Sunday, February 04, 2007

Two and a Half Stats

I checked the girls' current stats at home, and plotted them on their growth charts. It's so weird for me that we had their last physical when they turned two, and don't have another one until they are three. How am I supposed to go a whole year without weight checks to make sure they are growing okay? I think I will send the pediatrician an email to see if he thinks we should come in earlier, or if he thinks I am just being neurotic.

Anyway, Holland's weight at 30 months (unadjusted) is 21 pounds 3 ounces. She is 33 inches tall, and her head circumference is 46.75cm. This puts her at the <0 percentile in weight, the 3rd percentile in height, and the 10-25th percentile for head circumference. Her length to weight ratio is at the <0 percentile.
Eden's weight is 19 pounds 2 ounces. She is 32 inches tall, with a head circumference of 48.5cm. Her weight is even further from the curve than Holland. Her length is hovering close to the 3rd percentile (maybe at the first), and her head is at the 50th percentile. Obviously, her length to weight ratio is also at the <0 percentile.

In other words, we don't seem to be getting anywhere fast. On the bright side, they are bigger than they were at two, and they ARE growing. On the not-so-bright side, they are impossible to feed, and although there are some good days, it isn't getting much better. Meal times take SOOOO long, and I feel like my life revolves around trying to get them to eat. It's excruciating. It really is.

The truth is that I start feeling like this (depressed and stressed out) every time I plot them on the stupid chart. At least when we are at the doctor's office he can talk some sense into me. He always stresses that he thinks they are fine, and he doesn't feel like their small size is something we should worry too much about right now.
In some ways I feel like I should get a second opinion. At the same time I am fairly certain if I go looking for someone to say Eden needs the g-tube, I will find them. But does she need it or not?

I think the pro of a g-tube would be that we wouldn't have to worry so much about how many calories we are getting into her. We could make up for anything she did not eat during the day at night while she is sleeping. We could load her up on calories and she might grow. The cons would be another surgery, the possibility that her reflux would worsen and cause problems with her wanting to eat, and her losing the ability to regulate when and what she wants to eat. I wonder if she felt full all the time if she would EVER eat.

I really don't know. I guess at this time, I still feel like the cons outweigh the pros, so I don't think I will go looking for someone to say she needs it just yet.

Other considerations I have to take into account...I looked at John and myself on the adult weight charts. For our heights, John is at the 5th percentile for weight, and I am at the 2-3rd. It just isn't very likely that we would have big kids under any circumstances. Also, Eden's PT pointed us to a growth chart for kids with CP. Eden is between the 10th and 50th percentiles on that chart (around the 30th). So, she has small parents, was born 16 weeks early weighing less than 1.5 pounds, and has CP. G-tube or no g-tube, she is always going to be little.

Maybe I should focus on the advantages to having tiny kids. They aren't as heavy...period. This alone makes it easier to care for Eden. It makes getting her in and out of the tub easier, carrying her, lifting her, moving her around, all of those things. The smaller she stays, the easier it will be to take care of her. And she won't have to worry about her weight when she gets older.

Of course, I'll still continue trying to force all the food and calories into skinny little Eden that I possibly can, in hopes that she will one day grow to a normal adult height and weight.


Anonymous said...


Anonymous said...

Some kids are just going to be petite and that's okay. I don't blame you for worrying though, I have a petite daughter too...we had her tested and tested when she was 1 yo - and found that she is just always going to be on the smaller side. She eats though - everything. And she is still small.

Viscouse said...

Sorry been awhile since I last posted. A couple thought ran through my head though...

Growth: who's to say that if you pumped a whole bunch of calories in them that they'd be used for growth & not getting, well, fat? (I'm not a nutritional specialst, so I could be way off base here).

Is their weight gain harming their health in any other ways? Do they look/act malnourished? (I don't think so, from what you describe).

These are the things I am keeping an eye out for in our girls. They aren't breaking any growth records, but they seem healthy, and are growing (however slight).

G-Tube: there was always something in the back of my head not liking a g-tube. If they feel full and nourished, they will have even less incentive to eat, no? (just a guess)

Normality: as for getting them to grow up normal, we will all grow up and be normal. It's the rest of the world that will perceive us as abnormal.

Anonymous said...

We have been/are still going through the same debate over the G-tube as you with our son. Luckily we have been able to avoid it up until this point because it does have so many disadvantages compared to advantages. Our neuro-developmental doc mentioned evaluating the babies at 24mo for growth hormone if needed. I have not done any (not a drop) of research on that yet as it is still a year away, but has anyone mentioned anything about that to you? I'm sure there are cons to HGH as well.

Shannon said...

I hate that I have to wait a full year between visits, too. I want to make sure D is growing darn it!

We have the constant worry about enough calories, etc.., too. Darsie, I think, is about the same stats as Holland. I'm very small (5'1" and 100 lbs. usually) but my husband is a big boy. I just figure she is taking after me (at least to rest my nerves).

Both Holland and Eden are as gorgeous as ever!

Minnesota Momma said...

I know all too well the feelings you are having with their growth. BTDT! At over 4 years old, my 24 weekers are still on the very small side at 27 & 29 lbs. I looked back to see where they were at at age 2, and L was 19 lbs. 12 oz. and S was 20 lbs.

There are things that we still do to keep up the calories, like staying on whole milk. Back then, they were still on the generic pediatric drink like Pediasure. That's a whole other discussion.

It's hard to give up the worry, but I've always been told and always tried to focus on the fact that they don't have to be ON the chart/curve, but just following the curve, their OWN curve, and you have to look at it over time. Which is exactly what my girls have done.

Your girls are such cuties!

E said...

I feel your pain. We have only one bad feeder, I can only begin to imagine how much MORE stressfull it is with two! Something that should be so easy, like feeding your babies, consumes your life. Every night when I come home from work, I don't ask how are the babies, I ask how much did Cole eat today. Seriously, how can a growing kid survive off of 8 ounces a day?

After all the craziness that's happened to our babies since their early entry into this world, the one thing you would think we could help influence would be their eating. There seems to always be something else you should or could be doing to help them grow. I guess that's the mark of a good parent, always making sure you are doing everything possible for the well being of your children.

Take care!

Anonymous said...

My children were not preemies, but my middle child still makes me nervous because I think he is very thin… but I try to remember that if he seems ok (energetic, not lethargic, happy, learning, etc.) then he probably is ok. From what I can see from the pictures of your girls is that they are happy, energetic, sweet little girls. You are doing a wonderful job. I give you and your husband so much credit! But, I realize it is hard not to worry…but you are doing the best for then always. Good luck and God bless.

Mete said...

Ethan was under the charts for a while, and they pushed a g-tube. We wanted to wait, because he could still eat by mouth and we just weren't ready to give up one of our last ties to "normal" life. One day he jumped onto the charts and has been in the 50-75th percentile ever since. I know he may need the g-tube someday, but I'd definitely like to wait as long as possible for all the same reasons you mentioned.

You bring back memories... I used to be obsessed with his head circumference, as you are with their other measurements. I used to check it on my own and be so sad to see it was still wayyyyyy off the charts. (He has microcephaly and has never had a normal head size.) I kept worrying and being depressed about it. Researching those damn charts all the time.

Finally something in me snapped and I just accepted it: my son has a small head. So what? He's healthy. He smiles a lot. He's 'active' in his own way. And he's growing - just at his own pace.

I'd say the same for your girls. They look extremely healthy in their photos: glistening hair, shiny skin and gorgeous smiles. No sign of dehydration or nutrition deficiencies. I'd focus on those stats as much as you can.

(Of course, you're The Mom. We're built to worry. I know exactly how you feel.)

Life said...

Well, I can say that if she has to get a g-tube at some point, it isn't that bad. The surgery is fast and there isn't a long recovery time. Our daughter doesn't eat and I wonder if the g-tube makes it worse but it doesn't matter since we don't have a choice. Her doctors and therapists tell me most g-tube fed kiddos eventually eat with gusto. They tell me one day she'll probably start eating and we'll never know why she started again.

owlfan said...

My ped let us come in for weight and height checks (no charge even) as often as we wanted - we went weekly for a while as my son, A, was tiny. We finally went with a ng-tube for a few months when his height stopped growing. With the extra calories, he got a growth spurt and got back on the chart, height and weight. I kept watching to see that he kept growing, however slowly. Over time, while I wasn't watching so closely, he's hit the 25th %.

I'd say as long as they are continuing to grow, I'd continue to watch and wait.

Unknown said...

I am so sorry you are stressing and worrying about their feeding. I can sympathize with your plight and can also understand the desire to ease the stress with a G-tube. Viscouse made a good point about stuffing them with empty calories making them fat, but I also worry that getting them used to fat/greasy food will give them a taste for bad foods as they grow up.

My ECI nutritionist says that kids could literally live off Pediasure if they drank 3-4 bottles a day. Of course Pediasure is like $2 a bottle, but something to consider when 8 oz bottle gives them 237 calories. (I have probably told you about it before, I swear by it and that is where my boys get most of their calories since we have had similar feeding issues).

*Hugs* to you and your family. Take care of yourself and know that so many people care about you and your little family. :) You are loved!

Anonymous said...

I looked and it doesn't look like the 2 1/2 year old visit is recommended by the AAP, but our ped does have us come in then. So, I would say that if you're neurotic so are all the moms and dads of NYC. (Which we are, so I guess that's not too reassuring...) I say if a ped visit would ease some of your worries, it's worth it.

Anonymous said...

My daughter was only 5 weeks preemie and we didn't have the feeding issues. She's small too (only 45 inches and 40 pounds at 8 years old). She is the smallest in her 2nd grade by far. I worried too but like the doc said "her parents aren't giants, so she won't be a giant". Some kids, and adults, are just small. Good luck to you!

Anonymous said...

I'm the mom of a one-year-old 24-weeker and a huge fan of yours. I love that you write about the negatives as well as the positives--some of the micropreemie blogs I read are so darn rosy that they make me feel worse about the struggles I'm having with my baby (eating is a HUGE one, by the way). Thanks for your honesty. You make me feel less alone.

hallegracesmama said...

I understand you worries about growth. We still go for weight checks and they really help me feel like I have more control.

Love the picture of you and Holland coming down the slide!

Kate Giovinco Photography said...

I was just going to say that you and John are not big people in anyway so your girls are going to be smaller. But if they eat that is all you can do I am sure your pediatrician knows what he is doing but getting a second opinion is ok as well. Good luck! Do what you feel is right for you and the girls and your family!

Jimmie said...

I know it doesn't help to say not to worry about their size (I worry all the time - and Nick wasn't even born prematurely!), but you and John were bound to have small children. I'm definitely no taller than you, and at 2 years old, Nick is at the 1% for weight and the 8% for height.

His actual weight and height go up a little with each appointment, but his percentile keeps going down. Although it worries me, his doctor isn't concerned because I am short (even though Bryan's not), and I was always one of the smallest kids in school.

Nick will be going in for a check-up at 2 1/2. Atleast if you're neurotic, you're in good company.

Jacqui said...

Hi Billie,

I'm sure you know that the CP is going to keep the girls on the smaller end to start off with. What I also wanted to tell you is that Moo stayed only just on the charts until he was two and a half and then he just took off. I haven't weighed him recently but over a four week period in December he put on 1/2 kg alone. I'm sure he has put on a heap more weight because it feels like I'm carrying a tonne of bricks.

Keep an eye on it but try not to stress about it. These things have a way of working themselves out.


Anonymous said...

Hello to a fellow Mom of twins! I found your site on a twins blogroll....

We, too, have had struggles with weight issues (our boys were born at 34 weeks and then had/have GERD). Since conception one boy has been in the 3rd percentile for weight (dropping below for a ocuple of months when the GERD was at its worst). The boys just had their one year check-up and the doctor said, "See you in six months." My husband and I were speechless and felt exactly how you described - how will we know if he's gaining enough?

Anyway...enjoyed reading your post...


Anonymous said...

*Random Reader*

You have beautiful kids!! They are just adorable.


Hope they have a good life! And by the way you seem like a very dedicated mom...lucky kids!