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?