The Dreaded Growth Charts. Is Your “Underweight” Baby Actually Normal?
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
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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.
Michelles last blog post..New Study About Drinking During Pregnancy
Katie says...
My daughter is 16 mos old. She is 20 pounds. She lost wieght more when we started introducing solids (she is a very picky eater and only eats a little at a time) and ever since she learned how to walk she has been extremely active. She was formula fed for the most part and falls in the 30th percentile for her weight while her height is in the 95th percentile. When my doctor told me that she was underweight my heart sank, I felt like I had done something wrong, that I was not feeding her often enough or the foods that she needed to thrive. However, the more that I thought about it, the less worried I became. She has reached all of her milestones and is filled with boundless energy. My doctor recommended putting ice cream in her bottle and loading every food she ate with large amounts of butter. She hated it and I didn’t feel comfortable giving her all of that fatty food because I felt like her diet just consisted of butter and ice cream mainly. So I quit worrying and did what I felt was right.
Taryn says...
Well my daughter is eight months old and weighs 13 lbs. she was 6lbs 3oz at birth, she has always been at the 5th percentile but now she is below that line. She is breastfed and eating solid foods, she seems happy and healthy and sleeps through the night and reaching all of her milestones. Her pediatrician hasn’t recommended supplementing, so I am lucky for that and they said she will just be a pettite little girl.
tammy says...
Yes, I can relate. My folks have accused me of starving my child. Which just breaks my heart…because I waited so long for this child and would never harm him. He was exclusively breastfed for two months and now we supplement with an organic formula …8 ounces in total a day. The little guy is strong – even the doc mentioned that he had good muscle tone. I was feeding on demand and we had the correct # of soiled diapers. This is a happy child. His lowest hospital weight was 7.8 and he now weighs 9.2. And yes, I see that is a low weight gain…but let’s look for valid reasons other than constantly blaming the Moms. Remember that we (overbearing mothers) used to get the blame for schizophrenia as late as the 1970’s until it was discovered to be genetic. Hopefully we can further evolve on this issue.
Julie Halteman says...
I can also relate to this. My son was born at 8 lbs. 12 oz. and we thought WOW, he is gonna be big. But now his growth chart looks like a true down hill slope. He is 8 mo old and weighs 17 lbs, 11 oz. and is in the 10th percentile. At his 6 mo. check up, he had actually lost weight. We are currently going to the doctor every month to have him weighed due to his growth curve. He has gained a little under 4 pounds since he was 4 months old. I worry about this constantly and have found myself obsessing over what and how much he eats. I wonder sometimes if too much emphasis is put on the growth charts and if I am worrying without need over my son’s well being. I hope I am not going to regret all this time spent worrying and look back at his baby years only to wish I had spent more time enjoying them and less time obsessing.
Diana Lau says...
During his 6 month check up, my son (exclusively breastfed until 4 months) was at 14 lbs and was said to be underweight by his doctor, whom I now have mixed feelings about. The dr. told me that I need to pump 3x a day and add formula, and feed him 3x a day of solids. It’s now been a month and I haven’t really put much effort into pumping since I truly believe that my baby is NOT underweight and very happy.
Tamra says...
I too am feeling frustrated. At 8 months my baby was 14lbs and my pediatrician told me I needed to feed solids three times a day and supplement after every breastfeed with formula! This is my 5th child and I have breastfed all of them until at least 3 yrs old. I told my doctor that I wouldn’t supplement her with formula and he was very rude. I then left him and went to a new pediatrician who is more supportive of breastfeeding. I did introduce dairy into my dd’s diet after visiting with the new pediatrician and started giving her cheese with one meal a day, but even with that and the extra solids she gained only 7 oz in the last 6 weeks. She is not even on the chart at all! I have no idea if there are negative percentiles but I am guessing she would be -3%. She is 14lbs 13oz at 10.5 months old. My new pediatrician is now concerned and is sending us to a nutritionist. I am praying like mad that I won’t have to wean. I have started mixing butter into everything she eats, which she loves, but makes me feel like I am going to gag. It can’t be healthy can it? I don’t know what I am going to do!
Tamras last blog post..Virginia’s latest weight check
Alexandra Lutz says...
My baby has been consistently small. She was 6.10 at birth and dropped almost immediately. She liked to sleep–and would go into a low-blood sugar state where she couldn’t wake up to eat. We had three medical practitioners tell me to supplement, which went very well. She just turned 1 this week. She is in the 1st percentile for weight, and the 50-75th for height. Her pediatrician says he is not worried for these reasons: developmentally she is normal, her energy is good, she has 3 bowel movements a day. He just jokes that she is a runway model.
I’m not tall, but I am skinny–always have been. The doc did suggest I beef up her milk a little with Carnation instant breakfast. And not to give her watered-down juice (just always milk).
Elena says...
My son is now 18 months old and is still low in the percentiles for weight. At his last visit my pediatrician referred him to a GI doctor even though he doesn’t have vomiting, diarrhea, reflux or stool issues. He was gaining weight before the pediatrician visit but than caught a nasty cold and his molars are coming in, so he’s not a big eater lately. He’s very active and is reaching all of his milestones. I’m so frustrated because I know he’s fine but all the medical community cares about are the darn charts!