Tuesday, October 09, 2007

A healthy baby boy, and a disappointing doctor's visit.

Oliver is 6 months old today, and is a happy and healthy 25 pounds, 8 ounces and 28 inches long. Yay for my big healthy boy! My happiness at his glowing health was diminished a bit by the discussion that followed his exam.

I am going to find a new pediatrician. Our culture is so unbelievably paranoid about obesity, and this paranoia has apparently begun to rub off on her. Despite the fact that on average babies about double their birth weight by about 4 months of age, which in Oliver's case would have put him at 22 pounds 12 ounces at four months instead of 25 pounds 8 ounces at six months, my doctor suggested to me that I stop nursing him at night now.

Hmmm... we co-sleep, said I.

Oh, said she, well that will make it difficult to stop nursing him at night. We like to see babies his age sleep through the night and get all their nutrition during the day. So you should move him to his crib, and then stop nursing him at night.

Oh, I see, thought I, as she explained the health benefits of a crib sleeping baby. I should completely alter my parenting style and forgo any further co-sleeping or other attachment parenting planning because you like to see babies sleep in cribs through the night at six months of age without nursing.

Beyond simply waving away my parenting choices as unimportant or uninformed and failing to ask if I was interested in placing him in his crib at night, she went even lower in my opinion as her explanation continued.

She claimed it was to promote healthy sleeping and eating habits, and that is when it hit me. My pediatrician thinks my baby is fat. My handsome, amazing, baby, who has done his job of more than doubling his birth weight by six months.
He is not obese, he is a baby! When a baby's birth weight is over 11 pounds, of course he is going to be up in the 20 pound range at 6 months, unless there is some failure to thrive stuff going on. According to the experts, he is supposed to almost triple his birth weight at 8 months. If he does, he will be 34 pounds 2 ounces.

It sounds alarming doesn't it? A 34 pound baby? He must be fat! But a 6 pound baby is supposed to be 18 pounds around 8 months, because infants on average triple their birth weight in the first 8 months. Well, Oliver had a higher than average birth weight, therefore, it is a larger than average number when tripled. He would have to gain 9 pounds from today in order to meet the "average" increase in weight for babies his age. Yet I am supposed to stop him from eating at night.

Basically, I am supposed to limit my infant's calorie intake. Wait a minute.... I am supposed to put my baby on a diet?! Who on earth would put a baby on a diet? Don't most doctors tell parents not to limit their babies nutrition because they need it, including fat, for important brain development? Ack!

Anyway, I am seeking a new doctor, who at the very least, won't dismiss my parenting choices out of hand because she would like to see all babies sleeping through the night in cribs without nursing at 6 months. Babies are not kittens, or puppies, they are people. They are individuals. My little individual is afraid of his crib. If you put him in it, he cries his scared cry, his startled cry, his "mommy something is coming to get me please protect me" cry. Am I to teach him that his most urgent cry is something I won't listen to by leaving him in there to "get used to it"? What lessons will he really learn from being left somewhere that really scares him?

I don't believe 6 month olds need to be left in cribs to have good sleeping habits. My daughter never slept in a crib, and slept with me until she was 18 months old. Then we had one horrible week where she learned to sleep in her own bed, and she has had little to no trouble sleeping through the night ever since. For the most part, she goes to bed at 8 and gets up at 7, every night. Keeping her in bed with me has not seemed to destroy her ability to sleep well.

I also don't believe 6 month olds need to be placed on a calorie restriction diet. I was a hugely fat baby, complete with ankles that rolled down over my shoes and socks. By the time I was a toddler, I was a lean and muscular athletic child, and I remained that way until childbearing and laziness added a paunch here and there. I am sure my son will do the same thing, and will be a strong and healthy toddler and child, without me restricting his diet now.

Now I simply need to find a new pediatrician, and all will be well.

10 comments:

Amy York said...

Oh how frustrating!
There is not an instruction manual on being a parent... All we can do is what feels right to us ~ and as long as we're not beating the snot out of our kids, I think they mostly turn out Ok. I definitely have a problem with a pediatrician giving unsolicited advice... especially without hearing you out to see why you're doing what you're doing and how it worked with your older child.
I hope you find someone that fits your parenting style better!
Hooray for healthy (not fat!) Oliver ~ he sounds perfect to me!
(My babies were big too ~ not that big but still in 95%ile and I would never have considered putting them on a diet! Now they are running around, so skinny I can see their ribs!)

Catherine said...

I think your concerns are very real. And sadly, your pediatrician is very narrow-sighted. My babies required food in the middle of the night until 8-9 months. They were sleeping in their crib, but that didn't stop their tummies from being hungry. I (think) parented both kids similarly and Elliot is an awesome sleeper, Audrey not so much.

I wonder how much of your doc's concern is generational? I remember telling my mom Elliot's stats after one baby visit and she asked if the doc was concerned that he had gained too much weight. The kid came out at 5 lbs 14 oz. He had no where to go but up! And today, at 4 yo, he's 35 pounds. So, uhm, yeah - I think he's fine.

I wish you luck finding a doctor that appreciates you parenting choices. As you know, you & your doc need to be a team so that if there are issues trust won't be one of them.

ellen said...

Well, I know I talked to you earlier but I wanted to reiterate that you have every right to feel angry and want a new pediatrician. You are a good parent and you aren't over feeding him. I know I won't argue to much with ya anyway seeing as I am a co-sleeping, extended breast feeder myself!

You might get a few good recommendations for a new pediatrician if you can come along to the LLL meeting on Thursday with me!

Woman with a Hatchet said...

Wait a minute! Isn't this the same exact ped that hasn't made anything other than approving "Yay you" noises over his growth so far?

That being the case, what exactly has changed so suddenly? You don't have an "average" sized baby. You are not an "average" sized woman. Why would she expect your kid to suddenly turn into an average 6 month old?

Color me confused.

Red Flashlight said...

I'm all about finding a doctor who actually treats 'patients' like human beings. So yeah, I think you should find someone else. Even aside from the baby-fat issue (I'm totally with you there), it sounds like this pediatrician didn't listen to you, assumed you aren't capable of making rational, informed decisions on your own, and then couldn't read your face or body language well enough to know that she might have to do some damage control to keep you as a patient. Totally inappropriate! You, Misty, are one of the most intelligent, informed, and articulate people I know! What the Hell was she thinking?

But I think you should let her know why you're leaving. It's only fair. It gives her a chance to apologize. And it gives her a chance to learn and grow, so maybe she'll be better informed for the next Mom-of-an- Oliver-sized-little-one.

Crunchy Domestic Goddess said...

congratulations on a healthy baby boy! sounds like he and you are doing marvelously.

now as for that doctor - ugh!!! i would be looking for another ped too. what sucks is that some parents don't think twice about questioning a dr's advice and WOULD put their baby on a diet or restrict his nighttime feeding just because "doctors know everything."

julian is nearly 11 months old and still nurses through the night. my daughter nursed at night 'til she night-weaned on her own at 22 months. not saying i want julian to keep it up 'til 22 months, but i think our kids know what they are doing and will certainly not nurse at night for the rest of their lives.

keep up the good work. :)
amy

Coni Nelson said...

Oh my - as a parent of a child that is considered "overweight" I can see your frustration. Our doctor looked at Amber's BMI and told me that because of her build it was not entirely accurate. Amber is in the 150th percentile for height and BMI has been proven as "the best available" tool for weight calculation but it has been disproven more than 35% of the time.

Hang in there - find a new doctor and love your son the way you know how to - as his incredibly loving mother....... you know what's best for him Misty.

Anonymous said...

You are absolutely in denial - your baby is fat and you want to do what is best for you - not him. How selfish and thoughtless you are.

Anonymous said...

Wow! That is quite some weight I've to say. From what I know a baby's weight should double by 6 months and triple by their first b'day. And accordingly, your baby ought to be in the 30 pound range at 1 year.

Since most babies don't weight so much I think people may be shocked to hear his weight. On the other hand, if he is healthy and his weight is not causing any developmental delays, then I wouldn't worry.

The only irony here is that we live in a culture that is obsessed with being thin and I find it quite funny how people flaunt the weight of their babies.

Anonymous said...

Description

This section is from the "The Hygienic Care of Children" book, by Herbert M. Shelton. Also available from Amazon: Hygienic Care of Children
Chapter VIII: Fat Babies

A farmer once remarked to Dr. Page, in discussing the tenderness of his pig-pork which he had raised himself, "why, even the bones are so tender, they are almost as soft as the flesh itself."

Fat, rachitic children present about this same condition. But mothers, nurses and doctors all, as a rule, answer well to Dr. Felix Oswald's description in the following words from his Physical Education (P. 202):

"The representative nurse believes in cramming; babies like prize-pigs, are most admired when they are ready to die with fatty degeneration. The child is coaxed to suckle almost every half-hour, day after day, till habit begets a morbid appetite, analogous to the dyspeptic's stomach distress which no food can relieve till overrepletion brings on a sort of gastric lethargy."

The fat-disease is developed in infants as early as possible for everyone admires a fat baby. Such babies, however, are like fat animals; their muscles are very lean and attenuated. Mutton and beef, when excessively fat have very little muscle, and this is so "tender" that it hardly merits the name muscle. Fat hogs have very little muscle, sometimes being actually unable to stand up or to get to the trough to eat. Such hogs are well adapted to fill lard-cans but they are not the kind that supply meat eaters with ham or breakfast bacon. Such hogs are by no means healthy animals.

Of the fat babies so much admired, Dr. Page says -- "The excessive fat, so generally regarded as a sign of a healthy babe, is as truly a state of actual disease as when it occurs at adult age. Not only are the muscles enveloped with fat--they are mixed with it throughout and so are the vital organs--the kidneys, liver, heart, etc. Dissection, in these cases, often discloses the fact that these organs are enlarged and degenerated with fat; the liver, for example, is often double the normal size. The disease finally culminates in one of two things--a considerable period of nongrowth, or a violent sickness, which strips them of the fat, if not of life."

No farmer would think of fattening his growing animals. He knows that this stunts their growth. The same farmer adores his baby when it is "as fat as a butter-ball." The wise farmer has learned that early fattening stunts the growth of pigs, and does not permit them to fatten after they are weaned--they very rarely posses any surplus weight when weaned. The farmer who fattens his pigs never rears the largest hogs. Growing pigs and shoats are fed just enough to keep them growing steadily. They are fattened only after a large, healthy frame is secured.

Animals are born little more than "skin and bones" and are never, with the few exceptions of hibernating animals, fattened, unless man fattens them. Calves that are intended for a useful life are never fattened by the farmer. The young colt is never fattened by nursing.

Examine a litter of kittens and you will find that, however round and plump they may appear, this is due chiefly to fur and not to fat. But you cannot question or doubt their health or the rapidity of their growth.

We may safely put it down as a general rule, that animals do not fatten early in life. On the other hand, we know from our experience with our domestic animals that when animals are fattened while very young they do not grow and develop so well.

Most of us are aware of the evils of fat in the adult animal and man. We know that the trainer of race horses carefully removes all fat from his horses before entering them in the races. The hunter knows that he cannot hunt with a fat hound. The wrestler, boxer, runner and other athletes are in the "pink of condition" and ready to do their best work when there is no fat left on their bodies.

Knowing these things, why do we point with pride to our fat offspring? Why are we so proud of a fat baby? Only a few days before I wrote the above lines there was held here in the city of San Antonio a contest in which prizes were offered for the babies and children who weighed the most at certain ages. The winners weighed from twice to three times what they should. The announcement of the winners and their weights caused my mind to run back to my boyhood days when we used to fatten hogs to kill.

Why not give prizes to the best developed children? Why not offer prizes for the healthiest children? Why offer prizes for those children who show the greatest amount of fatty degeneration--who present the worst stages of the fat-disease? Fat babies are not healthy babies. Why encourage a people, already over-burned with ignorance, to build disease in their children?

Fat and plethoric children, with cheeks so red one can almost feel the fever in them, when he looks at them, are regarded as healthy children. In excessively fat infants says Dr. Page, there: "Follows one of three things--death; a saving sickness; or a feverish freful state, with a gradual reduction of fat, an emaciated stage, when perhaps for a year his body and limbs resemble those of a calf, a kitten, or a young robbin. Under this 'raw bone' state he grows as do the young of other species. The body and limbs stretch out and he grows tall." After a time their digestive powers recuperated, another period of fattening begins. Each year death eliminates thousands who are unable to endure the strain. "This culling process goes on, in a lessening degree, up to about the age of five, when the spindling age is fairly set with the survivors, and there is a corresponding exemption from disease, the proportion of deaths from five to twenty-five being very small."

All around us we see these fat, over-fed babies and children with running noses, difficult breathing, frequent colds, spells of feverishness, etc. If such children live, they gradually "work out of the fat stage into a correspondingly ematiated stage, seldom retaining a fair degree of roundness all the way along."

Surfeiting has gotten in its work. At the ages of ten or twelve, or even younger, we see these once fat specimens, "thin, cadaverous, with fitful appetites; eating at times like cormorants, of such things as they 'like,' at others having no appetite at all."

Fat babies are usually stupid. They usually present an appearance of dullness which is quite a contrast to the appearance and action of healthy and well-fed babies. At a later period, those who survive infancy, and learn to use their legs "run off the fat," and become not only brighter in appearance but more muscular also than during their fat stage.

The normal condition of man is not that of obesity at any age. Why, then, are parents so anxious to see their babies fatten up at the rate of a pound a week during their first few months of life? Why their anxiety to have "the fattest baby in the neighborhood," and "consequently the one most likely to die before it is a year old?" Ignorance, just plain ignorance, is the answer. They run the digestive organs of their babies at high pressure and keep them laying on fat, their little stomachs, which, are treated like toy balloons, vomiting. up what milk they cannot possibly retain, until finally, these little stomachs are so overworked that they no longer possess power to digest anything.

When this stage is reached parents and physicians begin a fruitless search for something that will "agree with baby's stomach" The only thing that will agree with such a stomach is rest, and if it does not receive this, serious illness and, perhaps, death, will be sure to follow. Such a child will waste away from want of nourishment--starve from surfeiting.

Infants are frequency saved from this fatty degeneration and its attending evils, due to the mother's inability to supply an excess of milk. The mother may, and usually does, lament this fact, the child does not. On the contrary it grows at a normal rate.

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