I am not a large person. At 5 foot 8, I'm taller than average, but I've always been a healthy size and my weight gain during both my pregnancies was well within the range recommended by my doctor. My husband isn't a big guy either.
So it was no surprise to me that both kids seemed to follow those same growth trends. Both were the same size at birth, just over seven pounds. My daughter was an ounce heavier and an inch shorter. Both were healthy. I was happy. So why were so many others concerned with their size, or lack of it?
Among the many comments I heard from mostly strangers were:
"Is your pediatrician okay with you breastfeeding?" (Of course she was.)
"When are you going to stop breastfeeding?" (None of your business.)
"Wow, my baby is the same age and he's much bigger-was he premature?" (No, actually he was born on his due date. And hey, guess what, it's not a contest.)
"If you give her some formula, she'll grow more." (Actually, she's growing just fine, thanks.)
I got to be pretty good at brushing off the comments and ignoring the unwanted advice, but the more I looked into it, the more stories I heard about parents of breastfed babies being hassled by family members, strangers or even their own doctors about their lack of "adequate" weight gain, regardless of the size of the parents or the health of the child. Why, in the face of a childhood obesity epidemic, does bigger continue to equate with better? Why are growth charts considered to be the number one indication of a child's health, rather than just one tool of many to assess wellness?
Consider the following:
**Ounce for ounce, breast milk contains far more naturally occurring ingredients than cows milk-based formula does. According to Dr. Sears, when vitamins and minerals are added to formula to compensate, it makes it harder to digest. Breastfed babies generally need to eat more often because of the easier digestibility of breast milk.
**A 1992 study at UC Davis showed that breastfed babies tend to be leaner than formula fed babies. Specifically, while weight gain for each group was similar, the breastfed babies had a lower weight for length ratio.
**Many doctors in the USA are still using the charts from 1977, which are based on decades of measurements of actual children, most of whom were formula fed. The CDC updated the US growth charts in 2000, and these charts can be used to track the growth of exclusively breastfed infants, but don't take into account how breastfed babies tend to grow. In 2006, the WHO published growth charts that represent healthy breastfed babies, but many doctors don't use them.
While both my kids are at the bottom of the US growth charts, they score significantly higher on the WHO charts. In addition, while small, both mostly stayed on the same growth trajectory as they got older. While my son did have a milk protein allergy, removing any traces of milk from his diet fixed his symptoms. And two years later when my daughter was born and she grew in almost the exact same way her brother did, without a milk protein allergy to complicate or slow things down, I didn't worry. She was healthy, and was just growing the way her genes had programmed her to do.
Still, I wondered. Are breastfed babies doomed to be the shorter members of their classes, simply because of how their mother's choose to feed them? Out of curiosity, I posted a poll titled "How Large or Small Were Your Children On The Growth Chart?" 30 people voted and the results looked like this.
So it was no surprise to me that both kids seemed to follow those same growth trends. Both were the same size at birth, just over seven pounds. My daughter was an ounce heavier and an inch shorter. Both were healthy. I was happy. So why were so many others concerned with their size, or lack of it?
Among the many comments I heard from mostly strangers were:
"Is your pediatrician okay with you breastfeeding?" (Of course she was.)
"When are you going to stop breastfeeding?" (None of your business.)
"Wow, my baby is the same age and he's much bigger-was he premature?" (No, actually he was born on his due date. And hey, guess what, it's not a contest.)
"If you give her some formula, she'll grow more." (Actually, she's growing just fine, thanks.)
I got to be pretty good at brushing off the comments and ignoring the unwanted advice, but the more I looked into it, the more stories I heard about parents of breastfed babies being hassled by family members, strangers or even their own doctors about their lack of "adequate" weight gain, regardless of the size of the parents or the health of the child. Why, in the face of a childhood obesity epidemic, does bigger continue to equate with better? Why are growth charts considered to be the number one indication of a child's health, rather than just one tool of many to assess wellness?
Consider the following:
**Ounce for ounce, breast milk contains far more naturally occurring ingredients than cows milk-based formula does. According to Dr. Sears, when vitamins and minerals are added to formula to compensate, it makes it harder to digest. Breastfed babies generally need to eat more often because of the easier digestibility of breast milk.
**A 1992 study at UC Davis showed that breastfed babies tend to be leaner than formula fed babies. Specifically, while weight gain for each group was similar, the breastfed babies had a lower weight for length ratio.
**Many doctors in the USA are still using the charts from 1977, which are based on decades of measurements of actual children, most of whom were formula fed. The CDC updated the US growth charts in 2000, and these charts can be used to track the growth of exclusively breastfed infants, but don't take into account how breastfed babies tend to grow. In 2006, the WHO published growth charts that represent healthy breastfed babies, but many doctors don't use them.
While both my kids are at the bottom of the US growth charts, they score significantly higher on the WHO charts. In addition, while small, both mostly stayed on the same growth trajectory as they got older. While my son did have a milk protein allergy, removing any traces of milk from his diet fixed his symptoms. And two years later when my daughter was born and she grew in almost the exact same way her brother did, without a milk protein allergy to complicate or slow things down, I didn't worry. She was healthy, and was just growing the way her genes had programmed her to do.
Still, I wondered. Are breastfed babies doomed to be the shorter members of their classes, simply because of how their mother's choose to feed them? Out of curiosity, I posted a poll titled "How Large or Small Were Your Children On The Growth Chart?" 30 people voted and the results looked like this.
I breastfed and my babies were smaller than average. (5/30-16%)
I breastfed and my babies were larger than average. (11/30-36%)
I breastfed and my babies were average size. (8/30-26%)
I formula fed and my babies were smaller than average. (1/30-3%)
I formula fed and my babies were larger than average. (4/30-13%)
I formula fed and my babies were average size. (3/30-10%)
I breastfed and my babies were larger than average. (11/30-36%)
I breastfed and my babies were average size. (8/30-26%)
I formula fed and my babies were smaller than average. (1/30-3%)
I formula fed and my babies were larger than average. (4/30-13%)
I formula fed and my babies were average size. (3/30-10%)
I didn't know what to expect from the poll, but the results show one thing candidly--babies come in all shapes, sizes and weights, regardless of how they are fed. Yes, both my children were little, but it wasn't because they were breastfed or because there was anything wrong with my breast milk.
Both kids are older now, and they remain small. My almost three year old is a twenty-five pound bundle of energy that eats anything that doesn't eat her first. At my son's recent five-year well child visit, his BMI categorized him as underweight, but his pediatrician isn't concerned. He did gain both weight and height over the past year, is rarely sick, is meeting or exceeding his milestones. He's just on the skinny side--just like his dad, his grandfather and other assorted male family members.
How about you? How were your breastfed babies sized, and did anyone hassle you about it?
**crossposted at API Speaks
Both kids are older now, and they remain small. My almost three year old is a twenty-five pound bundle of energy that eats anything that doesn't eat her first. At my son's recent five-year well child visit, his BMI categorized him as underweight, but his pediatrician isn't concerned. He did gain both weight and height over the past year, is rarely sick, is meeting or exceeding his milestones. He's just on the skinny side--just like his dad, his grandfather and other assorted male family members.
How about you? How were your breastfed babies sized, and did anyone hassle you about it?
**crossposted at API Speaks
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14 comments:
I nursed my daughter until she was 15 months old. When she was born she was 8lbs 4oz. She started gaining weight and just kept on gaining. She was enormous. She started out somewhere near the 50th percentile and continued on a trajectory that carried her waaaay outside the 100th until she started walking after her 1st birthday. My pediatrician would joke with me about bottling my breast milk or at least sharing it around a little.
I nursed both of my children for 11 months. For some reason, my body just doesn't want to produce milk after that. Anyway, my daughter was so tiny (healthy, but tiny) that a had a doctor (one of the other doctors in the practice, not mine) accuse me of not giving her enough nutrition! That child ate like 15 times a day! When my actual doctor called me back after my hysterical calls, he assured my that K was as healthy as could be and not to worry about it at all. And guess what, she is still super skinny to this day...tall and skinny. And totally healthy!!!
all 4 of my kids have been combination breast fed/formula fed. exclusive breastfeeding in first six months with a bit of formula here & there when i didn't produce enough no matter how hard i tried. they have all been in different places on the spectrum. the twins were in the 10-20%, boy was 50-75% & my youngest is the biggest at 75% - off the charts. they're all different. i think people just love chubby babies & can't help but want to give unsolicited advice.
I formula fed all three of mine, but looking back, wish I had tried breastfeeding. And being 5'9" myself, I expected them all to be off the charts in height, but they weren't. They were healthy and average. My oldest was always on the chunky side until high school when he grew to 6'3" and thinned out. My middle child was always skinny and on the shorter side until high school when he also grew to 6'3" and remains skinny. And my daughter, the youngest, has always been very solid and has reached about 5'8".
I find it ironic that you felt chastised over breastfeeding. I always felt like I was chastised because I didn't.
I breastfed both of my children exclusively for the first 3 months and then used a combo of breastfeeding and formula because they were in daycare and I couldn't pump enough. I have one who is sort of tall and thin and one who is short and stocky. There is 2 years in age, 8 inches in height and 6 lbs difference between the two at the moment. They are both happy and healthy little kids. My original pediatrician never even mentioned a growth chart to us so I never had a clue where my kids actually fell, I had to look it up myself. My new pediatrician tells me that my youngest is in the bottom 25% for height. I think I prefer not to know because it doesn't really matter and its not like I can do anything to make him grow into the 50th or 75th percentile even if I wanted to. I think they are perfect the way they are.
Terri--Overwhelmingly, my experience nursing my babies was positive. No one ever gave me an ugly look in public and most people, when they found out I was nursing, said something along the lines of "good for you!" And when I had milk supply issues, I had plenty of support and resources to get me through it. But the (very small) handful of people who had something to say about it were not anti-breastfeeding in general, they just automatically equated my kids' small sizes to the fact that they were breast babies, and implied that there was something wrong with *me* because my babies weren't round and fat. And yes, some babies are round and fat and perfectly healthy, but someone has to have the little ones too!
I think sometimes we're damned if we do and damned if we don't. I think breastfeeding is important and women should be given the information and support they need to make the right choice for their families. But a mom should be able to pull out a bottle in public without having to explain why too.
I agree with you about damned if we do and damned if we don't. For some reason people feel threatened if we make a different choice than they did, whether its BF/FF, homeschool/public school, family size, SAHM/WOTHM etc.
I'm glad to be past the stage in my life where my breasts/belly are the topic of other people's casual conversation.
My daughter was breastfed exclusively. She is small and I never worried about it because she was active and healthy but her pediatrician harped on it again and again and again. It was extremely frustrating and also one of the reasons why we're switching doctors. Charts are useful as a reference but not to the exclusion of all other available data.
It was 1979 and everyone and their brother wanted me to feed Grace something other than breast milk. She had colic and it was tempting and occasionally, I did try a little cereal or processed mush, but it didn't make any difference. She was always small to average; her brother, also breast-fed, was alway huge. It seems to be mostly in the genes, unless you're talking about malnutrition.
A funny story: I had just moved to Cumberland, Maryland with my ten month old daughter. I was at the bank opening accounts, it was taking a long time, and Grace was getting hungry and fussy. "Do you mind if I feed my daughter?" I asked the bank lady. "No, not at all," she said. I discreetly lifted the corner of my blouse and fed Grace. Cumberland is a small town and I was surprised to hear later through the grapevine how shocked the bank lady was. My aunts just whipped it out anytime without the discretion. Have things changed?
all four of my kids are breastfeed babies. They are all very tall and slender for thier age, and thats fine. They are healthy kids who eat good diets and had the best start ever. Formula is a lot of fat, which isnt a great thing,
You would think with the national trend of obesity in kids the kids who are normal sized would make doctors, family and whoever glad.
I'm currently BFing my almost 14 month old. He was exclusively BF'd til 6 months when we started with B-LW.
He's tall and skinny. Top to middle of the graph for weight, but off the charts for height so could be interpreted as underweight. I don't do regular health checks but was given a VERY hard time by the hospital staff (midwives/LCs of all things!) about his weight.
He was very slow to gain and took 6wks to regain birth weight. We had issues with tongue tie and everyone was freaking. However as a baby I and my sisters were also slow to gain and long and skinny. It's just genetics I guess, and certainly nothing to worry about.
My first son (now 5) was FF, as a baby was average length and top of the charts in weight. However he has completely different genetic origins to my 2nd.
Both boys were practically identical in weight/length at birth (same gestation).
I recently posted about this very topic, too. The male pedi in the practice we go to has given me a hard time every time we've seen him. I nurse my twins and they've always hovered between 15-30%. They're on track developmentally, extremely active and bright, and produce plenty of dirty diapers as proof of their healthy diet. My husband's extremely lean naturally, and I'm barely 5'2" (average weight). I get a mix of reactions about breastfeeding, but most everyone comments on how "small" my girls are. It really gets to me sometimes and makes me doubt myself A LOT. I still don't supplement, though I've been tempted to out of paranoia.
My daughter is just over 2 months old, and I've been breastfeeding her since she was born. At her 1 month checkup we were seen by a nurse practitioner rather than her normal doctor. She immediately voiced her concern with how little weight my baby had gained, and asked us to come back in a week for a weight check. Now, this is my first time bf'ing so, naturally, I was worried. When we returned we saw the pediatrician, and though at this checkup my baby was shown to have lost a couple of ounces, the doc still wondered why the N.P. asked us to come back at all if my baby was well within normal weight standards for her age. Just to make sure I paid a visit to a lactation specialist and, by all accounts, I was doing just fine bf'ing. A whole lot of worry for nothing! At my baby's two month checkup, her weight was just fine, not to mention she measured LONGER than most babies her age. But even without all the numbers you can tell she's developing nicely!
I breastfed my son until 17 months. I am 5' 5",and his father is 5'4". My son is now 15 years old and 6'1", so I'm quite sure breastfeeding doesn't adversely affect lifelong growth! Also, I am a vegetarian and maintained my diet throughout pregnancy and nursing.
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