What do you consider underweight?

Just curious on what everyone's opinion on the term "underweight" is, also what their pedi's opinion is.

 

My PEDI and I agree..


Underweight is when they fall off the growth curve and/or stop gaining.


My girls are slender and tall. One is 28 lbs and the other 31 lbs at a bit past 3 years - they are 38 & 39 inches. Height/Weight ratio is way off...but PEDI is not worried. I am small framed and skinny, DH is tall and large framed. They got one thing from both of us!!

One DD stopped gaining for about 6 months and he grew concerned (she got feeding therapy and started gaining again)....but he was never worried when she was actively gaining and growing ! They were off the curve for along time, and have slowly made gains and/or stayed in the same percentile.

-remember someone HAS to be in the lower & upper percentiles/growth curve-

KC

 

QUOTE(KCMichigan @ Dec 10 2008, 11:56 AM) [snapback]1105493[/snapback]
My PEDI and I agree..
Underweight is when they fall off the growth curve and/or stop gaining.
My girls are slender and tall. One is 28 lbs and the other 31 lbs at a bit past 3 years - they are 38 & 39 inches. Height/Weight ratio is way off...but PEDI is not worried. I am small framed and skinny, DH is tall and large framed. They got one thing from both of us!!

One DD stopped gaining for about 6 months and he grew concerned (she got feeding therapy and started gaining again)....but he was never worried when she was actively gaining and growing ! They were off the curve for along time, and have slowly made gains and/or stayed in the same percentile.

-remember someone HAS to be in the lower & upper percentiles/growth curve-

KC


Totally agree here.

 

QUOTE(KCMichigan @ Dec 10 2008, 05:56 PM) [snapback]1105493[/snapback]
-remember someone HAS to be in the lower & upper percentiles/growth curve-


Oh, I totally agree with that, as does my pedi. This is a total curiosity poll for me, as I am 100% comfortable with where my DD's fall on the chart.

 

Off the growth chart.. both my pedi and I agree.

 

I think the growth charts/percentile lists available in most doctor's offices are obsolete. They were created in the 1950's and based on formula-fed babies of European decent. Formula was very different in those days, breast feeding was going out of fashion, eating habits and recommendation on when to offer solids were different, and to me it's crazy not to take into account ethnicity, since it's obviously a factor (some cultures are bigger and/or smaller than others). Young children grow at different rates - some take a while to get into a grove, some grow and grow and then take a bit of a breather. Some children are thin and tall, some are thin and short, some are thick and short, some are thick and tall, some are of medium build but have huge heads...the combinations are endless! Your own family history, your child's health and eating habits, and your own common sense tell you whether your child is a good weight.

 

This is why our ped plots their weights/heights on the chart, but does not tell us their percentiles (she would if we asked, but I don't want to know). She and I just want them to stay on their growth curve. If they fall off that, we will worry, but otherwise, like CHJH posted, it's an obsolete, ethnically limited chart.

 

I voted other. I agree with my pediatrician, who has always been of the opinion that 'underweight' is when the slope of their personal growth curve is not maintained. We have always been under the 10th percentile for weight, and under the 15th for height. Head circumfrence, ironically, has always been 97%+ . However, the slope of their growth curves has always run relatively parallel to the 50th percentile slope, so they are growing at the same rate of the majority of kids their age, they just happen to have started out much smaller.

My boys eat a healthful diet where whole foods (not preservative-laden crap) are center stage. They are active, healthy, and happy. I'm not breaking any records in the size department myself, expecting them to look like linebackers just doesn't make sense.

At 2.75-years old, they are both around 26.5 pounds, and (I'm guessing, it's been awhile) 36" tall.

 

My ped is most concerned when they fall off of their established curve or plateau for a significant amount of time. Around here, that is pretty common. All of my kids have done this at some point, or a few points, in their lives.

 

I voted other. My pediatrician and I both agree underweight is when they fall off of their own growth curve. My girls just recently made it onto the curve (above 5th percentile), but they always grew on their own curve.

 

Our pedi and I both have a similar perspective on this. I have one string bean and one future linebacker (by body build). As long as he is staying within his own growth curve-- growing steadily for height, weight, and head circumference, we don't worry. This could mean staying in the 3rd percentile for weight forever, so long as that stays relatively consistent. If he is in the 95th %ile one visit and the 3rd %ile the next, then we have a problem. Overall health is more important than just the numbers. Hope that makes sense!

 

I was always concerned about my oldest daughter. She was so tiny even though she was full term and weighed 8 lbs 4 oz at birth. At age one, she wasn't over 15 lbs yet. Her doctor didn't get concerned until she fell off the growth chart altogether.

Through all the tests, we never did figure it out. At age 4, she just started catching up. She is in the 25% for both height and weight now.

 

There's a difference between being "underweight" and "failure to thrive". FTT is a medical concern, it involves either A. Staying under the 3rd percentile for just weight or height and weight, or B. swiftly moving from one percentile curve to a much lower one (within 6-12 months, going from say the 50th% to the 10th%.)

Underweight is simply being less than 50% for height vs. weight growth charts, not the simple height and weight. There is a specific growth chart that compares height to weight and being less than 50% for height vs. weight is underweight. Kind of like BMI for babies.

Failure to thrive can be for several reasons, malnourishment, medical reasons, physical stature, etc. Underweight kids really isn't something to worry about.

 

my girls are both really little. At our 2 yr visit Mia was 21.bs 3 oz which is below the bottom of the growth chart. Lily was 22.bs 4 oz which is just at the bottom of the chart. she is not concerned. Both myself and my husband are short/small people. I was even smaller then my Mia at that age. As long as they are growing and thriving, don't sweat it!

 

I think more of our problem with dd was that she was (and still is) at the top of the chart for height, but the bottom of the chart for weight. I remember when she finally got on the chart at the WIC office, she was nearly 4. She is finally at a normalish weight (I think, I should really look at a chart), but it is a muscle mass gain more than anything. The girl is still a rail. William is like DD in the since it took him a while to really get on the chart. He has never completely fallen off of it though, just hung out at the 3% range for a long time. Again, he is tall, so he seems skinny. My view on things, as long as they are happy and active, don't worry yourself about a chart.

 

QUOTE(Ellen Barr @ Dec 10 2008, 06:15 PM) [snapback]1105532[/snapback]
She and I just want them to stay on their growth curve. If they fall off that, we will worry...


This is where my pedi and I come down, too...

 

Yea, we just watch that they are on their growth curves as well. Lily is 18 mos and only weighs 20lbs. (7%) but that keeps her on her growth curve which is great. Jack, is 24lbs (45%) and he is also along his curve. Also, kind of funny, Lily's head is in the 5% and Jack's is enormous in the 80%. Again, right on with their growth curves!

The catch is that LIly eats everything in site and Jack is a picky eater, sometimes I am worried he will go to bed hungry but he is our linebacker and she is our peanut. They are both 85% for height but just build sooo differently.

 

Our ped also watches their growth curve. When he shows us their charts he has always mentioned that. DS has tapered off, but he's walking now.

 

QUOTE(CHJH @ Dec 10 2008, 06:07 PM) [snapback]1105517[/snapback]
I think the growth charts/percentile lists available in most doctor's offices are obsolete. They were created in the 1950's and based on formula-fed babies of European decent. Formula was very different in those days, breast feeding was going out of fashion, eating habits and recommendation on when to offer solids were different, and to me it's crazy not to take into account ethnicity, since it's obviously a factor (some cultures are bigger and/or smaller than others). Young children grow at different rates - some take a while to get into a grove, some grow and grow and then take a bit of a breather. Some children are thin and tall, some are thin and short, some are thick and short, some are thick and tall, some are of medium build but have huge heads...the combinations are endless! Your own family history, your child's health and eating habits, and your own common sense tell you whether your child is a good weight.


I agree. I took B in to see a nutritionist today since he is still having dairy problems, and one thing she said was never to worry about him "not being fat enough" as long as he's growing and gaining. She looked at me (I'm short and weigh less than 100 lbs) and asked about DH- who is 6'5" and 155 lbs, so for our boys, genetics does them in.

 

My pedi and I agree on the personal growth curve as well. I have one who is -3%, but she has gained weight every visit and my pedi thinks it is no big deal unless she suddenly dips several points below or has no weight gain.

 

I have one 5 % and one who WAS 3 % then decided to plateau and gain next to nothing in 3 weeks. They developmentally are normal and normal height & head circumference. it is still hard to look at the growth chart and see her own little line below the 3 %. You do have to consider the parents size for sure.

I read the book Child of mine: feeding with love & good sense which has really helped me to not be as concerned with their weight and to not have power struggles at meals. Having my dh feed them supper really helps to break up how many meals I give them. Just healthy options and a variety of choices in textures and temperatures and flavours and if they eat it, they eat it. Many times I've just had to walk away before I get frustrated (especially now that one spits) because I dont' want meal times to be a down time for all of us.

It really can be hard when a less than 3 % weight child refuses anything for a meal except for 2 bites. She has always been like this even as a small baby so I'm sure it will not change anytime soon.
Also, I quit telling my family what their weight was, or anyone else except for fellow twin moms of course. I found that weight became a competition with other children of similar age. That has really helped. I just tell people what size clothes they are wearing which usually varies depending on the clothes.

Anyone can PM me for support on low growth rate.

 

I'm with pps: as long as they're staying on their curve, it's fine. Little deviations are ok, big drops are something to keep an eye on, especially at certain times (a big decrease in growth rate before about 9 mo, when babies get really distractible and much more active, is worrying).

And it's also a matter of the big picture. If kids are eating plenty, or being offered enough opportunities to eat, and they're offered healthy foods, slowed growth isn't necessarily a big deal. It may just mean a really active kid. I think it's important to watch the "soft signs" as well. If their skin, hair, and nails look healthy, and they're alert and happy and meeting milestones on time, that's also a good sign. Toward the end of the first year, my kids' weight percentiles dropped a little, and though I knew it was probably nothing, I asked my EI rep (who was then coming monthly and knew us well) about it. She took one look and said, "These are not malnourished kids."

 

I read the book Child of mine: feeding with love & good sense which has really helped me to not be as concerned with their weight and to not have power struggles at meals.


Tried to quote that from above. Hope I did it right. This book was HUGE for me also in helping to overcome my paranoia with having a low weight child. It made a big difference in the enjoyment of mealtimes for us.

 

Both my girls are tallish and skinny.

I worried about the bird sized appetite they had and my pedi wasn't concerned at all. She said as long as they are growing and are happy and have energy to play all is good. She also pointed out that I am tall and skinny - which is also why it doesn't bother her.... she figures there is a genetic body shape happening too. LOL