Tuesday, August 7, 2012
Guest Post: A Tiny Toddler
The following is a guest post from a reader, who asked not to be identified. Hearing other mothers' stories will open up discussion on topics I may not have any personal experience with and provide a different perspective on parenting. I'm excited to present this first in a series of guest posts, in which this mother talks about her difficulty in getting her daughter to gain weight and grow according to the doctors' expectations. At what point do we go with our gut instinct over what the doctors think? How many tests, specialists, and evaluations do we put our children through before we decide on our own that maybe there's really nothing specifically wrong? And how do you convince a two-year-old to eat when she doesn't feel like it? We'd love to hear your comments!
I should begin this post with some vital stats- I am barely 5 feet tall and was 20 years old before I hit 100 lbs. My daughter was born 5 lbs 3 oz full term but two weeks early. At 6 months she was a healthy 11 lbs having doubled her weight as expected. At 12 months she was just under 14 lbs and at 24 months just under 20 lbs. Twenty pounds is the average weight for a 1 year old . Between ages 1 and 2 my daughter has had 3 visits with a nutritionist, 3 visits with a gastroenterologist, numerous visits to the pediatrician, blood testing for every known allergy and carries a “failure to thrive” diagnosis on her medical record. Between ages 1 and 2 my daughter has also developed an impressive vocabulary, shockingly accurate memory, all of the age-appropriate gross and fine motor skills, “friendships” with her toddler classmates, and a thriving personality. In that same year, our lives have turned into an endless feeding chore- finding food with the highest possible fat content, finding the best toys/stories/tricks to get food into her and most often finding the energy and patience within ourselves to get through one mealtime after the next.
A few months ago, after yet another period of no weight gain, I decided to do an experiment. I was pretty convinced that her lack of weight gain was due to insufficient intake of calories- there didn’t appear to be anything medically wrong- she just ate very small amounts of food and was much more interested in doing everything else under the sun other than eating. On any given day she probably burns all of the calories she takes in, if not more. Or whatever is left over for growth translates into height increases and brain development- both parameters for which she is on the charts and growing on the curve. So we found a solution that held her attention and physically kept her seated long enough to shovel large quantities of high fat food into her that required as little chewing as possible: we let her have an iPad. She watched and played and, blissfully unaware that she was “eating”, swallowed anything on a spoon we put in her mouth. The results were striking- she put on just over 1 lb in 1 month. QED. But not wanting to make a habit out of it and having proven satisfactorily to myself that this was unlikely to be a medically-based problem, I went back to more “normal” meals. Weight gain over the next 6 weeks- 5 oz.
And so it is that I find myself in my current predicament- do I give in to her current medical providers' requests and put her through specialist visits and further testing? Do I trust my instinct that she is fine, try to cultivate a liking for food in her in a relaxed non-forceful environment (someone please describe what that is because I certainly don’t know!)? Do I find an alternate medical provider who might think more along those lines? Or do I simply go back to the iPad-fuelled feeding frenzy and get her “on the charts”? Do I, as many of my colleagues have suggested, not give a second thought to “Westernized” weight standards? In a society so plagued by obesity the concept of focusing on weight gain is hard to explain. Case in point- the insurance company’s repeated denial of our nutritionist visit claims because they would only be approved if the patients’s BMI is greater that 35. i.e. if you are obese we support your treatment, but if you are underweight we don’t recognize that as a medical problem. Is it time then that I stopped considering this a problem too?