24 March 2012

big

So I've mentioned before that E is big for his age. Even for his birth (not gestational) age. He's a few days shy of eight months old - so six months gestationally. I thought he was about the size of a twelve month old, going by clothes sizes - he's in zeros and ones now. Until we were accosted in our travels in Brisbane yesterday by a chatty three-year old, his two-year old sister and Mum. E was the same size as the two-year old!

Fast forward a few hours. We're at our GP who did a measure and weigh and checked his percentiles. He's now above the 97th percentile for weight. The chart ends at the 97th percentile. And he's somewhere around 75th percentile for length. She then proceeded to tell me he is obese. Her words. I was gobsmacked. Incredulous. And mad. Are you kidding me? How can a baby be considered obese? Sure, maybe if I was plying him with sugary snacks and letting him watch TV all day instead of having physical play.

We still do a combination of breastmilk and formula. In the past few weeks, we've tried the occasional bite of fruit or veg, but his gag reflex is still strong. Yes, he is fed on demand. Yes, he eats a lot. No, I do not blindly stick a bottle in his mouth every time he cries. If he won't be settled, I try milk and usually discover that yes, he was hungry.

Behind a number of suggestions given to me by the GP was the inference that I feed him too much. I know formula-fed babies don't regulate their milk intake as well as those exclusively breastfed. And they are generally bigger. But I refuse to let him go hungry because he doesn't fit a norm. She also suggested his reflux might settle with less milk. After coming back down to a simmer over the past 24 hours, I can see why this makes sense. But what he drinks is more problematic than how much he drinks. I know this because he'll vomit his first small formula feed of the day when he is eating on an empty stomach. I give him smaller feeds because of the reflux. (I've also tried fewer larger feeds, out of desperation that something might help). The reflux and feeding is a vicious cycle - the more he vomits, the more he wants to feed to soothe himself and replace the milk he lost. 

She also suggested that maybe I am making more milk than I think. I can put a ballpark figure on how much milk I think my body makes, with 95% certainty. Assuming he gets more than I think, he is still choosing to drink the amount he does because he is hungry or needs comforting!

It's not the first time our GP has commented on his weight and how much we feed him. Despite it making me fume, it also makes me second-guess myself. I came home and googled obesity in babies, and read some interesting but inconclusive studies. But I keep coming back to this.
He is appropriately chubby - no one comments on his size until they know his age. He is also very long - but then so are his parents. And hey, we are also both pretty slim and eat very healthily, so I think his chances for turning out the same are pretty good. Call me old-fashioned, but babies are meant to have fat. It fuels their awesome growth. Some will have more, some less. This article has influenced my thinking a lot. I have tried holding off feeds for as long as I can and it just makes us both grumpy and stressed. He is - apart from the reflux - healthy, and has been trending upwards on both weight and length charts since his birth. He started life so small that gaining weight was a good thing! (And no, I am not overcompensating for that.) We are grateful that he is happy and thriving.

I get the wider social context with rampant childhood obesity, but I really resent her judgement. And the term 'obese' in the case of a healthy baby is pretty severe judgement. I resent that Western medicine ideologies have to fit everything into a box of known proportions, rather than assess an individual holistically. Am I being overly sensitive? Perhaps. I'm reassured by K, who is there when E is ravenous and knows what it's like. Who counteracts my niggly self-doubts about this and many other little things and tells me what a great job we are doing as parents. Perhaps she never had a difficult baby. A very hungry baby. Would she make these judgements if she had?

Sadly, after this and a few other things rubbing us up the wrong way, we are on the hunt for a new GP.

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