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Thread: possible weight loss? feeding guidelines...

  1. #1
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    May 2012
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    Default possible weight loss? feeding guidelines...

    LO is 13month + 3 weeks. Our health visitor came today for his one year check (late, obviously) and weighed him. He weighed in at 18.6 pounds. Which is particularly weird because at the end of September (so 9 months +3 weeks) he weighed 21 pounds. He was weighed naked both times, but on different scales. The HV wasn't concerned really -- he clearly is healthy and she thinks it is down to a difference in scales and that LO was sitting on her scale oddly. He was also pretty sick the last week, didn't eat much and I am sure he lost weight from that. I KNOW he has grown because he can't wear the same clothes he wore in September. Still, I feel anxious about this (had early weight loss issues that landed us in the neonatal unit, so this is a particular point of anxiety for me).

    Anyway, I have been wondering for some time if there are any guidelines about how much babies this age should be eating in a day. I know it will vary by baby and even by day, but I'd just like to get a sense for what a reasonable "goal" would be. I know if he nurses 3-5x/day that meets his dairy requirement, but what about the remaining nutritional needs and caloric intake? What does he need to meet those?

    Presently, he is nursing once during the night, at wake up, at nap, at bed, and once in the late afternoon. Maybe a few other short times in between, but I don't really know. When I am at work, he takes about 140-200 mls of either EBM or cow's milk in addition to solid food. We attempt three meals and two snacks each day but some days/meals he just isn't interested. I don't BF before meals, except that he almost always wants to nurse at 5pm and dinner is at 6pm. Is this too close?

    I have noticed that a lot of times he rejects what we offer out of hand or after a few bites. But, if you offer something else, he might eat that. How many things should we offer (I do not want to turn into a short order cook trying to find something he will eat) after he refuses something? I should say that he is not a picky eater in that he will eat just about anything but just not all the time (does that make sense).

    Anyway, any input is appreciated. I do feel anxious about the weight and making sure we are feeding him enough.

  2. #2
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    May 2006
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    Default Re: possible weight loss? feeding guidelines...

    You can google "toddler nutrition guidelines" or phrases like that and see the recommendations for yourself. I don't want to post any of them because they vary, and I honestly don't think they are particularly useful for young breastfed babies in the first place. As my pediatrician says, until a year breastmilk alone meets all a baby's nutritional needs, and after a year solids become an important part of the toddler diet, but the transition from needing only mama's milk to needing a lot of solids is a gradual one, with many breastfed babies not eating much in the way of solid food until well into their second year. Most of the guidelines recommend a much, much larger quantity of solid food than my children ate- and my kids were HUGE toddlers!- while also bemoaning the epidemic of childhood obesity. That irony is good for a laugh, at least.

    If your LO can't fit into his September clothes, then I am sure the issue here is the scale.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
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    Jun 2012
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    Default Re: possible weight loss? feeding guidelines...

    I do feel anxious about the weight and making sure we are feeding him enough.
    I can relate because my son had early in his age had weight issues (but not to the point of hospialtisation) so I do remember being anxious when he switched to solids. BUT that said at this age, 13 montsh, even without knowing your son I am positive you would notice if he was constantly hungry or malnourished. It sounds to me like you are doing your best to feed him well.
    I am not at all familiar with health visitors as we do not have those where I live, but if this person was not upset by the difference but found such logical reasons, try to accept their explananitons (unless you have particular reason to doubt their judgement?).

    I would not recommend offering him several other kinds of food of he does not want what you serve him. I did that and honestly I regret it now: he is four and i have a hard time teaching him mommy is NOT a restaurant. I wish I had not offered him several alternatives each time he refused a particular dish as a toddler, in my anxiety for his weight.

    I am not saying never do it because sometimes you might have to or he wont eat - and I certainly would never ever do what my mother and grandmother practiced which was so you sit in front of your plate until itis finished and if it is all afternoon, that was horried. But I try and select things I know he likes and if he wants an alternative offer him fruit or veggie sticks - but this is because he is now 4.

    re amounts guidelines etc, there are a milion out there and many conflicting ones. Can you ask the health visitor (is this a doctor? a nurse? pardon my ignorance) for some recommendation? I must say that After reading a lot of stuff and gettng confused by all the conflicting info I stopped after a while trying to follow guidelines because it is only stressful and so many are just fads anyway and most will not take extended bf into consideration or see it as negative.

  4. #4
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    Default Re: possible weight loss? feeding guidelines...

    Can you take him to a health visitor clinic to be weighed again? Are you in the UK? If so, there are usually baby weighing scales in sure start centres where mums can weigh their babies themselves if you don't want to go to a HV clinic.

  5. #5
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    Default Re: possible weight loss? feeding guidelines...

    Thanks for the input, ladies. Mammi--I really appreciate the empathy! Sometimes I feel like a crazy person because of how obsessed I can be about his weight. It's nice to know other people have been there and I'm at least not alone in my crazy.

    I had googled toddler nutrition guidelines and, as you have all noted, there are just so many and they all say something different. Plus, I don't find any of them to make mention on breastfeeding and I am not really sure how it all fits together. I mean, I know that 3-5 nursing sessions meets their dairy requirement, but I've also heard lots of BF moms say that they don't worry when their LO is a fussy eater because of BM (and, I even feel this myself at times) but that seems to conflict with the statement that BM is not sufficient nutrition on it's own after the first year. Anyway, we've been keeping track of what he's been eating and it helps to be aware of it...certainly, regardless of the guidelines, he is eating enough!

    Since a couple of you asked...a health visitor (in my part of the UK anyway) is a nurse who provides some care in the early years. They don't replace the GP but can act as a first port of call for basic queries about weight, feeding, etc. They also run weigh-in clinics, immunization clinics, and BF support groups and do home visits (usually for a 10 day, 6 week, 6 month, and 1 year check). In my area, they discourage babies over 6 months from coming to the weight checks and they cap it at 1 year. But, our HV asked us to come in this week or next anyway for my peace of mind. I'll have to check into the sure start centres. I'm not sure there is one very near me.

  6. #6
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    Jun 2012
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    Default Re: possible weight loss? feeding guidelines...

    The person that finally got through to me about the weight issue / food (that everything was fine and I should stop worrying) was my pediatrician - I have been very lucky to have her. She explained to me that in her evaluaiton she worries less about weight on that day we are there, but on overall health and how the child presents in general, and that I should not obsess about what he eats one day and not eats the next but an overall picture of a week. I should add she is an older and very experienced person so I do trust her judgement a lot.

    But in the UK i think going to a pediatrician is only when you suspect serious illness, right? And unless it is someone pro - bf it would be useless.

    Where I live (on the continent ;-) we dont have anyone coming to the home but there are scheduled check up visits to the ped, after 12months those would be annual, but i went more often voluntarily (mostly for my peace of mind) and I used to go to a midwives center for weight checks, until he was about 18 months.

    It is one of my pet peeves that seemingly all the mainstream info on toddler nutrition assumes weaning (= stopping bf) at 6 months. I event went to a baby/toddler nutritionist once when he was 6 months old to get info on introducing solids only to hear that I should come back only once I stopped bf which would be soon anyway, right. This person in fact said he was overweight (which he was definitely not) and cause was bf...

    I know that 3-5 nursing sessions meets their dairy requirement, but I've also heard lots of BF moms say that they don't worry when their LO is a fussy eater because of BM (and, I even feel this myself at times) but that seems to conflict with the statement that BM is not sufficient nutrition on it's own after the first year.
    Depends how you define sufficient nutrition. I do not think anymore (but i used to) that he needs all food groups and everything everyday at every meal. So i put together these perfect plates (I stayed at home until he was three) and then was disappointed when he did not eat from each food group but instead ate only cucucumbers for the entire day.
    Look at his intake over a week or 2 weeks, not on one day or two or even three. When they were tiny and every 12 hours made a difference this was different of course but now it is helpful to look at intake over several days not hours ;-)

    I think the point is that if he does not eat much or anything for a day or so there is no need to worry as he has the BM to fall back on. I would not think that beyond 12 months a child can go on exclusively BM for more than a couple days, only perhaps when he is ill.

    anyway, you are not crazy.

  7. #7
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    May 2012
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    Default Re: possible weight loss? feeding guidelines...

    Are you referring to the WHO growth charts? I think internationally, they are more useful. I'm guessing there were differences in the samples they used to put them together - cow's-milk-bottle-fed v breast fed, gluten-consuming v not, I'm not entirely sure but weight for height is apparently a useful one to check. Also, how do you feel about you LO's health yourself, generally? Are they alert, hitting milestones, do they have any trouble asking for what they need in other contexts? Have you explored food issues?
    I agree that you're not crazy. Personally, I think making mums worry so much about weight all the time is the problem. I still do it myself, and I think it's left over from my LO's hospitalisation after birth.

  8. #8
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    Default Re: possible weight loss? feeding guidelines...

    It is one of my pet peeves that seemingly all the mainstream info on toddler nutrition assumes weaning (= stopping bf) at 6 months
    YES. this is it exactly. When I read things there is NO mention of breastfeeding. Zero. None. Nada. Which is really weird, I think, given that the AAP and WHO recommend BFing at least until 1 and 2 years (and beyond) respectively. The information I have read also pretty consistently says they need 1300 calories per day and they all seem to make it sound like as long as you offer your LO will consume that!

    I do feel okay that LO is eating a variety of foods and all healthy things and I'm not overly fussed if he eats lots of veggies one day and none the next. It's the overall intake of food that sometimes gets me going. And, honestly, it didn't get me worked up until he was weighed. And, I've heard that you should look at intake over 2 days, rather than one. But, LO will eat like a champ for a couple of days and then like a mouse for a week. He puts lots of food in his mouth but then spits it out. And, it just seems like he MUST be hungry because he hasn't eaten in a few hours (and, though still nursing at least 3x/day, he is nursing much less than even 2 months ago). So, then I find myself constantly offering and worrying. Not really helpful.

    I guess I'm getting to the point of just accepting that this is how it is with toddlers. I do feel fine with him overall. He is SO active, everyone we meet comments on how bright and alert and smart he is. All our friends comment that he is really athletic already and never stops moving. Today we went to the park near our flat and didn't take the stroller and he walked 50% of the time on his own--up hills and everything. His skin looks great. He is on the long side but he still has nice plump thighs and a cute pot belly. So, yea, I'd say he's healthy.

    But, then, his nappies aren't very wet and he doesn't seem to be eating much. And he is a little crankier than usual over the past month or so. And, sometimes his lips look a little dry (but not cracking or parched). So, see this is how I start to get myself worried!!! AHHHH.

    Anyway, maybe one question (if you are still reading after this long rambling post)....can BF ever interfere with solid food intake? Could you ever BF too much to the point that LO doesn't want to eat? I know that you don't need to nurse before solids after a year, but should I be sure that he doesn't nurse for a certain amount of time (30 minutes? an hour?) before a meal/snack? (Okay, three questions).

    Quote Originally Posted by @llli*emumma View Post
    I still do it myself, and I think it's left over from my LO's hospitalisation after birth.
    Yes, yes. This is me exactly. I think I would be MUCH more relaxed if he had not been hospitalized (dehydrated and 16% weight loss). There was a nurse who kept saying to me, "you realize that was a LOT of weight he lost, right?!" She said it over and over again (she was horrible. I could go on an on). I already felt so terrible and ashamed and that just took me to a whole other level of awfulness. I kept imagining him feeling so hungry and wondering, "why aren't you feeding me, mama?" Ugh. Still makes my stomach sink and turn thinking about it. I'm relaxed about much of parenting but feeding....well, I think this post probably illustrates how not relaxed I am about feeding!

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