Pediatrician Keeps Saying Baby Is “ Small”

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Random thought: if he is STTN maybe you need to wake him for a feed

OP here. He just dropped one of his night feeds. He eats 7, 10, 1, 4, 7, 10, and 3/4am. Some days time shifts because he wakes up between 6:30/7:30am but this is pretty much his schedule. He was walking at 1am but dropped that feed last week and started taking more at the 10pm feed and the 3/4am

Right now he does 7am - 4oz, 10am - 4oz, 1pm - 4oz, 4pm - 4oz, 7pm - 4oz, 10pm - 4-6oz, and 3/4am - 4-6oz.

I'm not an expert, my babies are little porkers, but maybe he needs the 1am feed back. I don't know that 4 more ounces is going to make all the difference in the world. I went to a breast feeding clinic with my first baby, maybe that could offer you help? Or a lactation consultant?

OP here. We don’t have any issues with nursing. He took right to breastfeeding in the hospital and the lactation consultant we saw in the first week said things looked good. He nursed exclusively for the first month and regained his birth weight and then went from 6lbs 14oz at two weeks to 8lbs 10oz at 1 month. I only stopped nursing and started pumping because her bringing up him being small worried me that he wasn’t getting enough and I wanted to know how much he got at each feed. I have been freezing so much milk because I make enough but started supplementing with formula. He still nurses occasionally at night or before his last nap which tends to be the hardest to get him to sleep.

I can start waking him at 1am to feed but don’t want to force him to eat if he is naturally sleeping longer stretches.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Random thought: if he is STTN maybe you need to wake him for a feed

OP here. He just dropped one of his night feeds. He eats 7, 10, 1, 4, 7, 10, and 3/4am. Some days time shifts because he wakes up between 6:30/7:30am but this is pretty much his schedule. He was walking at 1am but dropped that feed last week and started taking more at the 10pm feed and the 3/4am

Right now he does 7am - 4oz, 10am - 4oz, 1pm - 4oz, 4pm - 4oz, 7pm - 4oz, 10pm - 4-6oz, and 3/4am - 4-6oz.

OP here. I made a typo before. He eats 4oz 5 times a day and then 4-6oz the other two feeds. I’ve tried feeding him more than 32oz or 4oz at a feed and he will refuse it unless bedtime or the 4-5 hour stretch at night. Times vary depending on 6:30/7:30am wakeup and naps but generally eats 4oz every 3 hours which I read is average and normal.

I don’t want to wake him up because he is a good sleeper and I want to follow his cues. He takes a solid 4 naps most days and is doing well at night. Unless we get a second opinion and they’re concerned, I don’t want to wake him and make him eat if he doesn’t want or need it. I’m all about following his natural cues and letting him dictate how much he eats, when he wants to eat, and how much he wants to sleep. He is on a schedule but we don’t force him to eat and I don’t want to get him in the habit of waking up and making him eat if he’s not hungry. I would do it if he wasn’t gaining well but he gained 4lbs in 6 weeks. I feel like he is small but growing at his own pace.

You might pay for waking him by having to sleep train a toddler later. Either get a 2nd opinion somewhere or re-evaluate after the next visit. Sometimes the nurse flubs the weight. My son dropped 10 percentiles then magically regained them a couple months later.

OP here. How do I get a second opinion. Do I just call around to pediatricians and explain what’s going on and if someone else can see us?

The pediatrician we have now is newer and I’m wondering if a more experienced pediatrician will be a better choice for us.

[Anonymous]

Is the ped using the CDC chart or the WHO chart? The WHO chart is recommended for breastfed babies.

https://www.cdc.gov/growthcharts/who_charts.htm

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Random thought: if he is STTN maybe you need to wake him for a feed

OP here. He just dropped one of his night feeds. He eats 7, 10, 1, 4, 7, 10, and 3/4am. Some days time shifts because he wakes up between 6:30/7:30am but this is pretty much his schedule. He was walking at 1am but dropped that feed last week and started taking more at the 10pm feed and the 3/4am

Right now he does 7am - 4oz, 10am - 4oz, 1pm - 4oz, 4pm - 4oz, 7pm - 4oz, 10pm - 4-6oz, and 3/4am - 4-6oz.

OP here. I made a typo before. He eats 4oz 5 times a day and then 4-6oz the other two feeds. I’ve tried feeding him more than 32oz or 4oz at a feed and he will refuse it unless bedtime or the 4-5 hour stretch at night. Times vary depending on 6:30/7:30am wakeup and naps but generally eats 4oz every 3 hours which I read is average and normal.

I don’t want to wake him up because he is a good sleeper and I want to follow his cues. He takes a solid 4 naps most days and is doing well at night. Unless we get a second opinion and they’re concerned, I don’t want to wake him and make him eat if he doesn’t want or need it. I’m all about following his natural cues and letting him dictate how much he eats, when he wants to eat, and how much he wants to sleep. He is on a schedule but we don’t force him to eat and I don’t want to get him in the habit of waking up and making him eat if he’s not hungry. I would do it if he wasn’t gaining well but he gained 4lbs in 6 weeks. I feel like he is small but growing at his own pace.

You might pay for waking him by having to sleep train a toddler later. Either get a 2nd opinion somewhere or re-evaluate after the next visit. Sometimes the nurse flubs the weight. My son dropped 10 percentiles then magically regained them a couple months later.

OP here. How do I get a second opinion. Do I just call around to pediatricians and explain what’s going on and if someone else can see us?

The pediatrician we have now is newer and I’m wondering if a more experienced pediatrician will be a better choice for us.

Is there another ped in the same practice that you can see? If not, just see who’s on your insurance and cross-reference with reviews online, or ask for recommendations from other moms in your area.

[Anonymous]

Pumping is nit the same. As the baby nurses, the fat content in the milk increases. The "hind milk". Put your baby to tge breast for that last eveni g feed and let him eat until he falks asleep.
Your pediatrician sounds misinformed and inexperienced. Is she very young? Kids of her own? To recommend quutying breast feeding when you seem to want to continue doesnt seem right.

[Anonymous]

Anonymous wrote:Pumping is nit the same. As the baby nurses, the fat content in the milk increases. The "hind milk". Put your baby to tge breast for that last eveni g feed and let him eat until he falks asleep.
Your pediatrician sounds misinformed and inexperienced. Is she very young? Kids of her own? To recommend quutying breast feeding when you seem to want to continue doesnt seem right.

This is wrong. You can exclusively pump and your baby still gets the fatty milk. It’s important to fully empty the breast. You can still pump and your baby will be getting the fat. My pumped milk always had a thick layer of fat at the top. This has to do with fat content changing throughout the day just like noon volume varies throughout the day. It has nothing to do with nursing.

And many babies fall asleep on the breast before they even get a full feed and that means they won’t get the fatty milk. You also do not want to get a baby used to being nursed to sleep. This will cause a lot of issues as they get older.

[Anonymous]

Based on the stats you gave, it sounds like your baby is doing just fine! He is gaining and following his own growth curve. That is all that matters. He is right on track, for him. Some kids are small, some are big. It doesnt really matter where he falls as long as he is gaining and growing, which he is. And being small now, doesnt mean he will always be small. Dont sweat it.

[Anonymous]

My older daughter was/is small. Our first pediatrician was like yours in that he was very concerned about her size and made me feel like crap (“you need to be doing more for this child than you are” when said to a mother of a 1 month old baby is just tactless particularly when I was doing everything he told me). We were referred to a pediatric endocrinologist at Children’s when DD was 8 months old because her weight was still unsatisfactory. The specialist evaluated her and we talked about her diet and activity and developmental milestones and her conclusion was that some kids are always at the 5%ile and some are always at the 95%ile and if DD was meeting her milestones and had enough energy and slept well, she wasn’t concerned about the 5%ile. Her dad and I are not large people, which the doctor pointed out.

We got a new pediatrician and DD is now a 12yo dancer who is still around the 5%ile. It’s just the shape her body is.

I know how hard it is when you are being told your baby is “wrong” somehow but yes, get a second opinion.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Random thought: if he is STTN maybe you need to wake him for a feed

OP here. He just dropped one of his night feeds. He eats 7, 10, 1, 4, 7, 10, and 3/4am. Some days time shifts because he wakes up between 6:30/7:30am but this is pretty much his schedule. He was walking at 1am but dropped that feed last week and started taking more at the 10pm feed and the 3/4am

Right now he does 7am - 4oz, 10am - 4oz, 1pm - 4oz, 4pm - 4oz, 7pm - 4oz, 10pm - 4-6oz, and 3/4am - 4-6oz.

I'm not an expert, my babies are little porkers, but maybe he needs the 1am feed back. I don't know that 4 more ounces is going to make all the difference in the world. I went to a breast feeding clinic with my first baby, maybe that could offer you help? Or a lactation consultant?

OP here. We don’t have any issues with nursing. He took right to breastfeeding in the hospital and the lactation consultant we saw in the first week said things looked good. He nursed exclusively for the first month and regained his birth weight and then went from 6lbs 14oz at two weeks to 8lbs 10oz at 1 month. I only stopped nursing and started pumping because her bringing up him being small worried me that he wasn’t getting enough and I wanted to know how much he got at each feed. I have been freezing so much milk because I make enough but started supplementing with formula. He still nurses occasionally at night or before his last nap which tends to be the hardest to get him to sleep.

I can start waking him at 1am to feed but don’t want to force him to eat if he is naturally sleeping longer stretches.

The clinic might have better info for you than OMG HE IS SOOOO SMALLLLLLL. They can re-weigh him at least. Maybe they will tell you the ped needs to chill. The one I saw was run by a pediatrician so maybe you can get your 2nd opinion too. I'm not in DC otherwise I'd tell you where I went.

[Anonymous]

Sounds like your doctor is advising that you supplement with formula. Not replace breastmilk with formula. If your baby is not getting enough nutrients or milk from your breastmilk, it does not hurt the baby to supplement with formula. He still getting the fatty breastmilk. Maybe he has trouble nursing and you are unaware of it so even though he’s sucking at your breast he’s not getting the full breastmilk that he needs. That happened to one of my friends babies. He was not gaining weight at the correct rate that he should be. And then he actually dropped and was considered to be failure to thrive. She definitely supplemented with formula after that and her baby gained weight. Sucking out of a bottle is easier for the baby then at the breast.

[Anonymous]

It appears that he is following his growth curve, and on the small side….but totally in the range of normal. He is slightly larger than what my daughter was at the same ages, and the pediatrician has always focused on the fact that she is following her growth curve. To me it sounds like you don’t feel supported by your pediatrician. I think this is concerning and you may want to consider finding a pediatrician who instills in you and sense of trust and support.

[Anonymous]

Next time you go to the pediatrician and she/he mentions your baby is small. Speak up and ask him if it’s a problem because he has mentioned it every time. Don’t let the doctor intimidate you. They’re there to inform and maybe they don’t realize that they’re alarming you for no reason. Or maybe there is something to be worried and they need to be clear about that. You should never leave an appointment wondering or confused about what they mean.

And if that still doesn’t work too help you feel better than maybe it’s time to look for a different doctor.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Okay, your baby is on the small side. It also sounds like your baby is healthy and growing steadily.

Both things can be true.

Keep breastfeeding if you want. (Or stop if you don’t want to— you’re lucky your baby accepts both.) It’s impossible for everyone to have high percentile babies. By definition half of all babies are going to be below the median and half are above. Your baby is perfectly healthy! Let go of trying to make him jump percentiles and enjoy your baby!

Many parents supplement and baby takes both. It’s not rare.

Okay? It wasn’t normal for me. Each of my kids threw up immediately with formula. Later we found out they had food allergies. Still it was super stressful not to be able to supplement.

Again, the point is to be happy about what works and not overthink it. Enjoy the baby you have.

[Anonymous]

I think you need to get a second opinion for your own sanity. You might also want to contact your existing pediatrician and ask for clarity on how concerned he or she is about your baby's size and growth curve. There's a difference between "your baby is on the smaller side and you could consider supplementing with high calorie formula" and "your baby's growth rate is concerning and you need to take action right now." Docs don't always make it clear which message they're conveying.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Random thought: if he is STTN maybe you need to wake him for a feed

OP here. He just dropped one of his night feeds. He eats 7, 10, 1, 4, 7, 10, and 3/4am. Some days time shifts because he wakes up between 6:30/7:30am but this is pretty much his schedule. He was walking at 1am but dropped that feed last week and started taking more at the 10pm feed and the 3/4am

Right now he does 7am - 4oz, 10am - 4oz, 1pm - 4oz, 4pm - 4oz, 7pm - 4oz, 10pm - 4-6oz, and 3/4am - 4-6oz.

OP here. I made a typo before. He eats 4oz 5 times a day and then 4-6oz the other two feeds. I’ve tried feeding him more than 32oz or 4oz at a feed and he will refuse it unless bedtime or the 4-5 hour stretch at night. Times vary depending on 6:30/7:30am wakeup and naps but generally eats 4oz every 3 hours which I read is average and normal.

I don’t want to wake him up because he is a good sleeper and I want to follow his cues. He takes a solid 4 naps most days and is doing well at night. Unless we get a second opinion and they’re concerned, I don’t want to wake him and make him eat if he doesn’t want or need it. I’m all about following his natural cues and letting him dictate how much he eats, when he wants to eat, and how much he wants to sleep. He is on a schedule but we don’t force him to eat and I don’t want to get him in the habit of waking up and making him eat if he’s not hungry. I would do it if he wasn’t gaining well but he gained 4lbs in 6 weeks. I feel like he is small but growing at his own pace.

You might pay for waking him by having to sleep train a toddler later. Either get a 2nd opinion somewhere or re-evaluate after the next visit. Sometimes the nurse flubs the weight. My son dropped 10 percentiles then magically regained them a couple months later.

OP here. How do I get a second opinion. Do I just call around to pediatricians and explain what’s going on and if someone else can see us?
[/b]
The pediatrician we have now is newer and I’m wondering if a more experienced pediatrician will be a better choice for us.[b]

You get a second opinion by either requesting to see a different doctor at your practice OR going to a different practice for your next well visit.