# My 20 month old weighs 20lbs. and Ped yelled at me to wean. Please help!!!



## Toposlonoshlep (Jan 14, 2010)

(x-posted in breast feeding beyond infancy)

I spent the day crying yesterday after our well-toddler visit. My ped, who BFed her own kids to 18 months and was always supportive of me, raised her voice at me and said "I always told you he was MALNOURISHED!" She told me I need to stop nursing him during the day. She yelled that, "He is almost 2 years old and nurses like a 2 month old!" And the thing is, it's true. My kid eats, but he is super-picky. He doesn't eat any snack foods that other kids eat, like cereals, for example. He eats a lot of chicken soup with egg noodles, organic chicken sausage, avocado, sprouted grain bread, some beans, hummus, potato, and some coconut yogurt. The biggest issue is that he has a dairy allergy, so cow's milk products are out for us. I always thought I was doing a good thing by nursing him om demand because of the calcium, but now I am doubting everything...

He is in the 30%-45% for height, so no concerns there. But he is only 20 lbs. and his head is at 4.7% at 18 inches.

But he is brilliant! Ahead on all his milestones (started walking at 9 months and is now talking up a storm), super-active, happy...Could he really be MALNOURISHED?!? That word just freaks me out.

My biggest point of contention is that he was born small (just under 7lbs. with a (lol) small head at 13.5 inches). So, his head circumference, for one, seems to be growing fine on his own curve. Not to mention that my DH is 5'9", only 135 lbs, and was always really really really petite, even in childhood.

Why did she yell at me?!? Do I really need to step it up by nursing less and thereby forcing him to eat more?!?

I am doubting everything, even more after the same ped told me she lets her kids have McDonald's once a week to "maintain their weight".

Sorry this is so long. I am really distressed. Thanks ahead of time for any advice on whether to wean or not, and the like...


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## CallMeMommy (Jun 15, 2005)

Quote:


> Originally Posted by *Toposlonoshlep*





> (x-posted in breast feeding beyond infancy)
> 
> I spent the day crying yesterday after our well-toddler visit. My ped, who BFed her own kids to 18 months and was always supportive of me, raised her voice at me and said "I always told you he was MALNOURISHED!" She told me I need to stop nursing him during the day. She yelled that, "He is almost 2 years old and nurses like a 2 month old!" And the thing is, it's true. My kid eats, but he is super-picky. He doesn't eat any snack foods that other kids eat, like cereals, for example. He eats a lot of chicken soup with egg noodles, organic chicken sausage, avocado, sprouted grain bread, some beans, hummus, potato, and some coconut yogurt. The biggest issue is that he has a dairy allergy, so cow's milk products are out for us. I always thought I was doing a good thing by nursing him om demand because of the calcium, but now I am doubting everything...
> 
> ...


So his weight is the only thing she's concerned about? Is he falling off the curve or maintaining? You said he's meeting or exceeding all his milestones, so if weight is the only concern then IMO it's not a concern. My son, on the other hand, was very low on the weight curve but also had developmental delays, so we knew it wasn't just a weight issue. I never understand the logic of "he's super picky, so let's take away the only food he'll actually eat" to make kids gain weight. I wouldn't even consider weaning. If anything, keep nursing but try to sneak more good-fat foods into him.

I'd also plot his weight on the WHO growth charts, the ones most doctors use are based on formula-fed kids from the '70s and it's a known fact that breast-fed kids gain weight at different rates than formula-fed kids. He's probably not as low on the curve as you think he is.


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## myfairbabies (Jun 4, 2006)

My 19 month old nephew is 19 lbs. My sister just has small babies, but they went ahead and did some blood tests just to rule out thyroid issues and such because he eats like a horse (he was getting blood drawn anyway for allergies). I would get a new Ped, if that's an option. It really doesn't sound like you have a problem, especially with your small husband and the fact that his milestones are all great. I would absolutely not stop nursing, I have a friend that recently did that for the same reasons (doc said toddler was too small and she needed to stop) and totally regrets it. Guess what? He's still small. Your sons sounds perfectly healthy to me!


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## Toposlonoshlep (Jan 14, 2010)

Quote:


> Originally Posted by *CallMeMommy*
> 
> So his weight is the only thing she's concerned about? Is he falling off the curve or maintaining?


Yep, he fell off...He was hanging in there at 5% for a while, but hasn't gained more than a pound since 12 months...

He has become a pickier eater and RUNS everywhere, even when walking is in order...

As for why take away the mama milk, according to the ped, "He is getting nothing but comfort and extra hydration" from it...She thinks that the reason he will not eat more is because he prefers the milk and defers to it.


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## CallMeMommy (Jun 15, 2005)

Quote:


> Originally Posted by *Toposlonoshlep*
> 
> Quote:
> 
> ...


Except it's not WATER, it has nutrients and fat in it! Gah!


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## Toposlonoshlep (Jan 14, 2010)

Quote:


> Originally Posted by *myfairbabies*
> 
> My 19 month old nephew is 19 lbs. My sister just has small babies, but they went ahead and did some blood tests just to rule out thyroid issues and such because he eats like a horse (he was getting blood drawn anyway for allergies). I would get a new Ped, if that's an option. It really doesn't sound like you have a problem, especially with your small husband and the fact that his milestones are all great. I would absolutely not stop nursing, I have a friend that recently did that for the same reasons (doc said toddler was too small and she needed to stop) and totally regrets it. Guess what? He's still small. Your sons sounds perfectly healthy to me!


Thank you. This is what my gut says. The ped says I am getting defensive, but I am just so surprised by her approach...The reason I picked her (after MUCH research) was because she was the only one in this whole city supportive of delayed/selective vaxes and extended BFing. Now I don't know. I am seriously considering whether to search again for another one.

Thanks for your words of reassurance!


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## crunchy_mommy (Mar 29, 2009)

It seems like so many people I know have this same discussion with their docs -- even with super-crunchy 'breastfeeding-supportive' docs. I don't understand it.

My DS has also only gained about a pound since he turned 1 year. He's 22 mos & 23lbs so a little bigger than your guy but not a ton. He doesn't eat a ton of solids & he nurses more than a newborn as well. We try hard to make sure when he does eat table food that it's nutrient-packed & lots of fat (so we make a lot of calorie-dense sauces, put olive oil on everything, etc.)

I wouldn't worry if he's meeting all his milestones and there don't seem to be any other problems (sensory issues etc.)

However, I do want to point out that weaning & not weaning are not your only options.  If you feel something needs to change, you could just cut back on nursing or only nurse at certain times or not nurse X hours before a meal... some people seem to have some luck with that in terms of better solids intake. I cut DS back some around 18mos because I just couldn't take nursing 20+ times a day. But I did this for sanity, and I felt he was ready (but reluctant) to try eating more solids, not specifically to gain weight -- because unless you have low supply or something, breastmilk would be more nutrient dense than any other food you give him.

I would be nervous with a doc who intentionally feeds & encourages others to feed kids McDonald's on a regular basis for the purpose of improving health.


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## CherryBomb (Feb 13, 2005)

Mama, if it makes you feel better, my 33 month old dd weights *26* pounds. She was nursing constantly and I weaned her shortly after her 2nd birthday (due to pregnancy) and it did NOT make one bit of difference in her weight. She is just tiny and always has been. It sounds like your kiddo is doing just fine. If he were not meeting milestones and was sickly, I'd worry, but he sounds healthy and small.


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## shanniesue2 (Jul 4, 2007)

I don't think the issue is one of whether or not to wean. I think the real issue here is a doctor who does not treat her clients with respect. Did she actually YELL at you?!?! I'd say it's time for a new pediatrician.

I "fired" our family doc for a much smaller infraction. We switched to a new doc when DS was 17 months old b/c I was tired of getting vax lectures at every visit (even though the doc had agreed to a delayed schedule before DS was even born). The doc was always spoke respectfully to me, though... he would say, "I'm okay with you delaying, as long as he does get his vax's because some baby he knew was hospitalized with whooping cough one time." He never yelled at me, though. I think I would take serious issue with yelling.


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## MrsBone (Apr 20, 2004)

Quote:


> Originally Posted by *Toposlonoshlep*





> (x-posted in breast feeding beyond infancy)
> 
> I spent the day crying yesterday after our well-toddler visit. My ped, who BFed her own kids to 18 months and was always supportive of me, raised her voice at me and said "I always told you he was MALNOURISHED!" She told me I need to stop nursing him during the day. She yelled that, "He is almost 2 years old and nurses like a 2 month old!" And the thing is, it's true. My kid eats, but he is super-picky. He doesn't eat any snack foods that other kids eat, like cereals, for example. He eats a lot of chicken soup with egg noodles, organic chicken sausage, avocado, sprouted grain bread, some beans, hummus, potato, and some coconut yogurt. The biggest issue is that he has a dairy allergy, so cow's milk products are out for us. I always thought I was doing a good thing by nursing him om demand because of the calcium, but now I am doubting everything...
> 
> ...


Are you vaxing at all? If not I just wouldn't go back for well visits. I haven't taken my DS since he was 16 months old. he'll be a year this month. Why sit there and listen to criticism? You're the one paying her, so you shouldn't take it. You're the mama, you know best. If you feel like he's doing okay, he probably is. I wouldn't worry about it! As far as food intake, you could give him toast with some coconut oil on it, instead of butter. It will add some good fat and calories to his diet. Will he eat eggs? The fat and cholesterol in the yolks will him help put on some weight too. As for chicken soup, add some fat to that.. do you make it? If so, you could make chicken stock out of bones, and he'd be getting tons of minerals, vitamins and calories from the chicken fat. I'd use pastured chickens though if you're going to give him that much chicken fat I'm sorry, but taking kiddo to mcdonalds to put on weight is just not a good answer! Oh..one other thing.. does he like bread and crackers? I have some yummy recipes for bread and crackers made from almond flour..full of protein and fat, and calories!


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## crunchy_mommy (Mar 29, 2009)

Quote:


> Originally Posted by *MrsBone* View Post
> 
> I have some yummy recipes for bread and crackers made from almond flour..full of protein and fat, and calories!


I know *I* would love the recipes!


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## geekgolightly (Apr 21, 2004)

How about smoothies made with coconut milk, banana and his favorite fruits?


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## motherhendoula (Feb 13, 2009)

Not to mention that my DH is 5'9", only 135 lbs -( i think if i met your husband i might say he was underweight







)

It doesnt sound like your children are destined to be gigantic people to start with - i think the other posters are correct, breast feeding is not encouraging malnourishment - (i dont think malnourished children have the energy to *run* everywhere)

You sound like you are fine with how often he nurses and have a good handle on non-dairy foods (speaking of which i want to mention Hemp Milk ...i have been dairy free for nearly 10 years and i LOVE this stuff!)

I agree with Mrs Bone - you can easily dodge 'well visits' and downplay how much the child nurses and list all the great foods he is eating.


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## mamaofthree (Jun 5, 2002)

i think sometimes doctors forget to look at the whole patient and focus on one thing. if you and your dh are small people then why would your child be a bigger person.

it sounds like what he does eat is really good. i would also second adding a bit of fat to what he does eat if it is worrisome to you. but taking him to eat crap fast food seems like the most silly thing i have ever heard. lol like why not get him eating stuff that is healthy? i would look around and see if you can find someone else. maybe some into alternative medicine.

good luck.

we had a tall skinny baby with my dd and that is because dh and i are both tall skinny people. (dh is 5 11 and until the last two years never weighed more then 145. he always looked good, he just wasn't a hulking guy) she would be 95% in height and 10% in weight. our ped just said nurse her as much as she needs and add butter to her food. so we did. now she is 16 and tall and thin. and that girl can pack away the food. lol

h


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## Toposlonoshlep (Jan 14, 2010)

Quote:


> Originally Posted by *shanniesue2*
> 
> I don't think the issue is one of whether or not to wean. I think the real issue here is a doctor who does not treat her clients with respect. Did she actually YELL at you?!?! I'd say it's time for a new pediatrician.
> 
> I "fired" our family doc for a much smaller infraction. We switched to a new doc when DS was 17 months old b/c I was tired of getting vax lectures at every visit (even though the doc had agreed to a delayed schedule before DS was even born). The doc was always spoke respectfully to me, though... he would say, "I'm okay with you delaying, as long as he does get his vax's because some baby he knew was hospitalized with whooping cough one time." He never yelled at me, though. I think I would take serious issue with yelling.


I really think the only reason that we haven't "fired" her is because she is totally and completely ok with delayed/selective vaxes and I broke my back trying to find a ped who was in the city...

She did YELL, and she often seems insecure to me. She actually told me once that she feels "intimidated" by DH and I because we are so opinionated...She once also said to me that she sees it as a problem that so many parents these days are doing their own research and think they know it all. My DH asked her, "Isn't it a GOOD thing that people are becoming educated about their kids' health?" and she said, "Well, no, not if they're going to not bring their kid in when they don't know what they're looking for."

I am ped shopping just in case, but what a pain it would be to switch. But she says now that she wants to see him every month because he is "malnourished", and she came down hard on me when I skipped 2 well-visits...She said she will "not condone it."


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## AFWife (Aug 30, 2008)

Quote:


> Originally Posted by *mamaofthree*
> 
> i think sometimes doctors forget to look at the whole patient and focus on one thing. if you and your dh are small people then why would your child be a bigger person.


Exactly this. A friend's oldest daughter is TINY (she's 7 and her sister is 4-5 and they weight about the same and are similar in height) She's always been teeny tiny...like, barely shows up on the charts tiny. Her mom is a little person (she's 5ft-nothin' and can't be more than 100lbs soaking wet) and her bio-father was apparently a small guy (shorter and about as thin as mom) so the ped has always said, "As long as she's eating and not showing signs of malnourishment there's no reason to worry."


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## LauraN (May 18, 2004)

Tell her you "will not condone" being yelled at and will not continue to bring him in if she insists on yelling about something she has not solid facts about. His weight alone is not an indication of malnourishment, so tell her to stop trying to intimidate you.

Stopping breastfeeding will not change his eating patterns, nor will it have much effect on his weight, except perhaps a negative one when he stops getting those extra calories.

But your ped sounds like a piece of work. My old ped (we're no longer in the US) always *liked* having parents who did their research and had ideas and opinions and loved talking with us and explaining his point of view when our ideas differed from his. But he also always deferred to the parents' wishes.


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## pbjmama (Sep 20, 2007)

If my employee yelled at me I would reply with "you're fired".

You are paying her for her medical advice. She is your consultant. The way she treated you is absolutely unacceptable. I realize you may not have the option for other care but if you do I would not go back to her and I would write a letter explaining your reasoning.

Beyond that, IMO you should not wean. Wouldn't hurt to get a second opinion and see what kind of problems may explain low weight even if it seems the norm in your family.


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## Toposlonoshlep (Jan 14, 2010)

Quote:


> Originally Posted by *motherhendoula*
> 
> Not to mention that my DH is 5'9", only 135 lbs -( i think if i met your husband i might say he was underweight
> 
> ...


Ha ha. Yeah, my husband has always had issues with people judging his health and strength based on his physique. But he is a hardcore yogi and has the immune system of a superhero, so big ain't always strong. I can't downplay the well visits because she came down HARD on me for skipping a couple. Said she would not condone it and that she cannot track my child's growth if I don't bring him in....*sigh*


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## Toposlonoshlep (Jan 14, 2010)

Quote:


> Originally Posted by *LauraN*
> 
> Tell her you "will not condone" being yelled at and will not continue to bring him in if she insists on yelling about something she has not solid facts about. His weight alone is not an indication of malnourishment, so tell her to stop trying to intimidate you.
> 
> ...


Ha. I wish I had the cojones to tell her that. maybe I'll grow some if she keeps this up.

I wish there were more peds like your old one. I hate that you have to experience this crud before you really know where they stand. I swear, with her, it seems personal. And unprofessional.


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## AFWife (Aug 30, 2008)

Quote:


> Originally Posted by *Toposlonoshlep*
> 
> Quote:
> 
> ...


She can't yell at you if she's not tracking his growth so freaking closely....just sayin'


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## Katwoman (Apr 15, 2004)

Okay, the comment about you needing to come in every month because he's malnourished is fairly distressing to me. Does anyone know what the threshold for her mandatory reporting of the health of a child? I think scheduling an appt with another doctor would be something you would want done ASAP. The new doctor can check your child out and you could have something "on file" about your child not being malnourished. (I know, I know, easier said than done.)

I had an allergy specialist say she was going to call CPS because I was a negligent mother because I took my child to see a natural path. (This was at a follow up appt with the specialist where I was going over her recommended care plan and how I followed everything to the letter.)

Very disturbing the power they have just because they don't agree with your parenting choices.


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## Karamom (Mar 26, 2007)

I would absolutely not go back to this ped. I know you said it would be hard to find a new doc but you don't deserve to be treated like that.


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## Maela (Apr 2, 2006)

Don't have any advice, just sympathy. DS is 14 months and 18.5 pounds (under 1% on the (CDC, I think) charts). The doctor is telling me to wean and told me not to feed him plain whole milk yogurt because it would be too much dairy with all the breastmilk he was getting.







He sent me to speak with the nutritionist and she debunked that (yay!), BUT she did agree that I should be nursing him less (like 1-2 times a day). I am not going to do it, and now I'm dreading his Jan appt

ETA: I would definitely look for a new dr. The McDonalds comment is just .... wow.


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## Marissamom (Dec 17, 2009)

it does sound like it's pretty personal for her, that she didn't breastfeed past 18 months, so she doesn't understand why you feel the need to. and yelling is not professional, you do not have to tolerate it.


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## HawaiianBlesing (Nov 21, 2010)

I can tell you from personal experience that I was not a good eater as a child. I was BF too and SUPER picky eater. I had a waxing and waning metabolism where I could eat little to noting in a day and then eat 10x a day the next day. It was hard for my mom but she learned to deal with it because if she tried to force feed me, I would throw up. My pediatricians even threatened to put a feeding tube in me.

By the time I was old enough to play recreational sports I was only the size of a kindergardner. I only weighed 45 lbs at 10 or 11 yrs old. I had a massive growth spurt when I was 15. I specifically remember my doctor asking me "hey when did you get so 'heavy'" I was 5'5" and weighed 125lbs (not heavy by any means but heavy compared to my previous years)

He will catch up. My girlfriend has an 18 mo who's head was only in the 6th percentile when he was born. He measured light for his age at his 1 year check up and the docs told her to feed him pats of butter to "fatten" him up. It only lasted about 1 meal. He is progressing just fine.

I doubt your son is *malnouroushed* as the doctor proclaims....

He will catch up just give it time.


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## mamakaikai (Apr 17, 2009)

Aside from your distaste for being yelled at, makes sense, it sounds to me like your concerns are with regards to extended breastfeeding and the part about malnutrition. Firstly, many children are breastfed well beyond the age of your child, mine is one of them. Breastfeeding is known to complement nutrition for a child your sons age. So I see no need to wean your child. Weaning as far as I'm concerned is between you and your child and you can continue to see your Dr. and get decent care even if there is a disagreement about what age one should wean their child. I think it is possible that your Dr.'s intent may have been that sufficient nutrition is not being met with a diet of mostly breastmilk. Therefore suggesting that nutritional needs may be more adequately met with a more substantial non-milk diet. So perhaps decreasing breastfeeding is not a bad idea, so that the child may be more interested in other food sources, thus gaining more sustenance from a variety of sources.

My concern for you is that your child's weight may actually be an indication of malnutrition. I know that may be a tough pill to swallow, and may not even be accurate...but I think by the sounds of your alarm, some part of you may be wondering if it actually may be factual. Have you looked at the WHO charts? Your child is very much way off the charts. If I were in your shoes, and I am not and don't actually know the whole picture...but since no one here has dared mention it...I would definitely reconsider my child's diet. If your child can't have dairy, I would look into other healthy sources of fats and calcium. Adding butter, or hemp seed oil to foods, or even by spoonful (I do this for my child and she loves it). There are alternatives for good sources of calcium too. I would also be concerned about iron, since it can impede growth and there is not enough available through breastmilk, particularly after 6 months of age.

As far as the comment about McDonalds, I think it might be fair to give the benefit of the doubt in this case. Maybe what her intent in saying that was more about acknowledging that kids can and should have fats in their diet and that sometimes it's ok to not give the healthiest of health foods. B for Balance. HCP are just people too and sometimes in a busy stressful day we say things that are not exactly what we mean, or we say things that come out the wrong way because we are tying to make a point which completely backfires on us. I think your Dr. might have your kids best interest at heart, but it's hard to see that when you feel under attack.

I'm just offering a different, perhaps harder to accept, point of view.

BTW, I'm tandem nursing a 2.5 yr old and a 5 month old. We're vegetarians, also lactose intolerant and would never *ever* eat at McD or anywhere like it...we cook from scratch and eat organic.(just to give you an idea of where my thoughts are coming from) My dd1 was about 85% breastfed at about 15 months old and she's always been in the 99% for weight, and height. My DP is 6F and weighs 145 soaking wet, I'm 5'5 and 135 postpartum...so I don't think we can always count on genetics to tell us what size our babes will be.

Wishing you and your kiddo all the best.


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## weliveintheforest (Sep 3, 2005)

I wouldn't stay with her... I'm not sure what it's like in your community, but here if you don't have a family doctor you can go to a walk in clinic or in emergencies, to the hospital. Walk-ins are not ideal, but we only go if I need a test or a prescription anyway. Maybe you could re-evaluate your need for a ped?

And for the record, your son sounds perfectly healthy to me, just petite. My daughter didn't weigh very much more than your son at that age.


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## havengirlsmama (Jan 28, 2010)

My family is from Cuba, and my grandmother nursed my dad and her four other children well beyond toddler hood--I think she said age 5. She said her kids didn't eat solids until they were older babies, had teeth, could feed themselves. They lived in a rural area, and they were poor. She thought it was so strange that I was giving my 6 month old twins solids. In most parts of the rest of the world, babies aren't weighed constantly, are nursed until they are good and ready to stop, and eat food for nourishment when they are ready, not when the doctor suggests it. It sounds like your baby is doing fine. The idea of not nursing him a few before meals sounds like it might work. It's hard not worry. My daughter at 13 months weighs 18.5 pounds and hasn't gained in over a month. I was spoon feeding her a giant bowl or avocado/yogurt/banana/rice cereal mixture right when we got home from the docs because I'm convinced she's not getting enough solids. Ack. Good luck.


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## ElliesMomma (Sep 21, 2006)

what are signs of malnourishment? seems like getting all of the facts would be good information to have. i haven't looked it up, but i would suspect that signs of true malnourishment would show up in poor condition skin, hair falling out, eyes lackluster, etc. in addition to falling weight and lack of growth.

the pediatrician should not be yelling at you. she should be working with you, as your health care advisor, and she needs to have you on her "side" if she wants to be successful in her approach.

but until you decide that you don't need to take that from her, she is going to continue doing it. does she know that you searched high and low for a pediatrician who met the other criteria you outlined? and therefore that you won't dump her?


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## Toposlonoshlep (Jan 14, 2010)

Quote:


> Originally Posted by *MrsBone*
> 
> Quote:
> 
> ...


We do vax, but very sporadically and selectively. He has all the vaxes he will get before school age. I DO make the chicken soup myself, not with stock, but by boiling chicken, bones and all. We only eat free range organic chicken, so I'm with you there. He DOES like bread A LOT, crackers are touch and go. I forgot to mention that he does eat egg yolk!!! I would love the recipes!!!


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## Toposlonoshlep (Jan 14, 2010)

Quote:


> Originally Posted by *Katwoman*
> 
> I had an allergy specialist say she was going to call CPS because I was a negligent mother because I took my child to see a natural path. (This was at a follow up appt with the specialist where I was going over her recommended care plan and how I followed everything to the letter.)
> 
> Very disturbing the power they have just because they don't agree with your parenting choices.


GASP! ( I am too lazy to look for the jaw-dropping face) Yeah, when she said once a month, it seemed like she was trying to prove a point. I really did feel like she was trying to belittle me. Earlier in the appointment she said make an appointment in two months, and when I pointed that out to her she said indignantly "well, I just changed it!" This really does look bad when I type it out and re-read it. I think I was too upset in the moment to realize how she was treating us...


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## Toposlonoshlep (Jan 14, 2010)

Quote:


> Originally Posted by *ElliesMomma*
> 
> what are signs of malnourishment? seems like getting all of the facts would be good information to have. i haven't looked it up, but i would suspect that signs of true malnourishment would show up in poor condition skin, hair falling out, eyes lackluster, etc. in addition to falling weight and lack of growth.
> 
> ...


Yeah, she probably knows....I may have mentioned that I appreciated her values and flexibility when we first went to her....How did I let this relationship get so manipulative? Geez.

As for signs, I did ask her how an active, happy kid can possibly be malnourished and she said that "kids are incredibly resilient and will adjust to any situation."


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## Toposlonoshlep (Jan 14, 2010)

Quote:


> Originally Posted by *havengirlsmama*
> 
> My family is from Cuba, and my grandmother nursed my dad and her four other children well beyond toddler hood--I think she said age 5. She said her kids didn't eat solids until they were older babies, had teeth, could feed themselves. They lived in a rural area, and they were poor. She thought it was so strange that I was giving my 6 month old twins solids. In most parts of the rest of the world, babies aren't weighed constantly, are nursed until they are good and ready to stop, and eat food for nourishment when they are ready, not when the doctor suggests it. It sounds like your baby is doing fine. The idea of not nursing him a few before meals sounds like it might work. It's hard not worry. My daughter at 13 months weighs 18.5 pounds and hasn't gained in over a month. I was spoon feeding her a giant bowl or avocado/yogurt/banana/rice cereal mixture right when we got home from the docs because I'm convinced she's not getting enough solids. Ack. Good luck.


LOL. Your post was so soothingly reassuring until I got to the bowl or avocado/yogurt/banana/rice cereal mixture part. That's pretty funny. That could easily be me, except my DS would NEVER EVER EVER even THINK about trying that.


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## mamatoElias (Aug 2, 2006)

I cannot give an accurate opinion on whether or not your child is malnourished or not based on the information in your post. I'm sorry to say that neither can any of the other ladies on this board. We simply do not have access to your son's medical history and physical exam. And most of us do not have the necessary qualifications to make that assessment even if we did have access to your son's records and could examine him.

You absolutely should not tolerate being yelled at by your son's physician. I would confront her and ask for an apology and/or leave her practice. However, please do continue to see a qualified care provider and track your son's growth. If he truly is malnourished it can have long-term effects on his physical and mental development. Please try to find a care provider who will listen to you and work with you. Also, as a couple of previous posters mentioned, I would be concerned about CPS involvement if you are not being followed by a doctor closely even though you know there may be a concern about your son's growth.

My younger son gained less than a pound between his 12 and 18 month well child check. His head circumference and length were increasing appropriately. Weight is typically the first measurement to drop off the curve when a child is not consuming adequate calories, followed by weight and then head circ. Our pediatrician recommended weaning in a kind and respectful, but concerned manner. I thought about it and decided I wasn't comfortable weaning before the age of two. She was okay with that and was completely willing to work with me to get him gaining appropriately without weaning. He is now three and a half (and weaned at 2 1/2) and is still tiny, but is roughly following the fifth percentile curve.

Perhaps you can find someone willing to work with you to meet your son's needs without weaning? IME, it is very hard to find a physician who feels strongly supportive about delaying vaccines and breastfeeding beyond a year of age. However, I don't think it is too hard to find a doctor who is respectful of a variety of parenting choices and is willing to support delayed vax and extended breastfeeding even if it is not a choice she would make for her own children. I would suggest making some phone calls and interviewing some doctors. Good luck!


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## Toposlonoshlep (Jan 14, 2010)

Quote:


> Originally Posted by *mamakaikai*
> 
> Aside from your distaste for being yelled at, makes sense, it sounds to me like your concerns are with regards to extended breastfeeding and the part about malnutrition. Firstly, many children are breastfed well beyond the age of your child, mine is one of them. Breastfeeding is known to complement nutrition for a child your sons age. So I see no need to wean your child. Weaning as far as I'm concerned is between you and your child and you can continue to see your Dr. and get decent care even if there is a disagreement about what age one should wean their child. I think it is possible that your Dr.'s intent may have been that sufficient nutrition is not being met with a diet of mostly breastmilk. Therefore suggesting that nutritional needs may be more adequately met with a more substantial non-milk diet. So perhaps decreasing breastfeeding is not a bad idea, so that the child may be more interested in other food sources, thus gaining more sustenance from a variety of sources.
> 
> ...


Thank you for this! You pretty much hit the nail on the head with your understanding of concerns outside of the whole heavy-handed approach factor. He is good with iron (just had him tested), but I have been relying primarily on breast milk for calcium and hence the nursing on demand. I do see him relying on the breast milk to the point of choosing it over food, so in the best case scenario, we find a way to balance the nursing with the meals without weaning. I think I just need to be more conscious of when and under what circumstances I nurse him. As for butter and oil (we add coconut or olive oil), I have been supplementing all of his foods with such boosters. I really do think the issue at this point is the quantity. Some days he will eat full meals, other days hardly any solids at all. Thanks for your care and for your perspective.


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## Toposlonoshlep (Jan 14, 2010)

Quote:


> Originally Posted by *mamatoElias*
> 
> I cannot give an accurate opinion on whether or not your child is malnourished or not based on the information in your post. I'm sorry to say that neither can any of the other ladies on this board. We simply do not have access to your son's medical history and physical exam. And most of us do not have the necessary qualifications to make that assessment even if we did have access to your son's records and could examine him.
> 
> ...


Thank you for this. My plan of action as of right now is to search for a just-in-case replacement ped while working with this one and going to regular appointments with her. I am by no means AVOIDING medical care for my son, and I even told her that when she said she was intimidated by my DH and I. I told her I value her expertise and opinions and consider her advice, and that I would like to work with her. I may be misunderstanding, but you said that things drop off in this order: weight, height, head, right? If I understand that correctly, then his small head must really be genetic, as he is in the 45% for height and at 4.7% with his head (which is also the case at birth). Thank you for all your help!


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## Marissamom (Dec 17, 2009)

Quote:


> Originally Posted by *mamakaikai*
> 
> Aside from your distaste for being yelled at, makes sense, it sounds to me like your concerns are with regards to extended breastfeeding and the part about malnutrition. Firstly, many children are breastfed well beyond the age of your child, mine is one of them. Breastfeeding is known to complement nutrition for a child your sons age. So I see no need to wean your child. Weaning as far as I'm concerned is between you and your child and you can continue to see your Dr. and get decent care even if there is a disagreement about what age one should wean their child. I think it is possible that your Dr.'s intent may have been that sufficient nutrition is not being met with a diet of mostly breastmilk. Therefore suggesting that nutritional needs may be more adequately met with a more substantial non-milk diet. So perhaps decreasing breastfeeding is not a bad idea, so that the child may be more interested in other food sources, thus gaining more sustenance from a variety of sources.
> 
> ...


that link is to the CDC growth charts, not the WHO growth charts, and he's doing a lot better according to the WHO growth charts.


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## crunchy_mommy (Mar 29, 2009)

Quote:


> Originally Posted by *Toposlonoshlep*
> 
> Ha ha. Yeah, my husband has always had issues with people judging his health and strength based on his physique. But he is a hardcore yogi and has the immune system of a superhero, so big ain't always strong. I can't downplay the well visits because she came down HARD on me for skipping a couple. Said she would not condone it and that she cannot track my child's growth if I don't bring him in....*sigh*


She's right, if you want to continue to work with her, there are minimum efforts from you that she needs. She does need to see him to track his growth & she does need to know that she's not wasting her breath giving you a bunch of ideas that you won't follow. It's a relationship; both sides need to work at it to make it work, but there's absolutely no reason for her to be so unprofessional about it, nor is there any need for you to continue the relationship if you feel like it's not in your/DS's best interest.

Quote:


> Originally Posted by *Katwoman*
> 
> Okay, the comment about you needing to come in every month because he's malnourished is fairly distressing to me. Does anyone know what the threshold for her mandatory reporting of the health of a child? I think scheduling an appt with another doctor would be something you would want done ASAP. The new doctor can check your child out and you could have something "on file" about your child not being malnourished. (I know, I know, easier said than done.)
> 
> ...


This is a concern I have for you as well. You certainly don't need to comply with everything your doctor recommends but if the doctor feels your child is at risk (and it's clear from what you've said that she very likely does), she is required to report it. We switched pedi's for this very reason; it was clear that our former doc did not feel that we were doing what was in DS's best interest (even though we made very educated & informed decisions & he was healthy as a horse). I would have worried that the next step would have been calling CPS (which we could absolutely be cleared of if they investigated but why invite trouble into your life?

It's not hard at all to switch doctors. Inconvenient, yeah, but not hard -- I went over to finding your tribe & got some recommendations. I called the one I liked best & scheduled an appointment. I called my insurance to switch PCP's. That's all... took me no more than 20 minutes total. And I *LOVE* my doc now. (I'm sure it's possible that there really ARE no other docs in your area but that's what I thought too & was surprised to find out that there was someone perfect for us if I just drove 5 or 10 minutes further!)

Quote:


> Originally Posted by *mamatoElias*
> 
> Perhaps you can find someone willing to work with you to meet your son's needs without weaning? IME, it is very hard to find a physician who feels strongly supportive about delaying vaccines and breastfeeding beyond a year of age. However, I don't think it is too hard to find a doctor who is respectful of a variety of parenting choices and is willing to support delayed vax and extended breastfeeding even if it is not a choice she would make for her own children. I would suggest making some phone calls and interviewing some doctors. Good luck!


This is important too. If someone had medical concerns about DS that I was unsure about or didn't quite agree with but still nagged at me a bit, the biggest thing I would want is a second opinion. Even if you don't want to switch pedi, it might benefit you to make just one appointment with someone else so you can get a fresh perspective & re-evaluate whether your DS is on track. Most of us assume your DS is doing great because it sounds like YOU believe he's doing great, mom's intuition is likely on target, but we don't know your kid & we don't have a full, objective perspective. If you plan on bringing him in every month, you need to be prepared to comply to some extent with her suggestions -- otherwise, what is the point of bringing him in? And there are many doctors who will work with you without requiring you to wean.

I think I had another point but now I forget it lol plus I'm really rambling, sorry!!


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## MrsBone (Apr 20, 2004)

The bread recipe:

http://www.elanaspantry.com/gluten-free-bread-20/

I can eat one slice and feel full for hours. If he likes it at least then you can get as much fat and calories into him at once as possible 

The cracker recipe:

http://www.elanaspantry.com/rosemary-crackers/

In the crackers, I leave out the rosemary and add a touch of honey to give it a more sweet/salty taste.

But the website is great for lots of recipes too! It's very almond flour/agave nectar focused, but you can sub sweeteners for all her recipes. Don't sub the almond flour though..it won't turn out the same!


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## mamakaikai (Apr 17, 2009)

Quote:


> Originally Posted by *Marissamom*
> 
> Quote:
> 
> ...


Actually, it IS the WHO chart. Look at the bottom of the chart on the left where it says Source. It's also indicated in the webaddress too that it's a WHO chart. The WHO growth charts can also be accessed from this website, which comments about the importance of using growth charts representative of the difference between breastfed babies and formula fed babies. If you were to actually print the chart and plot a 20 pound 20 month old, you would see that the point would be made completely off the chart.


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## dancingWNC (Dec 12, 2007)

I really agree with what Mamakaikai said. I hope you can find the time and energy to look for a new ped right away.

As well, there may be some concern about getting reported if you do not comply. What many people are unaware of is the H.E.A.V.Y. pressure being put on docs to force compliance with the medical standards. Docs are being encouraged (actually if you read the med articles it's more like scaring them) to fire patients who do not comply. It's completely backwards to the "informed patient" attitude that we here employ. So shopping for a good doc is something you want to do sooner rather than later.

That said, *hug*!! I have a dd who dropped off the WHO charts entirely between 18 months and 2 years. She actually DID get lean and start to look too thin, and almost sickly. We tried feeding her everything at all hours of the day. My DH even got up at night to feed her a bowl of peanut butter and honey (which he often inserted hemp seeds, acidophilus, etc into) when she woke fussing that she was hungry. I think she at as much at 3 & 4 am as she did in the day altogether. .... sigh. It was a very difficult time.

Some suggestions:

- use almond milk - but make sure it's one of the ones that has lots of calcium. or even switch from peanut butter to almond butter. Ours eat it by the spoonful.

- sit with your little one and try making eating time a social time. ours eats much better if we let her sit on our lap to snuggle and feed bites - she comes and

- eat playfully - my DH plays a mouse game with our girls - they get under the table, and he puts a spoon of food under the table and says, "I hope a mouse doesn't eat my bites." "Noooo! Don't eat my bites!" (reverse psychology). He also pretends that his food is so good and "begs" them not to eat his food.

gotta go - baby is waking!


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## rebecca_n (Nov 1, 2010)

my son is 24 months old and 21 and a half pounds. his doctor is finally laying off us about his weight after this last round of blood tests where they checked for celiac disease as well as thyroid and vitamin problems. he's always met his milestones and is active active active. if your son is healthy, and you would know if he wasn't, then keep doing what you're doing. i get so frustrated at doctors who know next to nothing about breastfeeding. you're son is very lucky to have you for a momma


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## flightgoddess (Mar 4, 2009)

Well, my kid is a string bean too, he's 26 months and 25-26 lbs. We finished BF around 18 mo? Anyway, keep BF if you want to. YOU eat as much nutrient and fat dense foods too, butter, whole milk, nuts, etc. The foods you feed your son sound healthy, keep doing it.

Definatley get any related blood tests: anemia, lead, thyroid, also ask about celiac blood tests. One 'symptom' for babies is often 'failure to thrive, malnourishment, or slow growth'. It can't hurt to check.


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## Spring Lily (Sep 26, 2006)

Here's the thing: weaning has nothing to do with the real issues here. If he's not eating well yet and the ped is concerned, her job is to make the appropriate referral. If he has issues with texture or aversions to trying new food, maybe get him evaluated by an OT or something. Ask that you check witht he allergist about further testing. Send you to a dietician about the food choices. Talking to you about cutting down the number of times you nurse during the day, or coming up with a plan to offer x, y, and z foods before you nurse him. Those are all plans to get to the root of the problem. Telling you to wean is not. So, even if for a second you ignore the inappropriate way she told you, it does concern me that she chose that approach. Has she done blood tests to determine if he truly is lacking in nutrients?

I can really relate in a lot of ways because my twins are small, were born small (like 1/2 the weight of your son) and weren't close to 20 pounds at 18 mos, and were on limited food as well, and no dairy at all. Oh, and we're vegetarian. I'll tell you my experience, because sometimes it's nice to know how other doctors handle similar situations. My pediatrician was glad that I was nursing because it was giving them that little bit of extra that they needed. We did blood tests to check on their iron levels, in part. We wanted to get the whole picture. I went to an allergist who ran celiac tests and quite a few others. Iron-deficiency, celiac disease, and wheat sensitivities can cause kids to be really underweight. I also met with a dietician, twice, to discuss in depth the foods and meals I was giving them. She came up with a bunch of ideas for me, including mixing in oils to certain foods, to give them extra calories. She also took my limited list of foods they could eat at the time and thought of a few other recipes I could make, with plenty of oil added in. Fats are so important, especially when dairy isn't an option. When all of that only made a small dent in the problem, my ped said they are just metabolizing everything they eat. That isn't a bad thing. She was more concerned with family history of sizes and metabolism, and the babies sticking to their own healthy curve, regardless of if they're on the charts or not.

Edited to add: I forgot to mention that the main focus of the dietician was actually protein rather than fat. They're both important, but each meal or snack should ideally include a good amount of each of those things. If you focus on getting him bigger proportions of protein, it could help make a difference.


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## AKislandgirl (Jun 2, 2008)

It can be hard having a baby/toddler off of the charts. My daughter is also tiny. At 22 months she weighs 20.8 pounds. What we looked for was her dropping off of her own curve not off of general charts. We did track her weight every month for a while and when we saw that she was maintaining her own curve we relaxed a bit about it. We have also focused on adding fats to just about everything she eats. Almost everything gets flax oil, butter, coconut milk, etc... Another thing was that she had some terrible skin issues that we thought was food/allergy related. It took some time to figure out but now that she (and me!) is gluten free her skin has cleared and she is gaining at a more steady rate. We also looked at her other milestones. She was and is meeting and exceeding them.

My Dr told me she weaned her son at 20 months and looking back she wishes she had nursed him longer. She is glad that we are still nursing! She said that as long as I am comfortable with it she encourages me to stick with it. I'm sorry for the way your Dr is treating you but I would take some of her advise about tracking weight and such. It would be great for you to find a Dr you were more comfortable with who could help you. I didn't know if my daughters weight was something to be concerned about or just the way she was. I am soo glad that we followed through in keeping track of things so that I can be assured that she is healthy and growing on her own pace.

Good luck Mama!


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## Toposlonoshlep (Jan 14, 2010)

Well, here is the update...Because I got quite a few responses with concerns over the Dr. calling CPS on me (which would be a silly thing to do...), I was really set in not closing myself off to her and explaining to her that I am not ready to wean. She recommended a blood test for lead/anemia, as well as a cardiologist visit (she heard a murmur at the last visit that she thinks is innocent, but she wants to be sure and rule it out). My concern is that the heart murmur is from anemia and potentially also responsible for slow weight gain. I didn't know that anemia could restrict growth before I posted this. Just in case, I am giving him some Floradix (which is supposed to be more bio-available than the PolyViSol I was previously giving him). I have scheduled both appointments. I told her I am not AGAINST her, but that I am defensive about breast feeding and using healthy foods to boost my kid's growth. She apologized that she came down hard on me (although she was still indignant) and told me that she has seen a lot of low-weight kids and was able to get them back on the curve. She repeated that a lot of her kids with allergies are skinny and that genetics certainly play a large part in it. She recommended we make mealtime more ceremonious and fun for him, and I think that's a great idea. Most importantly, she said that I could cut down on daytime nursing to allow him to get a taste for a variety of foods. She said to think variety, not quantity. She said she would like to see us every 2 months to monitor his growth and I agreed. Overall, I am glad I called to talk to her, because I feel as though I could work with her better without it getting "personal" like that again. Next time she gets personal, I am certainly out for good.

I cannot thank you all enough for all of your fabulous advice and for the love. I really feel encouraged to approach this with love, patience, and instinct. You guys rock!


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## belltree (Mar 10, 2009)

That sounds like you found a great solution. I am happy for you. I know it is so hard to not worry, when your child does not seem to be growing well. It is great you are paying attention, and most kids, that fall out of their growth curve eventually catch up again.


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## weliveintheforest (Sep 3, 2005)

I'm glad to read your positive update! I hope you get good info from the tests.


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## shanniesue2 (Jul 4, 2007)

Quote:


> Originally Posted by *Toposlonoshlep*
> 
> Well, here is the update...Because I got quite a few responses with concerns over the Dr. calling CPS on me (which would be a silly thing to do...), I was really set in not closing myself off to her and explaining to her that I am not ready to wean. She recommended a blood test for lead/anemia, as well as a cardiologist visit (she heard a murmur at the last visit that she thinks is innocent, but she wants to be sure and rule it out). My concern is that the heart murmur is from anemia and potentially also responsible for slow weight gain. I didn't know that anemia could restrict growth before I posted this. Just in case, I am giving him some Floradix (which is supposed to be more bio-available than the PolyViSol I was previously giving him). I have scheduled both appointments. I told her I am not AGAINST her, but that I am defensive about breast feeding and using healthy foods to boost my kid's growth. She apologized that she came down hard on me (although she was still indignant) and told me that she has seen a lot of low-weight kids and was able to get them back on the curve. She repeated that a lot of her kids with allergies are skinny and that genetics certainly play a large part in it. She recommended we make mealtime more ceremonious and fun for him, and I think that's a great idea. Most importantly, she said that I could cut down on daytime nursing to allow him to get a taste for a variety of foods. She said to think variety, not quantity. She said she would like to see us every 2 months to monitor his growth and I agreed. Overall, I am glad I called to talk to her, because I feel as though I could work with her better without it getting "personal" like that again. Next time she gets personal, I am certainly out for good.
> 
> I cannot thank you all enough for all of your fabulous advice and for the love. I really feel encouraged to approach this with love, patience, and instinct. You guys rock!


I'm glad you talked with her. I think that if you want to stick with her, all parties involved are going to need to work on some relationship re-building... it soulnd like things in that area have gotten off track.

As for the cardio appt. if she thought she heard a murmur, then it's a good thing to check it out. Our new doc heard a murmur in DS and that's how we found the cause for his weight plateau (he only gaind 4 pounds btw 5 months and 17 months). So that is a good thing to look into.

I think that it sounds like you guys are getting things worked out and coming to a good solution. I hope that it continues in a good direction.


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## mamaofthree (Jun 5, 2002)

coming from a medical background, my biggest issue with the medical profession as a whole is the idea that they know best and some can get so bullying to the people they are suppose to care for. it takes alot for people to stand up and question their doctor. i am glad you did. and she needs to say she is sorry. she can be concerned but bullying and being disrespectful is just a no go in my book. it makes me mad when doctors get all nasty and then refuse to say what they said or how they said it was wrong.

it is so important for people to be educated and to question even the best doctor if you don't agree with what they said or understand it.

h


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## klk197 (Apr 24, 2009)

Another option (and the one we used with my small fry): find out if there is a lactation consultant/nutritionist in your city. If one is available, it would take the weight and breastfeeding issues out of your ped's hands, and you could maintain your relationship for the other reasons you selected that doc. In my case, the children's hospital has one on staff, and since it was classified under "nutrition" rather than "LC", my insurance covered it. It was the best decision we made to get my son back on the growth curves.


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## Toposlonoshlep (Jan 14, 2010)

Quote:


> Originally Posted by *klk197*
> 
> Another option (and the one we used with my small fry): find out if there is a lactation consultant/nutritionist in your city. If one is available, it would take the weight and breastfeeding issues out of your ped's hands, and you could maintain your relationship for the other reasons you selected that doc. In my case, the children's hospital has one on staff, and since it was classified under "nutrition" rather than "LC", my insurance covered it. It was the best decision we made to get my son back on the growth curves.


Huh. I like the idea A LOT. She did recommend I see a nutritionist, but I really feel I have a grasp on what foods to be offering him these days. It would be very cool to have an LC/nutritionist to talk to, though. What did you search for? I can probably look on my insurance's web site for something of the sort, but would she be called a nutritionist?


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## klk197 (Apr 24, 2009)

Quote:


> Originally Posted by *Toposlonoshlep*
> 
> Huh. I like the idea A LOT. She did recommend I see a nutritionist, but I really feel I have a grasp on what foods to be offering him these days. It would be very cool to have an LC/nutritionist to talk to, though. What did you search for? I can probably look on my insurance's web site for something of the sort, but would she be called a nutritionist?


I have friends who work at our local children's hospital and alerted me to this option. Only later did I find out she's a rock-star in her field (both relative to my own experience with her and in her broader professional work). Hopefully you'll be able to find an equivalent "angel"--I'd first investigate your local hospital if there is one. This LC floated among several departments. I think I was billed through the GI dept, but she was often in the NICU, allergy, and developmental delays areas of the hospital. good luck!


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## cart-kay16 (Jul 27, 2011)

i wouldnt worry i think breast feeding is great ifu dnt wanna stop then dnt i knw a friend of mine that still breat feeds he 3 year old


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## holothuroidea (Mar 30, 2008)

You're not doing anything wrong and your baby isn't malnourished if he is gaining some weight, meeting his milestones and is generally happy.

I make tiny babies, too. My first DD was 19lbs at her 2nd birthday. She also fell off her curve a little bit, first at 9 months then again at 18. They did some tests to rule out malabsorption issues but she tested fine and nobody's worried.

Why did she yell at you? I don't know, maybe she just had a thorn in her paw that day.


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## waiyi (Jan 30, 2010)

My 18-months son is less than 21lbs, he is picky eater, so nursing is a MUST. Everyone comments how small he is, but I was underweight even though I ate like a cow when I was young, I think he just got my genes, so I don't have problem with him underweight, as soon as he is happy and active, and he seldom gets sick. I don't see the weight should be an issue.


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## nia82 (May 6, 2008)

Granted, my son is not little, but he gained 6lbs in 2 years. He weighed 31lbs at 12 months (and that was EBF with some yogurt started at 11 months) and now at 3 years (he'll be 3 in 3 weeks) he weighs 37lbs. It's common for toddlers to not gain much. His cousin, who has always been tall but super lean (pants fall off of him) weighs 24lbs at 3 years. And yes, he nurses still and eats foods just like your son. His pediatrician is not concerned at all. Some children are just more petite than others. Goodness I weighed as much as an average 3 year old when I was 6! As long as your child is healthy and meets milestones, I wouldn't worry.


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