Question on WHO charts

[Jaz_Trio]

OK, I just found the WHO breastfeeding charts - duh! LOL

And researched where Zachary falls... his is 24 pounds or 10.89 KB...he is almost 34 months old (will be on the 13th of Sept)

The WHO says that he is between -1SD and -2SD cat, but I have no idea what that means, I mean 14.0 KB is the median....is he really that bad?

I mean on the "normal" charts he's in the 3rd percentile, or a bit lower...he's really active but does not eat ALOT of solids, though he is doing MUCH better (ate 4 pancakes the other day for breakfast, silver dollar but still)

Thoughts? I am still nursing him, he nurses, ALL night from around 1AM (when I got into bed) until around 8:30 AM (when we wake up) then he sometimes nurses on and off till around 9, IF I stay in bed...then he nurses anywhere between 3 and 8 times during the day...

Thanks, LOL I was all set to be fine with all this and KNOW that I was doing the best for him, continueing to nurse ect...and now, wavering again...

I looked on the WHO site to see what SD ment, but cant find that?

[@llli*mommy22princesses]

I don't know either, but I would like to know and then I will be using it to compare for my dd also. I was told that I needed to up her solids a lot as she is only 16 lbs at her 1 year ck up. She acts happy and loves to eat, I just don't incorporate them all the time, as I want her to nurse more than get the food for nutritian. I hope someone can help you. Can you tell me where you got those charts?? Thanks!

[Jaz_Trio]

Can you tell me where you got those charts?? Thanks!

Here's the link, and thanks!
http://www.who.int/childgrowth/standards/en/

Our ped does not seem worried, course he has not seen Zachary since the beginning and I have not transphered his records yet, nor do we go in for "well baby" check ups, so LOL we never have that talk, but Z is seen by a nutritionest and a speech theripest both of which are working with him and eating (as well as talking) and BOTH want him OFF breastmilk, and ONTO some kind of milk substitute since he will not drink milk, both of them refuse to beleive that MY milk is of any consiquence, and that it CANT hold enough caleries for him to be getting enough, and his nutritionest says IF it were, he would be growing!

ARG!

[jillanne]

SD usually means standard deviation, which is a term to indicate how spread out the data points are that make up a data set . . . for data with a normal distribution (such as height/weight data), about 95% of data points will be within 2 SD of the mean (average). So if your son is 2 SD below the mean, his weight falls in with the lightest 2% of children. It's just another way of stating what you already know from the %ile chart . . .

HTH!

Jill

[jillanne]

Ooops---just reread your post--if your son is between -1 and -2 SD then his weight falls in somewhere between the 3rd and 15th percentile . . .
Jill

[llmommy]

Hi Jaz_Trio. I read some of your history with Zachary on your other thread and see some similarities to my DS (now 29 months). Not exactly the same, but I had a few thoughts I thought might be helpful. First regarding the breastmilk/milk substitute: breastmilk has approximately 22 calories per ounce, or 176 calories in a cup. Whole milk (according to the carton in my fridge ) has 150 calories per cup--obviously less. The only kind of liquid that I am aware of which would have more calories than breastmilk per ounce would be something like pediasure (which my DS would never drink and I don't really blame him--tastes awful IMO). Anyway, listening to your description of your son, it doesn't really sound like having him drink less breastmilk would suddenly make him start drinking something else that he's currently refusing. Why can't you try introducing other high calorie things in addition to the BM? If there is a problem with not enough calories, then it seems more that your DS just isn't taking in enough total of anything. Different wouldn't necessarily mean more (and if its a less preferred drink it might actually mean less). Also, have you considered that maybe your supply has dropped off (mine did) and that trying to increase it might help to up his calories?

My son has oral sensitivity/aversion problems which led to complete refusal of solids until 21 months when we went to a feeding clinic and started an intensive intervention program. You can read more about my DS's history in my response to a thread "Oral aversion-is this real?" on the Starting Solids forum if your interested.

My son's feeding clinic team (OT, Speech Therapist, Nutritionist) also want me to wean, though for different reasons than yours. My DS is now gaining very well but they say continuing so much sucking hinders his development of new oral motor patterns (he doesn't chew and puts his tongue forward when taking food from the spoon). I'm fine with slowly cutting back on nursing at this point, but really don't want to push complete weaning and am not real sure about the logic of their argument. It has been helpful to us though to get into a routine of a meal of solids first and then nurse after the meal. This makes sense to me at this age because I figure my DS will likely only take the solids when he's pretty hungry but will top off on breastmilk even if he's already eaten pretty much. You could try that if you are ok with setting some limits on nursing.

We also looked for very high calorie nutrient dense foods. I'm not sure what your son takes, but the first one mine accepted was yogurt. We get the whole milk kind so its high calorie. Then we started mixing other things in with the yogurt. One of my son's favorite things now is a mixture of avocado and banana (both mashed), and plain yogurt. He will also eat mashed avocado and banana without the yogurt.

Another recommendation that the nutritionist made which may be helpful to you was to add some supplement called Duocal to his food. Duocal is a powdered carb and fat supplement which disolves into food or liquid without altering the taste or texture at all. Its made primarily for ill people (like cancer patients) who need to increase energy but have trouble eating enought food. I wasn't really excited about using this since I think real food is better, but a little bit does go a long way.

One final suggestion, we got a book called "Just Take A Bite" (can't remember the authors but could look if you interested) about working with children with food aversions and eatind problems. Most of the information in it was for a little bit older children and was not appropriate for our son at the time (he was 20 months when I read it), but some of it may be helpful for a three year old. I found it very child friendly--nothing aversive. In the beginning they discuss the difference between normal pickiness and "resistant eaters" who may, due to sensory issues or oral motor delays, severely limit their food intake even to the detriment of their health.

Hope some of this is helpful!

[Jaz_Trio]

Thank you for your post!

First off, yes our Nutritionest did mention the powder that you mentioned, it's expensive, and insurance will not pay for it, with being single and working from home to be with him, it's impossible to get "often." I have gotten some which we tried, if Zachary see me use it, he refuses the food its in! If not, he does not always eat it.

Anyway, with foods, yes I too try to find high calorie foods, however things like you mentioned, yogurt - avocado are two he will NOT eat! His big issue now is getting things to be "ok" in his mouth!

Like your son, Zachary did not start typical "feeding" behavors, and I was fine with that, I mean he did not like baby food so we did not push it...which now, my speech and Nutritionest both say that was a "bad" thing because apparently children NEED that "food" to learn to eat and move there mouth later in life.

Zachary also has the "thrust" though so far no one has told me THAT reason to wean...the ONLY thing his theripest's have said is that "he's not getting enough calories into his body."

As for my supply, I can hear him "drinking" when he nurses, MOST times, I know when my peroid comes, its less...what can I do to help boost it, just to be sure! I mean he only nurses from one side as well, so its he right breast doing ALL the work!

I guess all in all, I am worried that maybe there is something wrong with him making gaining weight harder for him? I am not even sure what...but he's eating more foods, but STILL not gaining anything...I mean 24 pounds for so far the last 6 months straight, is not exactly normal! A 3 year old wearing 18 month cloths because everything else falls off, is not normal either. (I am not sure what to do this winter, 2T falls off his butt, but 18 month is to short!)

I love LOVE LOVE our nursing relationship and REFUSE to quit...I do however, as much as I can offer "food" first and "nursing 2nd" heck there are several days he goes all day with not nursing at all, on these days I do not see an increase of eating at all...

Sometimes being a parent is so hard! That book you mentioned sounds good, i will have to check that out thanks!

and thank you for your thoughts, I REALLY appreciate it...its nice to know he's not the "only one"

[Feorsteorra]

How big was he when he was born?

[llmommy]

I completely agree its nice not to be the ONLY one with this type of problem! Early on I didn't worry about my DS because I thought he'd just eat when he was ready, or if he was hungry. I knew several other people who's children had started solids very late and thought he was just one of those, but I was wrong.

Yeah, the Duocal is pricey. We ordered it online for $119 for 4 cans--I don't know if that's any less than you pay where you get it or not. I wish it came in smaller cans. The can says to use within 30 days of opening, but we always have some still left after 30 days. Just a thought--would your nutritionist or therapist know any other people using it that might want to split a can with you? $15 for a month supply (1/2 can) wouldn't be quite so bad.

I looked up the full title and authors of the book I mentioned. It's "Just Take A Bite: Easy, Effective Answers to Food Aversions and Eating Challenges" by Lori Ernsperger and Tania Stegen-Hanson.

Your son's oral-motor skills must not be TOO terrible if he can eat four pancakes for breaskfast. It would take my DS forever to eat that much of a nonmashed food. His current strategy is to take a small bite and then just hold it in the front of his mouth until its soft enough to swallow--not very efficient.

How tall is Zachary? We were told that in cases of inadequate calories, first weight drops off, then height, and finally head growth. When calorie intake goes up, again the weight jumps up first and then the other areas. That's exactly the pattern my DS showed. It sounds like maybe Zachary is taller and thinner though? Has he grown in height over the last six months?

What foods does Zachary eat? Are there ways to sneak in some extra fat and calories to those foods-like making the pancakes with whole milk even if the mix calls for water (or maybe you make them from scratch?)? Or adding olive or canola oil to things. I used to put canola oil in DS's oatmeal before I started using whole milk and the Duocal. Have you tried the Dannon La Creme yogurt-its very tasty. I prefer the Stonyfield Farm or other plain yogurts because there is less sugar/flavoring, but the La Creme is really good--I think that's the first thing my son accepted. If you don't see any increase in solids when your son doesn't nurse all day, I don't see how weaning would help things any... There are some malabsorption problems that can cause difficulty with growth. If your son seems to be eating more food but still not gaining I think I'd push the doctor to do some more testing. Have you taken an inventory to see how many calories you think he takes in a day?

Oh yeah, for milk supply I had a lot of success with fenugreek. My supply starting going down when my cycle returned. I didn't really notice an up and down each month just a gradual, steady decrease over several months. I think I also wasn't drinking enough fluids. When I started taking fenugreek (I took 3 capsules 3x/day) and making sure I drank 64 oz. of water each day it made a big difference. We started seeing MANY more wet diapers after a few days. Of course, this may or may not be an issue for you.

[Jaz_Trio]

How big was he when he was born?

Hey was 7 pounds 9 oz when he was born.