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18 months

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Margaret's measurements at 18 months: 48 cm head circumference (85th percentile), 31.5 inch height (about 47th percentile), 24 lb weight (about 51st percentile).

She's now above average in weight for height - about 65th percentile according to the charts - which is to say, she's a little bit overweight. I am pretty sure that's the result of having added a lot of high carbohydrate baby food - mostly fruit based - to her diet. Unfortunately we have not been able to find any high fat or high protein baby foods that she likes; the meat based baby foods are skanky in both her opinion and her parents'. We give her one vienna sausage per day, but are reluctant to give her too many since they contain a lot of nitrates and salt.

She's had fairly rapid weight and height gain over the past six months, from well below average to average. I'm pretty sure that's the result of transitioning off breast milk and that she'll stabilize at around the average. Fortunately the DHA/ARA formula additives seem to be keeping her brain growth ahead of her body growth.

The doctor seems to be worried, either about the rapid weight gain or the gain in weight for height, and has recommended that we switch her to skim milk. I think he might be unfamiliar with the breast milk to formula curve transition, and he has certainly bought in to the mistaken medical belief that it's fats rather than carbohydrate that cause overweight. This seems to be standard advice; I have a nephew who is particularly lean and whose doctor put him on whole milk, and he certainly isn't getting any less lean on it.
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On December 19th, 2009 06:06 pm (UTC), chenoameg commented:
Hummus and avocado are often toddler favorites.
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On December 19th, 2009 06:48 pm (UTC), kirisutogomen commented:
My mother fed me pureed chicken livers, and I only turned out slightly insane.
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On December 19th, 2009 07:08 pm (UTC), chenoameg replied:
I have access to organically raised pastured animal livers if they would be helpful.
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On December 19th, 2009 08:06 pm (UTC), readsalot commented:
Tofu has lots of protein, and should be easy enough to puree--I guess the problem would be in flavoring it without adding tons of sodium.
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On December 19th, 2009 09:47 pm (UTC), psychohist commented:
Just to clarify to everyone, I do appreciate the suggestions, but any solution that involves using a blender or food processor counts as too work intensive here. I do not have time to clean a bunch of mechanical parts each day. Note that I don't have a dishwasher, nor do we have the space or interest in getting one.

Moderate amounts of mashing with a spoon or cutting with a knife would be fine.
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On December 19th, 2009 11:54 pm (UTC), jaedian commented:
I think carbs are worse for weight gain than fats. I just went to a nutrition meeting that said we need more fats and protein at each meal. (the low fat craze cause people to gain lots of weight) Still dunno how to get protein for breakfast quickly.

I wasn't a big fan of baby food. It is kind of yucky and mushy (and expensive). We would just give the kids (when they were babies) whatever off our plate. You need to eat a healthy diet (which I know you do) and you cut things up really small and mash things up. We would cook our vegetables a little more and mash. (not puree, I think it is good for them to get used to texture) And I would cut meat up pretty small, but it was not pureed. Fish is pretty soft, as long as you check for bones. Yogurt is good. And I like them getting used to eating what we eat. (didn't work for Alex (he is super picky) but the other two seem to eat a lot of foods now) Hummus seems like a good suggestion though. We are finally ordering Juliette her own meals at restaurants, but for about a year or year and a half, I would base my ordering decisions on what she would like.

I am not sure I would worry too much about this. You are looking at a snapshot. She could be putting on weight in preparation for a growth spurt. (which is what happens) so if you look at that time, you think they are heavy and not tall enough, but that isn't the whole picture. And I don't think 65th percentile is overweight, it is a little off the mean, but I am pretty sure there is a pretty large range around the mean that is fine. And if she is very squirmy at a visit, the nurses can easily be off by an inch or more during measuring. (I have seen it)

If there is a curve for breast milk to formula transition I would take a look at it. Formula growth curves are different than breast milk, and jumping from one to the other might cause alarm for no reason.

I have heard over 2 years old to switch to reduced free milk, but then you have a lot more sugar in the milk, which would muck with your insulin levels more, and be less filling, so she might get more calories. I don't think I would go for skim, you could try 2% some of the time.

Maybe you can make minor adjustments, or none at all and just monitor her at home? Did the doctor say what his concern was? Rapid weight gain? Which would cause what problem exactly?
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On December 24th, 2009 05:46 am (UTC), enugent commented:
I'm sure you know this, but I'm shocked that a doctor would suggest switching her to skim milk before she's two. What does he think she's going to build myelin from?

How does she feel about hamburger? Howard will eat meatballs all day long. It's not "baby food," but it's easy to cut up to an appropriate size. If she doesn't care for it plain, perhaps there's a seasoning that would make it work for her - even something unusual like grated apples or something. The nice thing about meatballs is that if you can find a version that she likes, you can make a big batch and freeze them, so you're not messing up the cooking equipment every night.

But I also agree that you're looking at a snapshot, and it's not useful to get worried until you've seen a pattern for a few visits. Do you know anything about what your or Elizabeth's growth patterns were like? (Did either of your mothers keep a baby book?) It may be that spurts and stops are totally normal for her. Both of my kids have seemed to get rounder and rounder, and then one day I turn around and their wrists are sticking out of all of their sleeves and all of their pants have turned into high-waters.
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