"Underweight" child.

When my daughter was 6 months old, things started going haywire with her growth chart. By haywire, I mean she wasn't gaining weight the way they like to see it happen with kids her age.
By not gaining weight the way they like, I mean her growth curve plateaued. Flatlined. Freaking STOPPED. It's almost impossible not to panic in that situation.

The worry was compounded by the night, referenced in the previous post, when she had what we later found out was an absance seizure. There were no more until 7 months, when she had several more of them. She was hospitalized, an EKG and EEG were run. There were blood tests and the fear in our house was a fog as thick as pea soup. We were absolutely terrified.

The tests were all normal, and there's not been another seizure since shortly after that hospital visit at 7 months. Ultimately, after a lot of research and connecting of the dots, when we saw a recurrence of the rashes that appeared when she had seizures, we found out that she is extremely intolerant of foods that are high in salicylates. What started out as a major orange juice craving for me turned out to be dangerous for her - but it saved us the scare of her first introduction to orange juice being straight out of the cup at around a year, when it might have been incredibly dangerous for her.

Back to the weight thing.

We could not understand why she wasn't gaining weight, blood tests had ruled out any genetic or metabolic reason, and we were all just perplexed. On paper, she fit the definition of failure to thrive. However, we knew that couldn't be right. She was ahead on every possible milestone and doing extremely well. In fact, if we had never laid eyes on a growth chart we'd know she was petite but never would have thought something was wrong with her. Even with the people who asked "don't you feed her?" At one point we were having weekly weight checks. I'd get excited, knowing she'd eaten really well in the previous week, only to be devastated by a growth of an ounce or two...sometimes none. I'd just know she'd grown, her clothes fit differently.

Then we realized during one two month period, she'd gained only a few ounces but she'd grown two inches in height. Further talk with the pediatrician pointed to the knowledge that calories go first to their growing brains, then their heights, THEN weight. She had two out of three, and we decided unless there were other reasons to worry, we were going to STOP freaking out about this.

It was hard to let go of the worry about why she wasn't gaining, especially having heard that kids grow really fast the first year and slow down the second. My daughter was the complete opposite, and when she hit 18 months she really started gaining faster. She's still petite, but you'd never look at her and think she was underweight. She's tall and thin and has a quick metabolism. She eats until she is full and stops, something many of us just don't know how to do.

Last night I talked with a friend who was worried. Her son, 20 months old, hasn't gained much weight in recent months and her pedi has her worried. I've seen him very recently and petite isn't a word ANYONE would use, but because he's in less than the 10th percentile for weight (he's TALL!!!!) they are concerned. She was asking me what we did with Em and food.

I told her the things my friends told me when I was worried about my own baby. To keep offering healthy foods, including good fats, but don't force food. To avoid making eating a power struggle and look at the baby, not the growth chart. To remember that if someone is in the 90th percentile, SOMEONE has to be in the 7th and that doesn't mean there's something wrong with them. That it's okay to rule out any problems, but assuming all comes back well it's ok to just acknowledge this may be his body type and that's ok. I reminded her of her brother - tall and lanky his entire life. I told her if the tests come back ok, and I'm confident they will, then to go with her instincts. If she wouldn't have worried BEFORE looking at the growth chart, it's ok not to worry after.

I realize the system of weight checks and growth charts is intended to track a child's progress, to catch problems before they get out of hand, but this system is not perfect. Just as there are children who achieve developmental milestones on their own time, they aren't all going to grow at the same rate or on a nice little curve.

And for the record - if you look at Em's growth chart now, and cover the plateau with your fingers, she's right back on her original curve. My son is now at the age where she started plateauing. I've introduced foods in the same order (Though I'm not drinking OJ while nursing!), and he has gained in a completely different manner. He eats more, gains more and weighs what she did at over a year. More than ever I realize she grew and is growing the way she is meant to, and so is he.