunately I found the WHO charts and realized that he was actually totally normal from a world standard.
   
   He's now 2 and although still quite lean he's very normal even in US terms.
   
   I think there were two factors at play. First, the 100% breast-feeding. Second, he was and is EXTREMELY active - walking at 11 months, always moving.
   
   Although our doctor did a good job helping us interpret the charts and telling us that really the most important thing is that the infant is keeping up developmentally (milestones, etc.), she did NOT inform us of the WHO charts which are very different. If she had that would have helped even more.

   posted by : k1 on 5/27/2008 at 2:22 PM Flag For Abuse

4. Our daughter was exactly like the ones in this article - she started out big - was in the 85% for weight, but by her 9 month appt had sunk to the 10%, and has stayed there (she's 14 months now). She was exclusively breastfed. Luckily for us, though, our peds are in the swing of things and reassured me that there was nothing amiss. And there's not! She's growing like a weed and eats like a horse.

   posted by : bookmama on 5/27/2008 at 2:29 PM Flag For Abuse

5. Wow, I am so glad to see this! I went through a whole drama with my doc (who I previously thought was so cool) - my totally breastfed baby (refused bottles, refused food until almost a year) was very high at 5 months and had "dropped significantly" at around a year and THEY WERE VERY ALARMED and I got a serious talking-to. Percentiles were around the 90's when she was a little baby, went to the 20-30s around 1 year. Oh, and she was 2 weeks late and 9 lbs at birth, so she started out "older" than other babies her age. So I was asked to bring her in for "weight checks" which I did once, I think. That's a nice start to raising a girl without body issues, huh? And it was totally upsetting and I felt like I had just gotten a "D" in Feeding The Baby. I actually started feeding her ice cream and relented on avoiding sugar to get her to eat as many calories as possible and now I'm really annoyed that I folded on my own ideals for feeding my own child. Meanwhile, my mother and sisters were telling me the whole thing was ridiculous and you could just look at my daughter and see she was thriving.
   Lo and behold, soon after she got interested in solid food and started a growth spurt. Much ado about NOTHING!!

   posted by : Chiara on 5/27/2008 at 3:50 PM Flag For Abuse

6. My ped. office now uses a growth curve software instead of percentiles. They still put them on our baby well visit documents (which are drastically out of date, they still include CIO as a method for sleep training), but the ped.s actually go by the growth curve, not the percentiles. My daughter started out a normal weight and is now below 3% according to the percentiles. Her height and head size are very low in the percentiles as well. Yet people still can guess her age correctly and she is growing, 2-3 pounds between each appointment. The growth charts by the CDC are probably crazy out of date. We can only expect now that 75% of moms breastfeed and kids are supposed to start solid foods at 6 months or even later, that children will smaller that in previous generations. Or bigger. Statistically people now are taller and weigh more then our parents. People come in all shapes and sizes and infants do too. I see exclusively breastfed babies that are giant and some that are itsy bitsy.

   posted by : dhsredhead on 5/27/2008 at 10:09 PM Flag For Abuse

7. Thanks to those of you who posted about your large kids. I, too, assumed that this article would discuss babies off the large end of the chart. My son has been 97th percentile (height and weight) all along.
   
   I am 5'5" and his dad is 6', so his destiny is not the NBA, but he's 14 months old and wearing 3T clothing. The clothing manufacturers use the same charts as the doctors, so I can't find onesies that fit anymore.
   
   Discovery Channel had a show on a condition that makes kids huge, and I was afraid to watch it . . . I guess only 4 kids in the world had that particular problem.

   posted by : TRex on 5/27/2008 at 11:44 PM Flag For Abuse

8. Me too! My baby is on the heavy end, though proportionally big---in the 90th percentile for everything (height, weight, head circ.) It worries me because both her dad and I were chunky as kids, though we are both healthy weights now. The last thing I needed was an article like this to make me even more paranoid about it.

   posted by : marie on 5/28/2008 at 9:14 AM Flag For Abuse

9. My baby has always been on the lower end of weight (25%) and higher in length (85%), but fortunately I have a pediatrician that seems have a good handle on perspective. He is more interested in the fact that my son is healthy and developing normally than the actual percentage. I agree with the author that the WHO model would be better, but I think there is a larger issue here which is that pediatricians need to be better educated or informed about their own charts and graphs and able to see the whole picture.

   posted by : Camille on 5/28/2008 at 9:30 AM Flag For Abuse

10. I don't understand why a pediatrician doesn't know enough to say, "Sometimes breastfed babies grow differently than the chart indicates," or, better yet, "All kids grow at different rates but otherwise s/he is very healthy!" Our pediatrician watches for changes in where he sits on the curve, and even when there is a change, she says, "Sometimes kids find a new curve, we'll watch it." Perfect.

    posted by : EG on 5/28/2008 at 12:28 PM Flag For Abuse

11. I live in Europe, and here I don't hear the word percentile. 90 percent of mothers breastfeed at 3 months, and the government goal is that as many as possible should do it at 6 months, Our pediatricians looks at the baby's curve since birth, and expects the baby to stay in that curve. If he/she moves up a curve, fine, if he/she drops a curve or two you discuss why (Been sick? Just started crawling?). Babies are different, and it seems stressful to be compared like that.

    posted by : Sandra on 5/28/2008 at 3:04 PM Flag For Abuse

12. Yes! So great to hear from the parents of fatties! I dread the well-baby visits because my pediatrician is obsessed with BMIs, which, come on, for 6-month-old breastfed babies just feels hysterical to me. My girl came into the world overdue and big, and was an absolute tank until just recently (she just turned 3). She has probably gained, like, 5 pounds since she turned 1. Oh, but do you think the doc is patting anyone on the back or laying off the diabetes speeches?
    
    She's suddenly looking to me like she's slimming down (might be the missing bulk of a diaper). We didn't do anything special -- including NOT ending night nursing when she was a baby, as suggested by the pediatrician. We try to eat healthy, we drink mostly water, we do 1 or 2 percent milk, we're moderately active.
    
    The thing is/was, the doc never asked any questions about what our family eats, what we do. She just launched right into worst-case scenarios about heart disease at the age of 12. I understand these are concerns, but putting a baby on a diet is just weird. Oh, and I stopped combining my baby's appointments with my older daughter's (lean, lean, lean)because she was hearing it all and getting super confused and worried.
    
    Great article!

    posted by : TheNewsJunkie on 5/28/2008 at 5:48 PM Flag For Abuse

13. Our baby girl has stuck to the 3rd percentile weight curve her entire life. She's always been healthy and very happy but the doctors insist she needs monthly visits to track her weight. One doc, whom we no longer see, had us endure a weekend hospital stay and numerous test because she thought our baby's "failure to thrive" was due to CF! We're being punished because we have a small baby.
    Thank you so much for bringing this up. Can someone post a link to the WHO charts?

    posted by : springdaddy on 5/29/2008 at 10:04 AM Flag For Abuse

14. Here's the link to the WHO charts:
    
    http://www.who.int/childgrowth/standards/en/

    posted by : LauraLaura on 5/29/2008 at 10:59 PM Flag For Abuse

15. We had a similar experience to springdaddy's - my daughter has consistently been at the 5th% for weight and height since babyhood. Two different doctors have worried about this and subtly suggested there were problems with feeding. Luckily, I knew that I, my brother, my father, my aunt, my grandmother etc. etc. had all been very small children who turned out to be healthy, slim, strong adults of average height. It was also obvious to me as a mom that my daughter was thriving and growing consistently, albeit behind others her age. Too often, numbers on a chart are focussed upon, and people forget the evidence before them - a healthy child with a specific genetic endowment.

    posted by : anonymous2008 on 5/30/2008 at 12:51 AM Flag For Abuse

16. All the percentile stuff can get out of hand, especially in a culture like ours, which is obsessed with success... therefore a higher percentile must be "better" than a lower one.
    
    I feel very lucky to have a family doctor who told me (a typical nervous new parent) very early after my first child was born: "I don't look at charts, I look at the baby. If the baby looks healthy, then the baby is healthy."

    posted by : Doppelganger on 5/30/2008 at 7:57 PM Flag For Abuse

17. I was kind of surprised too that there was no real mention of the larger babies in this article. There was a quote toward the end about how we should look more at the trajectory of the curve, but that's it.
    
    Like some others on here, I have an almost 2 year old who has consistently been above the 97th percentile since the day he was born (10lbs 2oz!). He was exclusively breastfed for the first 6 months and still nurses a few times a day. He's not the best veggie eater, but he eats pretty well. I haven't worried about him because the doctors have pointed out at every visit that he is staying on his own curve. It IS too bad that not everyone has doctors like mine! They actually DID warn me that he could thin out between 6 and 9 months. When he just kept getting chubby, they didn't worry. Now he looks totally proportionate, just BIG. BTW, my hubby and I are just average sized people, but we were both big babies.

    posted by : tiffer on 5/30/2008 at 10:18 PM Flag For Abuse

18. This article describes my baby perfectly. Recently her pediatrician noted his concern that she was only in the third percentile for her weight. He didn't use the words "failure to thrive," and said that she seemed healthy enough developmentally, but it still worried me. My mother and husband thought I should start giving her formula but I was hesitant. After reading this I know my very active, breastfed 9 month old will be fine the way she is. Thanks to the writer of this article for making me feel better about the way I feed my daughter.

    posted by : aliasgoeshere on 6/1/2008 at 3:04 AM Flag For Abuse

19. I am a pediatrician, and in my opinion there has never been any teaching in my profession to try and keep kids in the higher growth percentiles. Percentiles have always been used, and are intended to be used, to track children's growth trajectories only. 98% of the children in my practice are breast fed, and I know that some exclusively breast fed babies are amazingly chubby, and some are skinny -- as long as children continue to grow there is no concern. This is not my personal view, but the accepted view of my profession, and therefore the idea that pediatricians are"abandoning the percentiles" seems inaccurate to me. What you are describing is either a misinterpretation of percentile ranking by parents, or a minority amongst pediatricians who either do not understand how to map growth or are uncomfortable with exclusive breast feeding.

    posted by : DoctorDolittle on 7/9/2008 at 9:34 AM Flag For Abuse

20. I liked this article because I worry about my son being in the lower percentile on the growth chart.  I should mention that he was born at 23wks 5 days gestation so he's a little behind for his actual age (he was 465g, less than a pint of ice cream!).  His doctor has been great! She points out that he is at the lower end of the chart but he is healthy so she's not really worried (he finally passed the 20lbs mark at 20 months). The doctors at the hospital (where he spent 4.5 months after birth) warned us that he might gain slower, one even warned us not to try stuffing to get him to gain more!
    
    Unfortunately, I still worry about him being smaller than other children.  He eats well (except when teething), but is very active.  The only people who seem concerned with his weight are the people at WIC. They are very tied to charts! One of the people at the first office we went to asked us if we believed in "adjusted ages" (that is going by the due date age rather than the actual age on premature babies). 
    
    More education all around!
    
    

    posted by : Babydragons Mom on 10/8/2009 at 11:54 PM Flag For Abuse