The Dreaded Growth Charts. Is Your “Underweight” Baby Actually Normal?
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My friend recently delivered a gorgeous, healthy 6lb baby girl. Her weight was below average but certainly healthy. Her daughter gained weight at every checkup, but remained in the 10th percentile, some way below the average line. She exclusively breastfed, and her doctor told her, fairly brusquely, that her baby was not getting enough to eat, and she should supplement with formula. She left the appointment in tears.
After a conference with mom’s friends, she sought out another pediatrician for a second opinion. Doctor #2 examined her baby, and asked some questions. “How often does she nurse?” Every two hours. “Is she peeing, and pooping?” Plenty. “Does she seem happy most of the time?” Yes. “Your baby is perfectly healthy. You are doing a great job. Go home and carry on breastfeeding. She doesn’t need any formula.”
Telling a mom that her baby is underweight is one of the worst things a doctor can say, implying baby is underfed, starving and neglected, and to breastfeeding moms, that your body is not working properly. Many moms across the country hear it every day from a doctor pointing at a growth chart and feel that same awful feeling my friend did. Many moms quit or reduce breastfeeding to supplement with formula, or start encouraging baby to feed or nurse more and more to attain that perfect weight.
But hold on. Did you know that the modern growth charts are based on data gathered in the 1970’s about a small group of wealthy, white, high-protein formula fed babies in middle America? Hardly representative of the general population.
Breastfed babies are well known to naturally grow more slowly than formula fed babies, and high-protein formula fed babies grow fastest of all. The charts used by your pediatrician today are from heavier-than-average babies. Growth charts were reformulated in 2000 to include more breastfed babies, but more recent studies encompassing a wide variety of social and ethnic groups, breastfed and formula fed babies, still show that the “real” average baby is still somewhat lighter than the charts would have you believe.
The result is that doctors are telling many moms to feed normal weight babies more food.
Obviously there’s a lot of self-protection from doctors here. Most doctors would err on the side of caution and tell a mom to feed baby more, rather than risk a future lawsuit over a malnourished baby.
Well, the doctors have covered themselves, but what about mom and baby? Aside from making new mothers feel bad, overfeeding a perfectly healthy, normal weight baby leads to health problems in later life. Encouraging a full baby to eat more interferes with the natural feedback that stops overeating, and may lead to obesity later in life.
The World Heath Organization is reviewing data from the recent studies, and is considering bringing in new, more relevant charts. Hopefully more healthy babies will be left to decide how much they want to eat, and it will be easier for doctors to identify babies who really are underfed, or have a medical problem preventing them eating or digesting their food.
Have you been at the receiving end of a doctor unjustly telling you that your baby is underfed? How did you deal with it?
Source -Babies Overfed To Meet Flawed Ideal, New Scientist
Michelle says...
Yes, actually I am dealing with this issue right now. My eight month old breastfed baby weighs 14 pounds. He is not on the growth chart at all. He is completely outside the range. However, I am a small person as well as the rest of my family. I consistently point that out. My baby is reaching all his milestones on time, gaining weight between every visit, he is happy, and very well taken care of. My pediatrician has strongly recommended that I start giving the baby formula before he has fallen so far behind that he can’t “catch up”. It makes me feel like she thinks I am a bad parent, or because I am reluctant to feed formula, I don’t care about my baby’s well being.
Amanda says...
I have been in a similar boat with my son, who was breastfed. He started in the 25th percentile when born and has remained in the 5th percentile or less since. The pediatricians have mixed ideas about his “low” weight and the causes. I feel they are playing a guessing game - unfortunately, they first assume I must not be caring properly for him. He seems to be developing normally, but the doctors claim that it takes time for developmental delays to show when a baby is “failing to thrive”. I remain in doubt, and feeling a bit helpless, because I don’t know what to believe. None of the tests they have done have revealed anything abnormal. I am concerned about my son’s growth and development being “on track”, but feel unsatisfied with the response of these medical professionals who seem to be basing my son’s individual progress on a single growth chart(even they have difficulty explaining the statistical development of) patterned after other babies maybe with very dissimilar habits and diets.
Corrine says...
I am dealing with a similar experience; my daughter is almost 7 months old and weighs 12lbs. One of her pediatricians told me “she is healthy and is just going to be a small person” (like mine and my husband’s families.) But another pediatrician recently told me to feed her more! She is in the 5th percentile according to the growth charts, but babies today are born bigger than they should be. I feel that my child is right where she should be; she eats till she’s full, and I can’t force her to eat more! I’ve even had her on formula since she was 4 weeks old. I think that as long as your child is healthy, happy, and reaching all of the normal milestones- you shouldn’t worry about what growth charts say.
carrie says...
I just got back from my daughters 1 year check up and she is only 16.5lbs. My doctor has been on me from the start about her low weight and had me start her on meat at 7 months old. She told me that she wants to see her in 2 months and if she does not put on more weight she will have to start doing test. IM not sure for what and my baby is a pig she eats all the time I just do understand why she is so tiny still.
Marcus says...
I understand ladies, my 4 month old daughter is 10lbs. Her doctor, family, and friends are all “requesting” that we start her on formula. She is a happy baby and nurses regularly. During our last visit, my wife fed her while we were waiting. The doctor gave his weight comments then started to examine her. While he was moving her around she spitup on him a little. His own words were, “Well, I see that she is eating”. Hummmm
We are parents that care so their nagging falls on deaf ears. I’d rather for my child to be slim than overweight. I am glad that we decided to nurse. There are so many more benefits over formula. I can look around and see two generations of overweight adults that were forced to eat extra food and formula as children. Habits start early. I don’t want that to be my daughter. Those growth charts are only a guide. They are not the rule. Just continue being the responsible parents that you are.
Janice says...
I am about to be a new grandmother and want to start buying diapers but I don’t know how many of each size I should buy. My daughter-in-law wants to use Huggies. So far I have bought two packages of size 1 and one package of size 2. I don’t remimber how fast babies grow and would like some help to determine how many diapers of each size I should buy.
thank you,
Janice
Elena says...
My son has been below the 10th percentile in weight since his 9 month visit. I’ve exclusively breastfed him. I tried formula after his 9 month visit and whole cow’s milk after his 12 month but he prefers breastfeeding. I feel he eats fine most times but I feel pressure to “fatten him up” to be like formula fed babies. I’m petite and my husband was slender as a child, so I feel that it’s genetic. I worry though what others might think because he is small. He is health and happy, which is what matters most.
Michelle says...
I just got back from my daughter’s 1 year check up, she weighed in at 16lbs 14ounces and is below the 5th percentile in weight at the 5th percentile in height. She breastfeeds and eats solid food but is allergic to eggs and cows milk. Her pediatrician said she looks fine but if at her fifteen month check up she is still under the 5th percentile she will have to do some tests to see why she is “failing to thrive”. She is not a skinny baby she has chubby cheeks, legs, and arms. I am confused as to why if she is eating healthy and developmentally healthy why she would still have to have tests.
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