Scene: a warm afternoon at the baby weight clinic.
Health visitor: "She's a little heavier than we would like her to be."
Me:"Oh?"
HV: "Yes."
Me: "Well she's still breastfed and she eats very healthily, just fruit and veg and a little bit of meat."
HV: "How many breastfeeds does she have?" (What kind of a question is this? How many breastfeeds does she have? Have people who ask this question got any idea of what on-demand feeding is like? So what counts as "one" breastfeed: the quick one minute burst in the middle of the night? The two minutes to calm her down when she's hyper? The ten-seconds-on-ten-seconds-off public feeds? This question has always puzzled me, from when she was newborn and fed all the time, to now when most feeds are blink-and-you'll-miss-it quick.)
Me: "Er, I have no idea. She feeds on demand."
HV: "Oh [looking puzzled]. She's obviously doing well on her solids. You could drop a breastfeed." (And which breastfeed would you suggest I drop? The one that comforts her when she's banged her head? The one that gets her to sleep for her nap? The one that guides her out of the fog of sleep when she wakes up? The one in the middle of the night that stops her fidgeting and moaning? The one she has on the evening when she's getting cranky, crying for me and pawing at my front? Have you any idea of the role breastfeeding plays in the lives of me and my baby? It is not so much about food as about mothering. And she is only eleven months old!)
Me: "Hmm. No, I'm not going to drop a feed. Maybe I could give her less solids."
HV: "No you can't do that. The solids are very important." (And what about the breastmilk? Is that not still protecting her against all manner of diseases? Is it not supposed to form the main part of her diet until she is a year old? Surely a breastfeed is worth more to her than an extra rice cake or half a potato, for example, especially given that she has no problems taking solids.)
Me: "Oh well. I'll do nothing then. I mean, look at her, she's perfectly fine."
HV: "Hmm. But she is heavier than we would like her to be."
Me: "Wouldn't you have to measure her height to see if she was in proportion?" (In fact we have measured her at home and she is in proportion. But she was born a skinny minnie, and now she's a big bouncy chubby thing, so she has failed to follow The Curve. So obviously there must be something wrong.)
HV: "Hmm."
Me: "Right, I'll do nothing then. Bye." (And I wish I could say that was the end of it, but that darned health visitor has planted the seed of doubt in my head now and for months I will be worrying about Cave Baby's weight, even though the rational side of my brain knows that there is not a jot wrong with her and the only problem is with our health service's draconian attitude to babies' weight gain. I do remember reading this post on Breastfeeding 1-2-3 about babies' weights, which made me feel better.)
Is this scenario familiar to anyone?
Saturday, August 8, 2009
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20 comments:
You know I have the same concerns. Except my DD's never seen a doctor or nurse or health visitor. She's just the chunkiest kid her age at church. I KNOW she's healthy- her diet is mostly (60% or more depending on the day, yesterday was like 90%) breastmilk with veggies and fruits and other healthy foods. I have to keep telling myself that she's active and eats right and that's all I can do.
Kudos to you for sticking up to the health nurse, and for believing in your instincts. I think that we all feel doubt at some point, and it's a very natural feeling to have. But if you know deep down that everything is fine... the it most likely is. If she gets all her fruits, veggies and protein, along with the all-important breastmilk, then she's doing great!
It's funny how often the opposite appears, how breatfed babies tend to be smaller on average than the "official" weight chart used by doctors (the WHO published a new chart that takes bfing into account, but lots of places still use the old one).
Good luck!
The best thing I've done to stop myself worrying about my little man's weight? I stopped getting him weighed after 11 months. That was 11 months of worrying that he was too skinny, not taking enough milk, not eating enough. But since I couldn't stuff food down him like a foie gras goose (he's baby-led weaned!) and he was obviously happy and healthy I figured the weighing clinic was a source of unnecessary stress.
Some HVs really annoy me with their ignorance.
Please, don't worry in the slightest and anyway, as she becomes more active her weight will stablise eventually anyway.
Joxy.
To be honest, I've never heard of that scenario! There's only ever been the worry of too little weight gain, as they do lose the chunkiness as they get more active.
My daughter was heaviest (in comparison to height and weight charts) at 9 months and hasn't put one a gram from 12 months (she's 2 1/2 now) while eating very well. Don't worry it'll all balance out.
Thanks for the support! The funny thing is, when she was 3 months old they were telling me she was too light. Now she's 11 months she's too heavy. She's an 11 month old yo-yo dieter! But JK, as you mentioned, she is mainly BLWed (she has breakfast spoon-fed but the rest self fed) so in theory she is not meant to over eat.
Most babies in our family are big, and I always thought it was odd that she as small. I figure that now she is just finding her proper weight.
We had this - I think Freya was 3 months when the HV told me I was 'overfeeding' her as she was off the top of the centile chart. I solved that problem by - stopping seeing HVs!
Is your little one walking yet? In my experience, both of mine stored up great rolls of chub, just before they became hugely active. So, they both put on tons every week until around 6-8 months, then it slowed as they started crawling, and then it stayed the same more or less (slight upward trend) for 3 or 4 months around the 10-14 month mark as they started walking, then went upwards in fits and starts, NOT a smooth curve, and that's how it's continued since then, and they're now 6 and 4 years old and both tall and slim, with long lean muscles.
First child, weight gain slow, dropped off bottom of her chart constant worry. Second child, effortlessly maintained his centile until 3 months and now has jumped off the top of the chart. Have no doubt that both were / are healthy and that we are on the right course.
Some HV are very process and find it hard to use their judgement. One of my chums always told them she didn't want to know weight or centile - just weigh her and record it please - was what she said.
Like JK, I've stopped going to health visitors too. I think with new baby I'll go to our local "pay & weigh" session and weigh him/her myself,for babybook purposes only. My boy is not as tall or muscular as other toddlers the same age within our family (constant comparisons by relatives) but seems fairly middle-of-the-road compared to friend's offspring,so I don't concern myself if I can help it at all. He's never had rolls of puppy fat, or been skinny,but he definitely slimmed down upon starting walking, and his solid food intake shot up too. In fact, my friend JK who commented above, has told me the amount he eats, he should be huge :-), but he's just so active, he must need every calorie. Plus hes very good at making it LOOK like he's eaten loads, when all he's really done is made a huge mess by manipulating every piece of food on his plate in one way or another. The joys of baby-led babies!!
Ah yes, familiar from the Other Side of the centile charts, my LO has been off the bottom of the charts for months and months. I no longer take her to be weighed. I can no more force this child to eat than I can fly. But isn't it depressing that when breastfed babies have [what others deem] weight issues, the breastfeeding is considered to be the problem and somehow eradicated or minimised? We were encouraged to wean early and replace bm with solid food- regrettably I followed their advice, she dropped even further off the chart. A friend's step-daughter has a baby girl who lost 1oz at a recent weigh-in. At 17 weeks old the advice was to top up with formula and GIVE THE BABY CHEESE!!! WTF?
I could go on...
My 13 month old was in the 50th percentile until he was 6 months and then started dropping down. He's in the 5th percentile now. But he's healthy and thriving. Would forcing more solids down his throat make him grow taller? Or fatter? Probably not. I think it's just his genes.
And so weird about the cow's milk. When are people going to realize that human milk is the milk children should be drinking?
Plenty of people have rightly encouraged you to continue following your instincts and commonsense, but I'll join the crowd! And I will echo that I am way impressed that you stood up to the health visitor.
Our baby was huge, off the charts over 100th percentile for months. Of course we got all the fears when he was born that he must have blood sugar problems or something, but he was perfectly healthy. Not everyone is the average size -- pretty much most people!
Our son is still bigger than most kids his age, but his growth skyrocketed till about 6 months, and then really plateaued from then on. He was 30 lbs at 6 months, got to 34 by a year, and he's been 34 lbs since then, even now at 26 months. Whereas he's gotten a lot taller, and "grown legs," as I like to put it. Slimmed down, and up! He's still a chunk (down to the 93rd percentile in weight...), but I look at pictures of him a year ago and think, "Oh, my word, he was enormous! No wonder people commented." LOL! But he was perfectly healthy then and is now, as well. He needed all those rolls for energy as he became more and more active and grew taller, and so does your girl.
I was fortunate to have a pediatrician who supported our breastfeeding and knew that kids come in all sizes and growth curves. Since your daughter's breastfeeding, then she already instinctively knows how much and what she needs to eat. I find my role is more to get out of the way and not force my own hang-ups about food (or a health visitor's misconceptions!) onto my son. I was looking for a journal article I read about how parental food control, even at a young age, translated into picky eating and more problems with weight rather than fewer, and I came across this article that strangely enough is from Gerber. To read it, you have to lie and say that you're a medical professional (unless you're not lying -- I was!) but it has 20-odd studies cited that back up the point I was thinking of: that, basically, children eat a wider variety of food and have a healthier weight if parents provide good choices and then let them be. I'm still trying to do both, but that's my goal!
You know, just looking at my son's old pictures, 11-13 months old was really about the edge of his super-chunky period. So I say enjoy it while it lasts, and gobble up those adorable fat rolls!
willow81: CHEESE for a 17-week-old?? Do these medical professionals even study human nutrition?
Annoying. That's why I haven't had her weighed and measured since she was 3 months old. I can see she's fine, don't need an 'expert' to tell me so.
Funny, I never thought about the number of feeds that way. Yeah, if someone said drop a feed (although she's on the bottle as you know, we also feed on demand), I wouldn't know where to begin!
We don't offer milk/food for EVERY time though, I think you'll recall I believe crying is just as essential to their development. And it's possible that food becomes a comfort and thereby produces overeating. I know of one mother who BFs on demand also for everything, and her baby is on the larger side of chubby.
But my baby does feed almost whenever she asks for it, and it's anything from a quick 10 seconds or a full 10 minutes.
Once CB starts walking, it does begin to come off anyway, right?
I also find the experts' ideas of overweight troubling. Like you mention, it's based on the curve mostly. I mean, obesity is something else altogether.
If you believe that she's in proportion, and you're content with your style of mothering, then my stance would be, towards the experts - scr8w you very much. ;P
oh, wanted to add - the idea to drop a BF rather than a solid feed is just plain weird to me.
Complete load of shite. HV clearly wants her arse kicking. Ignore it all and continue to do what is clearly working brilliantly for you and Cave Baby.
Oh thank you all again for taking time to leave these comments.
willow81 - cheese?
Hobo Mama - that is one big baby! I can't image how you must feel after lugging him around in a sling for a couple of hours! But it just goes to show that they do come in all shapes and sizes. And I agree about not passing any food hang-ups on - this is something I am trying hard with, giving her a very wide variety of things to try, not fussig whether she eats it or not (she eats it more often than not!).
Mon - yeah, I'm expecting her to lose it when she starts walking (not holding my breath for that just yet though! She's quite happy crawling at the mo). And I don't feed her every time she gets upset, breastfeeding is not habitually used as a pacifier. Just the really bad bumps, especially when she is tired as well.
Earthenwitch - you put it so well. Thanks.
I lost my entire comment yesterday, so let me simply say "ditto" to Earthenwich's succinct and dead-on note :)
Wow, I'm so sorry you had to even think of responses to that person!
I lucked out: my pediatrician was never alarmed by how fat my son was. She always just said that breastfed babies, particularly, exclusively breastfed ones, were extremely fat for many months (a lot fatter than their contemporaries), but then would lose weight at some point during their growth and would fit somewhere back on that graph.
I thought it was adorable that you couldn't see his neck for months and that he had about 12 rolls of fat all over his body. And I really loved it when people would exclaim out loud at how plump he was.
And now? He's a normal looking toddler.
It's almost like the Western World's sick fascination with weight is being applied to babies, who for the vast majority, are always a perfect weight (whether it be high or low) for their genetics, you know??
I don't know if you're still looking at comments on this post but... my ds is now nearly 5 but when he was 2 years old and attended for his general HV check the HV's assistant measured and weighed him and told me he was obese. He was on the 98th centile for weight. And on the 98th centile for height (having been born just above the 0.4th centile but there's another story...) Luckily for me I have Maths A'level and I'm a doctor and I understand statistics and proportion. I can totally imagine some people having been completely freaked by her statement. I tried to explain to her that he was large but proportionately large but she just said "over the 90th centile is obese in our book".... Grrrr. He remains disgustingly healthy and on the 90-something centile for height and weight and I imagine he always will!!!
I didn't read this until today. I was going back to read some of your older posts. I love the way you write!
I like this post because I'm getting ready to go in for my sons 1 year appointment. I'm thinking that some of this is going to be similar to what I'm going to have to go through. They always ask my how many times I nurse per day. My husband came with last time and we looked at eachother like 'how the heck would we count all the sucks per day?!'. Usually I just make something else up. Sometimes I wonder if I should just find a more attachment type minded doctor... Because like you said, do we really have to keep explaining to medical professionals that human milk is better for babies?
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