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Thread: Understanding Growth Charts

  1. #1
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    Default Understanding Growth Charts

    I've been struggling with poor weight gain in my now 11 week old baby.

    Reading about the growth charts I see lots of comments that if the weight is more than 2 centiles higher then the length then baby is over weight and BMI should be looked at etc. But they don't say anything about what should be done if the weight is more than 2 centiles lower than the length.

    DS is near the TOP centile range on length for his age but his weight is near the bottom of the centile range.

    In the weight for length chart he isn't even in the curve anymore.

    I'm worried about being diagnosed with failure to thrive but he seems so happy and alert and is meeting developmental milestones on target and some milestones ahead of time (like being able to lift head to 90 degrees while holding chest up with arms and rolling over one way from tummy to back.)

    Should I worry and if so what should I watch for most or should I not worry about it and just be happy I have such a lean happy baby.

  2. #2

    Default Re: Understanding Growth Charts

    Does your pediatrician seem concerned? Is baby having any issues nursing that concern you or make you think he's not getting enough? Is baby pooping and peeing normally? Is doctor using the WHO chart or the CDC growth chart (if in US)? Is he being weighed naked and on same scale as last time? Is baby not gaining weight at all, loosing weight?

    Babies grow at different rates. And growth includes all areas of growth not just weight, but height, head, and mental development. Breastfed babies tend to put on the lbs a little differently at first. For example, at one month, my DS was 2 percentile weight but 30th in both height and head. At two months, he was 6 percentile and 50th in both height and head. At four months, he was 11 percentile and 30th in height in head so it varies from time to time. At six months, I expect completely different. He's long and lean but meeting his milestones and satisfied after nursing. At first I worried a lot but then I realized they were rather meaningless numbers. They are not the greatest indicator of health and tend to be misleading as people think the higher the number, the healthier the baby, which is not true. A good pediatrician will just be looking at is baby gaining weight overall and is that weight curve steadily heading up.

    Your baby is clearly growing if he's off the charts for length. If you are concerned and/or pediatrician seems concerned, I would contact an LC to do weight checks (naked, same scale) and check latch etc...to ensure baby is getting all he needs.

  3. #3
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    Default Re: Understanding Growth Charts

    Quote Originally Posted by @llli*monkeyhmama View Post
    Does your pediatrician seem concerned? Is baby having any issues nursing that concern you or make you think he's not getting enough? Is baby pooping and peeing normally? Is doctor using the WHO chart or the CDC growth chart (if in US)? Is he being weighed naked and on same scale as last time? Is baby not gaining weight at all, loosing weight?

    Babies grow at different rates. And growth includes all areas of growth not just weight, but height, head, and mental development. Breastfed babies tend to put on the lbs a little differently at first. For example, at one month, my DS was 2 percentile weight but 30th in both height and head. At two months, he was 6 percentile and 50th in both height and head. At four months, he was 11 percentile and 30th in height in head so it varies from time to time. At six months, I expect completely different. He's long and lean but meeting his milestones and satisfied after nursing. At first I worried a lot but then I realized they were rather meaningless numbers. They are not the greatest indicator of health and tend to be misleading as people think the higher the number, the healthier the baby, which is not true. A good pediatrician will just be looking at is baby gaining weight overall and is that weight curve steadily heading up.

    Your baby is clearly growing if he's off the charts for length. If you are concerned and/or pediatrician seems concerned, I would contact an LC to do weight checks (naked, same scale) and check latch etc...to ensure baby is getting all he needs.
    I went and looked up These charts
    http://www.cdc.gov/growthcharts/data..._24LW_9210.pdf
    http://www.cdc.gov/growthcharts/data...W_rev90910.pdf

    Ped is mildly concerned.

    We have been struggling with weight gain, supplementing and supply all along
    see thread http://forums.llli.org/showthread.ph...te-milk-supply

    Birth 8 lb 14.5 oz 21 1/4" long, 13 1/4" head (dropped to 7 lb 11oz by day 5)
    1 month 9 lb 7.5 oz 23 1/2" long, 14 1/2" head
    At 2 months he was 10 lb 2 oz and 24" long with 14 5/8th" head circ

  4. #4
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    Default Re: Understanding Growth Charts

    The most important thing to know about the charts is that they only tell part of the story. Babies come in all shapes and sizes, just like adults. Some babies are long and lean, some are short and chubby, and there's every variation in between. How we view babies' body types has changed significantly over time. It used to be that doctors were most concerned about lean babies being underweight, but now our concern over childhood obesity has led to increased concern over the babies who are heavy for their height- that's why you found those comments about BMI at the bottom of the charts.

    Instead of focusing on the percentile, focus on the whole baby. If your child is growing in height, length, and head circumference and seems to be developing at a normal rate, and is happy and healthy, then maybe he's just destined to be one of those tall, lanky guys who will need a belt to hold his pants up. Mom and dad's build matters a lot, too: if you and your husband are on the leaner side, your baby is likely to be lean, as well.

  5. #5
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    Default Re: Understanding Growth Charts

    The best explanation of growth charts I have found-what they mean, what they don't mean, and how they are made- is in the book 'my child won't eat.' (Mind you I still do not really understand them.) From what I can tell, many people, even doctors, use growth charts incorrectly or at the very least, put too much emphasis on them. I think a diagnoses of failure to thrive is at least somewhat subjective.

    if you don't have the book and just want that specific info, contact me via pm. But I think it is a great book overall and not too expensive.

  6. #6
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    Default Re: Understanding Growth Charts

    Quote Originally Posted by @llli*lllmeg View Post
    The best explanation of growth charts I have found-what they mean, what they don't mean, and how they are made- is in the book 'my child won't eat.' (Mind you I still do not really understand them.) From what I can tell, many people, even doctors, use growth charts incorrectly or at the very least, put too much emphasis on them. I think a diagnoses of failure to thrive is at least somewhat subjective.

    if you don't have the book and just want that specific info, contact me via pm. But I think it is a great book overall and not too expensive.
    I'll check into that book. I tell ya, most people who see him say OH he's so big! Which makes me wonder how he could possibly be "too skinny"
    My partner and I are neither one of us Tall or exceptionally lean. I'm very average for a 5' 1" woman and daddy is only about 5' 7" and stout. Neither of us were chubby children though, I was a rather small child.

  7. #7
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    Default Re: Understanding Growth Charts

    Quote Originally Posted by @llli*tclynx View Post
    most people who see him say OH he's so big!
    In my experience, most people know how to say just 2 things about babies: "He/she is so big!" and "He/she is so small!" I wish they'd stick to "Adorable!"

  8. #8

    Default Re: Understanding Growth Charts

    I'm not sure if you've seen this yet but it might help.

    http://kellymom.com/bf/normal/weight-gain/

  9. #9
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    Central FL
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    Default Re: Understanding Growth Charts

    Quote Originally Posted by @llli*lllmeg View Post
    The best explanation of growth charts I have found-what they mean, what they don't mean, and how they are made- is in the book 'my child won't eat.' (Mind you I still do not really understand them.) From what I can tell, many people, even doctors, use growth charts incorrectly or at the very least, put too much emphasis on them. I think a diagnoses of failure to thrive is at least somewhat subjective.

    if you don't have the book and just want that specific info, contact me via pm. But I think it is a great book overall and not too expensive.
    I read it and thank you, great book.

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