Concerned about growth

I just got back from the twins checkup. They are still WAY off the charts in height and weight. Their heads just hit the 5th percentile. How long did it take your preemies to catch up?
We were told originally that it would only take a year, but now they are saying 2-3 yrs.

Jesse- 14 lbs 13 oz, 25.5" length, and 17" head cir.
Joshua- 15 lbs, 26" length, and 17" head cir.

What do you girls think? Even if I take their adjusted age it still looks like they may be very small. I'm starting to get concerned. The Dr. did say they look skinny, but not unhealthy.

 

wow, when did you have them? how early? Mine are 3 1/2 months and weigh almost the same as yours. I delivered at 37 1/2 weeks

 

Now I want to cry. They were born at 33 wks 6 days. They are over 9 months old now.

 

Don't cry! If your doc was concerned, you would know. True, your boys may be small, but that doesn't mean they are unhealthy. The most important thing to look at is how their weight compares to their height. If they are proportioned well, then that is all that matters. All babies grow at different rates, some are really small and others are really big. Most preemies catch up by age 2, but I've seen full-term singletons who are extremely tiny, not unhealthy, just small for their age. I hope this helps ease your fears.

 

QUOTE(NINI H @ Feb 25 2008, 08:44 PM) [snapback]639847[/snapback]
I just got back from the twins checkup. They are still WAY off the charts in height and weight. Their heads just hit the 5th percentile. How long did it take your preemies to catch up?
We were told originally that it would only take a year, but now they are saying 2-3 yrs.

Jesse- 14 lbs 13 oz, 25.5" length, and 17" head cir.
Joshua- 15 lbs, 26" length, and 17" head cir.

What do you girls think? Even if I take their adjusted age it still looks like they may be very small. I'm starting to get concerned. The Dr. did say they look skinny, but not unhealthy.


For our 9 month, I think Jake and Becca were just a little bigger - they were born at 36 weeks, but they were tiny. Our dr. always follows THEIR growth curve, Jake is 5th percentile and Becca is maybe 25th? At their one year, she was 19 lbs 8 ounces and he was 17lbs 6 ounces...I don't remember their 9 months but again, probably not much bigger than your boys.

Just make sure they are eating as much as they want. We let Jake eat ALL THE time and as of today he weighs 19 lbs 2 ounces, he gained almost 2 pounds in less than 2 months!!

Try not stress

 

No don't cry! I am alway concerned about my boys weights but the doctor always says if they are staying on the same growth curve that's what matters, if there steadlily gaining at lets say the 10th but then drop to the 5th or off the chart I think thats when they start to look into it a bit more.

erica

 

I guess we really don't have a growth curve for them. We went through some job changes and insurance changes and they haven't been to the Dr since they were around 3 months. So now they are at my Dr finally. I guess only time will tell. But they were born at really good weights for the Gestational age Jesse was 4 lbs 10 oz and Joshua was 5 lbs. So they have both gained 10 lbs in the 9 months since they were born. I really could have never guessed we would be having a growth issue it's just crazy. My eldest son was 10 lbs 10 oz at birth and my other son was born a wk and a half earlier at 9 lbs 9 oz. This preemie thing has really thrown me.

 

I don't know how early your twins were, but unless you doctor is concerned, I wouldn't worry. We were initially told Halle should "catch up" by the time she was two. Now I am reading that docs are saying it can take much longer for some preemies to catch up. Halle has never been close to the charts. She is three years old and 22 lbs/32 in. BUT she has been following her own growth curve, which is the most important thing.

Julie
mom to Halle, 23w5d, 1 lb 1oz
expecting b/b twins 8/23/08

 

QUOTE(NINI H @ Feb 25 2008, 01:25 PM) [snapback]639920[/snapback]
Now I want to cry. They were born at 33 wks 6 days. They are over 9 months old now.


Oh no, I'm sorry I didn't mean for that to sound like it's bad If your doc says they are fine, than I wouldn't worry about it too much. They may just be late bloomers, but they say they are healthy so there you go

 

Please, please, please don't cry!!!! My boys were born at 33 weeks and were almost the exact same weights as yours at birth My boys have never really hit high numbers on the growth curves, especially their heads. But, I have a small head. Some of this could be genetic. If you are concerned about the growth curve, call your pedi and ask. I am sure they could get the records from your previous doctor so you could see. As long as they are still growing and the numbers on the curves don't start going backwards, then all is well.

 

I went in last wk b/c I was worried about Jakes growth. She said that as long as he wasn't losing weight we were okay. She started him on rice cereal in his bottle to increase his calories. You may want to ask the dr if there is anything you can do to increase their calorie intake.

 

Agree with pps - if the doctor was concerned he/she would let you know! And keep in mind too that those growth charts are not only for full-term babies, but based on limited samples of mostly formula fed babies decades ago who started solids super-early - there's been a lot of talk about revising them to reflect normal growth for babies fed according to today's standards, but hasn't happened yet AFAIK.

As long as they're getting to eat whenever they're hungry, they should be ok. Maybe they're just naturally petite! Also, you must be on solids now - you could try giving them rich stuff like avocado, and cheese as soon you get the ok for dairy.

If you want to boost their calories, here's an idea to run by your pedi: you could make higher calorie formula (if FF) or give an occasional bottle of high-cal formula or fortified EBM (if BF). DS came home from the NICU on bottles, and we were adding a little Enfacare to his EBM to make it 24 cal, and whenever he got formula it would be mixed up to 24 cal.

:hug99: It's ok! It sounds like those babies are doing just fine. And it's great that they have you looking out for them.

 

Hi,

My closest friend has a 2.5 year old who is only 21 pounds. Madeline was born at 37 weeks and weighed six pounds but she just grew really slowly. She's a totally normal and healthy 2.5 year old... just really thin and not incredibly tall.

I agree with everyone else, that if your doctor isn't worried, you shouldn't either. That said, if you do formula, do you have your boys on high calorie? You can buy special high calorie formula, or you can just mix your regular kind a little strong (but check with your doctor first... some varieties of formula apparently work well like this, others it's a bad idea). I know for my friend's little girl, they put formula powder in all of her solid food to increase the calories and stayed on high calorie formula until she was about 15 months.

Good luck... and definately don't cry. Some kids were destined to be big and some small!

 

QUOTE(NINI H @ Feb 25 2008, 10:08 PM) [snapback]640023[/snapback]
I guess we really don't have a growth curve for them. We went through some job changes and insurance changes and they haven't been to the Dr since they were around 3 months. So now they are at my Dr finally. I guess only time will tell. But they were born at really good weights for the Gestational age Jesse was 4 lbs 10 oz and Joshua was 5 lbs. So they have both gained 10 lbs in the 9 months since they were born. I really could have never guessed we would be having a growth issue it's just crazy. My eldest son was 10 lbs 10 oz at birth and my other son was born a wk and a half earlier at 9 lbs 9 oz. This preemie thing has really thrown me.


I know exactly how you feel. My first son was 9 lbs at birth and has always been off the charts (the other way) in size. My twins were born at 37 weeks at good sizes, but have been really small. Lincoln especially has really struggled with weight. He is just now getting on the chart. He fell off his growth curve for awhile there as well. It is so hard not to stress about it. It feels like how big your kids are is a reflection of how well you're feeding them, but that is just not true. Because Lincoln's weight was such a concern for awhile the ped. put him on reflux meds to see if that helped, and it made a huge difference for him. I would never have thought he had reflux--he never fussed, and spit up what seemed a normal amount...but getting him on meds made a huge difference. He went from 14 lbs at 6 months to 18 pounds last month. I wonder if your little ones have something like that? If not, as long as they are eating well, and hitting milestones--there is nothing you should be doing that you're not. They are perfect just the way they are. Please don't worry. Being preemies makes a big difference. They will catch up. Just keep an eye on that growth curve. That's what matters. Big Hugs.

Reyna

 

Girls you all are so great!! Great ideas too. They were on enfacare as a supplement in their EBM bottles to make it higher calorie when they came home from the NICU. But after a few months of reflux and some other not so great effects of the formula, we took them off it. I guess we should consider putting them back on it just in the bottles they are getting. I nurse almost exclusively and if they do get bottles it's pumped BM. Maybe I need to eat better. If I thought feeding them more solids would help, I'd do that. But, when I try they don't nurse enough. I guess they could still be having some reflux, but they aren't complaining so I doubt that the ped would want to medicate again.
I got really stressed yesterday about this. I'm sorry. It just really took me off gaurd. I knew they were small but I didn't think since their 3 month appt they would go from between the 25-50th percentile for their adjusted age to completely off the charts now ( adjusted age). I guess it was the decline that caught me off gaurd.
I really appreciate all the reassurance!!!! HUGE HUGS for all of you!!!!!

 

One more question for you all.
Is there anyone here that their children have been diagnosed as Failure to Thrive?

 

QUOTE
Great ideas too. They were on enfacare as a supplement in their EBM bottles to make it higher calorie when they came home from the NICU. But after a few months of reflux and some other not so great effects of the formula, we took them off it. I guess we should consider putting them back on it just in the bottles they are getting. I nurse almost exclusively and if they do get bottles it's pumped BM. Maybe I need to eat better. If I thought feeding them more solids would help, I'd do that. But, when I try they don't nurse enough.


Hmm, it might be worth seeing if they'd tolerate that little extra bit of Enfacare better now that they're older. You never know, now that their digestive systems are more mature, it might not be too rough on them.

Don't worry too much about your diet (except for your own sake) - what you eat doesn't affect the fat/calorie content of your milk. Unless you're starving to death, you're making PERFECT milk for your babies.

Agree with you about not pushing the solids if it's cutting into their nursing. Your milk has way more fat, calories, and protein (and just all-around balanced nutrition) than a few more spoonfuls of rice cereal or pureed peaches!

Hang in there mama, you're doing great.

 

Thanks so much for your responses Fuchsiagroan. Dh and I talked and we are going to try to increase the amount of ozs they are taking in their bottles when they have them and add the enfacare. They have only been taking between 4-5 ozs since about 6 wks old. Of course that means that I probably have to try to increase my supply, but at least I can try. I guess I wouldn't be so concerned but after referring to their last checkup at almost 3 months they have dropped significantly on the charts (off). Do you know how long they have to be down to be considered failure to thrive?
My older son was very close to that when he hit about 2 1/2. But his was a gastrointestinal issue. He's small but on the charts at around the 25%.

 

Hmm, I don't know about FTT... But how's their diaper output? Has there been any change? If they're still making a good number of wet/dirty diapers, and not dramatically less than before, maybe the percentile drop is just because they get more active as they get older? It can be normal for babies to slim down a bit once they get mobile. Are they generally alert and happy and meeting their milestones on time (for their corrected age)?

 

Developmentally, they are inline with their real age not corrected. So that's great. I really think it's easier for them to move around since they are so little. They have a tendency to be constipated, which makes giving solids hard. And fruit doesn't seem to help that much either. I haven't really noticed a difference in their output changing. But I'll keep an eye on it. Thanks for the reminder. They seem to be pretty happy babies. One (the smaller baby) has been waking at night in the last 2-3wks. But we just thought it was him getting cold. I will feed them if they wake. So I'm sure the extra feed has only helped.
Do you mind me asking if your sons growth got steadily better? Or did it drop off at some point.

 

Oh I can sympathize with you very much! My girls were 10 weeks early and my little one had so many problems after birth that her weight lagged. Now they are 8 1/2 months and were weighed yesterday 12lbs 14oz and 15lbs 12oz. My pedi is concerned about my smaller one since she's skinny and her weight gain has slowed down. The pedi is sending us for a GI consult tomorrow. One thing all the MD's (cardiology, endocrinology, pedi) have said is if they are growing on a normal curve, whether on the chart or not then you shouldn't worry. We all know that's easier said than done. Also, as long as they are progressing devolpmentally, they are doing alright.

 

QUOTE
Developmentally, they are inline with their real age not corrected


Then WTH are you worried about? :lol: Seriously, if those babies weren't getting enough to eat, they would NOT be so far ahead of the game developmentally! I am very impressed.

QUOTE
Do you mind me asking if your sons growth got steadily better?


He's been growing like a weed from the beginning. Don't let that depress you, though - he only was tiny because his placenta was a piece of crap (too small, and 1/3 of it was clotted off) and wasn't feeding him enough. Before the placenta started failing, he and DD always measured above 95th percentile - because DH and I are both tall. He's been making up for lost time now and just getting back to his "normal" size. It really sounds like maybe you just have naturally small kids! It sounds like they're doing wonderful, try not to worry too much. (Yeah, easy as that, I know...)