just don't know what to do.

I am just a wreck right now. Let me give you a little info:

Our boys are currently on Medicaid because my husband is self employed and we can't afford private insurance. I am currently working on getting my teacher certification and hope to get a teaching job in the fall. Until them we are stuck.

Spencer is in the 5% for his weight and my ped. doesn't seem to think it is a problem. He used to be in the 15-20%, but since 6months on he has slowly stopped gaining. We had to take him in on March 26th for a sick baby visit and he weighed 17lb. 4oz. Well at their 9month visit, he weighed 17lb 6oz. and that was on April 15th. Fast forward to today, I decided to weigh him after his bath and guess what he weighed, 17lbs. 6oz! Everytime I bring this issue up with the ped. he dismisses me and says that his is just fine. I feel like my dr. hasn't been updated on the past 10-15 years. Spencer also has really bad allergies and he told me that babies could not be affected by outside allergies at this age. Also when Spencer was sick, I told him that Spencer's mucus we yellow/green and was told that the color of mucus makes no difference and doesn't mean anything.

He is the "best" Medicaid pedi. in the area and we have no other options at the moment, but I feel like he doesn't even give a damn about my boys. I am worried about the lack of weight gain and his allergies/severe ezcema, but I don't have a qualified professional to turn to!

I'm at a loss... :drown:

 

Have you considered switching dr's? I have never taken my kids to a ped, we all go to a family dr and he's fantastic. Not saying it's anything to do with him being a ped, but if there's a family practice around I would consider taking them there and see what a different dr says. Get a second opinion on things.

Their weight gain start to slow down towards the end of the 1 yr but it shouldn't stop completely :hug:

 

I agree with Danielle, their weight gain does slow but he should still be gaining. A difference in scales (from the doctor's office to your house) can make a difference as well. I think I would get a second opinion too. If you don't trust what the ped is telling you & there isn't another available pediatrician, I would just see a GP. I've never taken any of my kids to a pediatrician, they see our normal family doctor & she's fantastic. A second opinion never hurts! :hug:

 

I would trust your instincts! Get a 2nd opinion if you can. I can say that my pedi is focused on my boys weight gain - as of right now at least.

 

Holly
I agree with pp, get a second opinion if you can, their weight gain is not as dramatic as the first 6 months during the later months of the FY, but he should still be gaining. How is he eating? Has he been ill and vomiting a lot recently?
I don't know anything about allergies so i cannot help you there, but on the mucous thing, the colour of it does differ and means different things depending on its colour.
Trust your instincts, if you aren't happy, try to find another doctor, it will be worth it even if you have to travel a bit.
please let us know how you get on

 

He eats just as much as Reece who is almost 21lbs! He gets 4 7oz bottles a day along with three solid meals a day(each around 4oz)...they are pretty much off baby food and on mostly table food and he eats alot! That's what I don't understand, for breakfast we will do one of the following: yogurt, pancakes, oatmeal mixed with fruit, and cereal bars. For lunch I will do meatballs cut up with bananas, grilled cheese, mac n cheese, or the gerber graduates toddler meals and same for dinner. He is definitely eating!

 

That's very odd alright, there is a big difference in weights there. Cooper is smaller than Aaron by a few oz, the difference is physically noticeable but the weights are on track. And there is no possible way that the scale got a false reading in case he was wriggling too much or one leg was out?
Is there have a phone line with medical advice you could perhaps call and talk with a nurse?
I know it is easy to say, but please try not to worry too much, he sounds like he is very healthy and eating well which is great!

 

Holly i just did a search on babycentre and found this. It says a baby's weight gain can stop when a LO is ill, maybe this is what happened, i think you said he was sick recently. And it says, if he is eating and hitting his milestones, the likelihood is that all is well

http://www.babycenter.com/0_failure-to-gain-weight_1621.bc?page=1

 

He is hitting all milestones, about to stand on his own and takes steps with assistance. He was sick about a month ago, and that did affect the weight, but I feel like that shouldn't be an issue anymore. When I call to get any advice, the nurse just directs me to the dr. and he just says that I need to come in because he can't give advice over the phone. The scale at the dr. office is an old scale where you have to move the weight pointer thing(?) and we have a digital scale at home, but he sits perfectly still when I weigh and at the drs.

 

My kids are a little older, so this may not be a great comparison, but I can give you the trend of my son who grew like a weed for the first 9 months, and then has been on the slow track ever since - even though he's the good eater of my two. My doctor said it's likely that he started out big, and then tapered off to where he was meant to be - a small kid. My daughter is huge in comparison, and is a pretty cr@ppy eater so it can be frustrating. So I know it's so hard not to compare.

As far as the different colored mucous, I have heard that differnt colors can mean an infection - but they can also mean viral or bacterial for the same color. And if it's viral, antibiotics, or doing anything other than letting it run its course won't make a difference. Maybe he's focusing on his other symptoms as well, so looking at the big picture he's not concerned? If he doesn't have a high fever, is drinking and eating, and not acting lethargic, than he may not be way off base.

Here's my son's stats:
birth: 5 lbs 14 oz at 36 weeks
5 wks: 10 lbs 2 oz (see, he was huge here and way up on the growth chart, for a full term (41 wk)baby
4 mos: 16 lbs 7.5 oz
6 mos: 18 lbs 9.5 oz
9 mos: 20 lbs 11.5 oz
12 mos: 20 lbs 7 oz (actually lost weight here)
15 mos: 20 lbs 4 oz (still not growing in weight, only in height)
18 mos: 21 lbs 4.5 oz (finally put on a little!)
2 yr: 23 lbs 9 oz

so he's now in the 5th percentile where he's been holding steady from about 18 mos on. Between 4-12 mos he was anywhere from the 50-75%. So like the doctor said, he started out big, but is now following his curve of where he's meant to be. During the point he kept dropping (12-15), she was slightly concerned and wanted us to start pedia-sure and come back periodicially for weight checks. But since he's staying on his new curve now, she's fine with it. And he's been average for height - in the 50th percentile. My daugher was 28 lbs 5oz and 37" tall at her 2 year visit and she gets by on crackers, fruit and milk. They just grow the way they're gonna grow!

 

:hug: Holly thats what I was going to say too is that we usually only see our family doc but now that I am having some issues that I feel aren't being reolved by him I finally went to see a ped. So maybe try finding a family doc instead of the ped if he is the "best" medicaid doctor. I am so sorry you are feeling frustrated, I would keep pressing to find someone who can give you some answers. I am having issues with my dd and I am finding that I have to start pressing and demanding, maybe you will have to as well.

 

Also, kids stop gaining as much as they get more active. He sounds like he is moving around pretty good, and is simply burning up what he is taking in, that combined with having to recover whatever he lost when he was sick would mean an even gain. My ped. says the same thing about color, it really doesn't matter. Actually, my doctor said it to me as well. She said the color only indicates how long the mucous has been accumulating, and the color shows how much protein is in it.

 

I had one baby who only gained 2 pounds between 6 months and 12 months. At 6 months old she was 14 pounds and at 12 months old she was only 16 pounds, she fell off her growth curve. :unsure: I knew what our problem was though, I really struggled to get her to eat baby food and at the end of the first year she was way too active to sit still and finish a bottle. It sounds like you don't have a problem getting your baby to eat. My ped was concerned, and after the 12 month appointment we were told not to change the girls to whole milk, but to give them Pediasure instead. By her 15 month check up she'd caught up with her sister in weight and was back on track. :good:

I'd ask about pediasure when you make the transition off formula. It's sweet so my girls loved it and it helped Lily to gain weight.

 

Thanks Aimee! I will ask about pedialyte!

 

Is it possible that Spencer may have a milk allergy? I am starting to suspect that one or both my LOs have one (they have eczema, one wheezes occasionally, some diarrhea - plus I had one when I was a baby and young child and used to get bronchitis from eating dairy - this intolerance didn't show up until I was 6-7 months old) and I am going to try switching to an amino-acid based formula (because apparently soy can be a problem too). I found this checklist online of different possible signs that your baby might have a milk allergy and one is no to low weight gain. I would recommend seeing another pedi to get a second opinion and maybe try eliminating dairy - you never know! Good luck and try not to worry too much. :hug:

 

You could try being a little more forceful with your pedi. Maybe make a sick visit to discuss just this issue so that he will have more time to devote to you. "I know you probably think I'm crazy, but I'm really worried about the weight gain issue. Could we think about this a little more and run some more tests?" At least he should rule out really serious stuff like CF etc.

 

The dr. ordered a blood test to find out what he was allergic to and the only two things are dogs and peanuts. I hope he outgrows the peanuts! The dr. said that when he gets a bit older we will probably do a skin test to find out a more detailed view on his allergies.

 

As the pediatrician who is usually in hiding here, I feel like I have to take my mommy hat off for a moment and speak up. I hope you don't mind.

1. The weight issue is very difficult to evaluate without actually looking at a growth chart and also looking at the ratio between weight and length. There is a big difference between a baby who is 5th for weight and 25th for length and a baby who is 5th for weight and 90th for length. The difference on those charts between 5th and 15th is really just a couple ounces. I know when I have seen patients who haven't gained much at one point in time I often think that maybe an illness caused them to not eat well and we often see this in their growth parameters a few weeks after the illness. I also take into consideration that between 6 and 9 months many babies have a temporary plateau as they start burning more, crawling, cruising, etc. I know you said there is a difference in weight between the two and they eat the same but I don't know if they were the same weight at birth and if they are ID or frat. That can make a big difference in body frame, metabolism, etc. I speak not only from medical training but also from experience. My twins were 2 lbs apart at birth and the smaller one has always been a slow gainer. At 9 months he was only 15 lb 9 oz, but he is healthy and active so I am not worried. He also eats twice as much as his sister.

2. Allergies: Your ped is correct when he says it is impossible for a 9 month old to have seasonal allergies. In order to have an allergic reaction, the immune system has to first be exposed to the allergen (protein that causes the allergy). Once exposed, the body starts to see it as foreign and develop an allergic response. This takes months. Thus, 9-12 months is the very earliest we will notice allergic responses to indoor allergens such as dust, mold, pets. An outdoor allergy cannot develop until a season after the baby is exposed for the first time. Since your babies were born in the summer, this is their very first spring and thus the very first time they have been exposed to the things that grow in the spring. Food allergies are completely different because it is a totally different chemical response, which is why babies can show food allergies as newborns. When I read your post and you mentioned eczema, I was going to mention food allergy testing but I see from the pp it has already been done. If his eczema is severe then it likely needs better control with topical medications, less bathing, environmental control with detergents, soap etc and insane amounts of moisturizer.

3.Snot: Your ped is 100% right when he says that the color means NOTHING. Yellow/green mucous means that the body is fighting any type of infection, including the cold virus. When we examine kids with cold symptoms, we rule out ear infection, throat infection, pneumonia. If these are not present, then its not bacterial.

Lastly, I'm a little offended by your description of him as a "medicaid pedi". From your tone I gather you are a little embarrassed to have medicaid but honestly, in todays economy the percentage of people who do has gone WAY up. Most medicaid families are working class families whose employers just don't offer benefits. That being said, you make it sound like doctors who take medicaid are substandard. I see patients with medicaid, military insurance and private insurance. Most docs have a mixture. If there are docs in town who refuse to take medicaid, then I wouldn't trust them because they are likely only in it for the paycheck and not the good of the child. So, his competance, training etc should have nothing to do with whether he takes medicaid or not.

My advice is to make an appointment just to talk about your concerns. In our office, the patients are allotted different time depending on what they are there for. If a parent brings in a child for a sick visit (10 min time slot) and then tries to bring up growth and development or feeding concerns, I am likely to brush it off or try to answer as quickly as possible because I know I have rooms full of patients waiting. Even at a well child check, getting 2 babies seen, shots done, etc may be very hectic and he may have a full schedule. If you make an appointment just to have him seen and just to talk about your concerns re: weight, eczema, possible allergies etc, he will be much more likely to listen to your concerns and offer you a referral to a specialist. You might even ask the front staff to make it an extended appointment (if they do that) so that you can have his undivided attention for a longer block of time.

Hope this isn't too long winded. If you have any specific questions, feel free to PM me.

 

Sorry if I offended you that was not my intention. I meant that he is the best pedi. on our medicaid plan and therefore there is no better pedi that we can go to on medicaid.

Every well baby visit, he never tells us what percentile the boys are in and I'm not sure he is even charting it. I come home and look up the percentile so I will know where we stand. Spencer was 27in. long at the 9month checkup so he is petite all over. They are fraternal and there was a 15oz difference when they were born (Spencer was the smaller).

I guess it also comes down to bedside manner, which my pedi. definitely lacks. When the boys were born we had excellent healthcare and a pedi. who, I felt, really cared for our boys and did everything in his power to find out the problem. I know feel like a number at my current pedi. Anytime I bring up an issue of any sort, he just takes out his prescription pad and says that there is meds for this or that. For me personally, meds are a last ditch effort. For example, at my first pedi. Reece had a bit of torticollis and our previous pedi. gave us some stretches and exercises that we could do to help fix the problem. Fast forward to our new pedi. and I brought up the issue at our first visit with him. He told me that it wasn't that severe, but took out his prescription pad and said he would write me a prescription for physical therapy.

For the allergies and eczema, he put Spencer on Children's Zyrtec(generic) and some prescription ointment for the eczema.

It's just hard when a lot of dr. don't want to deal with all the Medicaid paperwork, so I only have 3 peds. to choose from. I want a ped. that acts like he enjoys his job and loves working with children, which I don't get with my current pedi. He doesn't even look at me when I ask questions, or when he answers them. He just looks down at the chart and dismisses me, in what I personally feel like he is saying I am an overprotective mother.

 

:hug: Holly. I am sorry that you are going through this. I think I would make another appt and take your questions written down. That way you have a goal to accomplish while you are there. Maybe just take Spencer if you can so that you only have one baby to juggle.

And FWIW, I read your "Medicare Pedi" comment that way you explained it. :good:

 

Thanks Rachel! :hug:

 

Fair enough. I guess I took things wrong because around here everyone takes medicaid, so being referred to as a "medicaid pedi" versus just a pediatrician seems like an unnecessary label. I think that it is particularly crappy that your old ped doesn't take medicaid and kicked you to the curb when your insurance changed. I think that shows he really didn't care about your boys...just the money he loses by taking state insurance.

I definitely agree that if the doctor's bedside manner is not good then you have a right to be unhappy. I also think it sucks that you only have 3 choices, but what makes this guy the "best"? Maybe you should meet with your other two choices and get a feel for their bedside manner. Just because one pedi is more well advertised or has a bigger, shinier practice doesn't mean they are better. One of the others may actually sit and listen to you and not just write a script for everything. I think some pedis do that these days because many moms actually demand it. One of my partners is like that...he will write a script just to make the parents happy and get them out of the office sooner.

Also, could you drive to the next town to see someone you feel cares about your kids? We live in a rural area and we have people drive up to 40 min to see us because they like our practice better than the options in their town.

Most pediatricians will let you come for a consultation where you can meet the doctor, ask them questions, get a feel for the doc's bedside manner, etc. You can also get a feel that way for the nursing staff. All board certified pediatricians have to meet the same standards, so a lot of time having a nurse triage system to answer your questions rather than punting everything to the doc can be a really nice feature. As a doc who has had to see 30-40 patients a day during the busy season and have 10-15 phone calls a day from parents, I can tell you that I rely on my nurses to help deal with those calls. If they are calls that my nurses feel like they cannot deal with, then I usually tell them to make an appt because I just don't have the time to spend calling that parent back when my schedule is booked. Sounds like at the office you are at now, the nurses really don't help with these calls, so that may be something to look for.

If none of these solutions are doable to you, I would just march in there and demand a referral for an allergist....that way you get someone to give you a second opinion on the eczema and that specialist can also address any possible food allergies and if they have any impact on his growth. As I said, he probably is just meant to be more petite than his brother but a specialist could reassure you of any worries you might have. Feel free to PM me if you have any specific medical questions.

 

My son has had allergies his whole life and ashthma. The ped put him on peditex at 3 months old and at 6 months old both my twins are on singular. They make a singular for children 6 months and older. My ped said that while childhood asthma and allergies are uncommon it's not unheard of, especially if you or your husband has them. I know what it's like to have your child not being able to breathe and the dr.telling you to clean out his nose and give him a hot shower, (that lasts for 1 min) Be pesistent, if you don't he will just let it go. I'm telling you once he gets some medication for his problem you will feel like you have a completely different child. Also ask them about a breathing machine to keep at home if he has any problems with wheezing, usually a few treatments will do it.

My son has had allergies his whole life and ashthma. The ped put him on peditex at 3 months old and at 6 months old both my twins are on singular. They make a singular for children 6 months and older. My ped said that while childhood asthma and allergies are uncommon it's not unheard of, especially if you or your husband has them. I know what it's like to have your child not being able to breathe and the dr.telling you to clean out his nose and give him a hot shower, (that lasts for 1 min) Be pesistent, if you don't he will just let it go. I'm telling you once he gets some medication for his problem you will feel like you have a completely different child. Also ask them about a breathing machine to keep at home if he has any problems with wheezing, usually a few treatments will do it.