A really small breastfeeding toddler

[Bridget]

Sawyer had his 19 mos check up and he weighed in at just under 20 lbs. Everything developmentally is great. He's physically ahead as far as running, climbing, jumping (he jumps!), language on target, overall healthy. The dr said that just by looking at his chart alone he would be labeled "failure to thrive" but in looking at everything else about him he is clearly a healthy and extremely happy child.
I want to also say that he is very pro breastfeeding and was happy to hear that Sawyer is still nursing but maybe not so much as to how often. He thinks the nursing may be filling his belly because it's easy and nice and snuggly to mommy but it's meaning that he is eating less food. I admit that he doesn't eat much. I offer it to him all day, often when he is asking to nurse I will offer him a snack but even if he eats it, it's just a bit. He ends up playing or throwing it. Don't get me wrong, meal times are not stressful with him. He's pretty darn delightful and messes do not bother me. I just wish he would eat more. Other times he will come to nurse and I'll see if he will play instead but I won't deny it if he's upset and can't be distracted.

If you were me would be more adamant about cutting out nursing sessions? He will nurse anywhere from 5-12 times a day depending on how busy he is or how he feels. I can't even say how much he nurses at night but it's a lot. None of this bothers me, I'm happy to nurse him whenever but I do not want to deny him needed calories to grow. Would love some perspective from other mom's who have nursed a child this age.

[macksmom]

I never went to 19M but DD1 was 18M and DD2 was 15M so I have nursed a toddler. Personally 5-12xs/day would be too much for me and I would try to gently wean that down a bit. But if it doesn't bother you then that is up to you. However I could imagine your doc may have a point in that he is being filled up by the BM and maybe not getting hungry enough to eat actual food. From what I have seen of him he doesn't look unhealthy or even underweight. I am pretty sure my DD1 was barely 20lbs at that age. At age 6 she is 34lbs! She is VERY thin and I am starting to stress about it so I understand the worry. While she isn't nursing she loves fruits and veggies and will eat them first first and fills up on them and just isn't gaining. So it's a similar idea where the child is getting full on something good for them but it's causing them to not gain.

Maybe you can just find some really high calorie or fattening, healthy snacks so what he DOES eat is more likely to put pounds on him?

But to truly answer your question I would try dropping at least one session, gently of course, and encourage him to eat more food. I only say this because while I think some kids are just naturally thin I think they need just a TINY bit extra weight in case they get sick or something. Even if you could get him to gain just 1-2lbs I would say that is enough. It sounds like he is perfectly healthy though. I am just saying I would try to get a pound or 2 on him

[Bridget]

That's what I am thinking too. Today I was able to distract him twice before dinner from nursing and he did eat more at dinner than usual but it was also his favorite thing so hard to tell. Everything I give him is high fat, really. We eat whole milk yogurt and lots of butter, cook with almond flour, lots of red meat. He's just so uninterested in food!

[macksmom]

That's what I am thinking too. Today I was able to distract him twice before dinner from nursing and he did eat more at dinner than usual but it was also his favorite thing so hard to tell. Everything I give him is high fat, really. We eat whole milk yogurt and lots of butter, cook with almond flour, lots of red meat. He's just so uninterested in food!

I would continue to offer him that favorite food then...this is what I am trying with DD1. While I love that she will eat anything and such a wide variety of foods, I am trying to make things that I know she will totally devour. At least for now.

[Joshua's Mommy]

I'm in the same situation. My daughter was 20 lb 4 oz at her 18-month appointment, and the doctor mentioned failure to thrive. Aside from being thin, she's totally healthy, active, talkative, etc. In the last few days, I've made a bigger effort to offer more high-calorie foods (full-fat yogurt and kefir, avocado, peanut butter, etc) and offer them more often. I've noticed her asking to nurse less often these last few days. I wouldn't try to cut down on nursing, just try to offer food more often and try different foods.

[anonsouthernbell]

I also wouldn't cutdown on nursing sessions, since it isn't bothering you. I would have snacks out and available for him, remind him to have a snack, etc. it sounds like he is doing great!

[MomOfAnOnly]

Hmmm. How to word this...... I guess I think babies know what they need, and they do things on their own time. Some walk earlier than others, some talk later than others, and they all eventually get interested in food and stop nursing as much. Maybe he has allergies (K does, right? Is your whole family gluten free now?) and it's an instinctive way to protect himself until he grows out of them. Maybe his belly just isn't ready for a bunch of foods even though he "should" be ready. Our bodies are smart and will let us know what is working and what is not. (I think tooth staining was the first sign that my DD was allergic to penicillin, it didn't agree with her body long before she broke out in head-to-toe hives). He could also just be a smaller guy for now, also like K was. What did K weigh at the same age?

[Bridget]

Thanks, Carrie. Was hoping you would respond. K did weigh about the same. Problem was, he weighed about the same at nearly 3. Sawyer is pretty much Gluten free save for some whole grain cereal on the rare occassion.

My gut tells me he is fine. Dbf is more concerned.
I like the idea of trying to offer more food as opposed to cutting out nursing.

[i.<3.cheesysmiles]

I would not cut down on nursing sessions. DS also nurses as much as Sawyer, and there are days where he won't eat. I sometimes try to offer a snack in place of nursing if I just nursed him 30 minutes ago, but even then, that doesn't always help.

[raspberry]

I cannot remember how many time G nursed at the age, but it was on demand, he was night weaned but he could have easily nursed as much as Sawyer. I looked back at G's baby book, he weighed 22 lbs at 17.5 months and was 25 lbs at 2 years. He is just a skinny boy with a lot of energy that he burns off all his calories. I imagine that is just how Sawyer is. Is Sawyer the same size as Kai was at that age? seeing his pictures there is no way he looks like a failure to thrive baby.

[moosh34]

Dd weighed just under or barely 20 lbs at 18 mo and my pedi did not mention failure to thrive. Ds was not much bigger at that age. They both nursed as often as Sawyer up to two years old. Dd also was not especially keen on most food. Both my kiddos are slim. It's pretty easy for us to tell it's genetic. Dh is 5'11" and weighs 135. I've never worried too much about it because my kids are clearly thriving.

[MomOfAnOnly]

I think it's fabulous you are still nursing him on-demand, that you know 1 year isn't some magic number they have to suddenly be weaned by.
You are also a thin person, from pictures it seems like dbf is too. Your family eats clean. You don't plop the kids in front of the tv, they're outside playing. Sawyer has older siblings and daycare kids to keep up with. There's so many things to take into account.
At 18 months Emme was still nursing at least that often during the day, and 8-10 times at night (and she barely slept "at night", so she was pretty much constantly nursing). In our family though we make chubba-wubba BF babies, so how much food she was or wasn't eating never came up.
Offering his favorite foods more often is definitely the way I would approach it. At 18 months I would be less concerned with variety.... I don't think it's necessary, especially since he is still nursing so much. I often think about that article that was posted here on APA about kids diets and how we expect them to have much more variety than what nature intended.

[NHKate]

I don't know if I would blame the nursing. My DD nursed that much at 18 months, and continued to nurse over 5 times a day every day (unless I was unavailable for some reason) up until I started weaning her a couple weeks ago. DD was right about Sawyer's weight at 9 months, but her weight gain did slow down a lot, and she's definitely been on the thin side after a year. If I recall correctly, she was 22 pounds and a few ounces as a year, 22 pounds and a couple fewer ounces at 15 months, and finally up to 24 pounds at 2 years. At 2 1/2 she had gotten to 28 pounds, and 36 inches tall. The pedi never said anything about her weight, even when her weight to height percentile was down under 5%. (I think they had given her an extra inch or so when measuring her height on that visit.) I also wondered if nursing a lot was keeping her weight down, but my view is a little different. Biologically speaking, our kids are supposed to be nursing at this age, but very few American kids are. Maybe all the non-nursing toddlers are really overweight, and our skinny kids are the ones who are the healthy weight!

How tall is Sawyer? I guess knowing his weight doesn't tell me much... is he tall and slender, or is he short and proportionate?

[Pineapple]

DD nurses a lot day and night. And some days does not eat a lot of solids. She weighs 34 lbs at 22 months, so I feel llike it's not the bfing that's making your DS weigh less, it's just his body type for now.

[motherof5]

DD is still bf'ing on demand at 2 1/2 and only weighs 22lbs. But she runs circles around other kids her age at the park, talks in complete sentences, knows all her colors and shapes, etc. However she is a really picky eater and eats great some days and some days not at all. The pedi has always shown me the growth chart and she is below zero on for weight and only 10% for height but said she is developing great and has tons of energy so not to worry. He did say that if I were to stop bf'ing she might start eating more but it is not a necessity. I think your pedi saying failure to thrive is pre-mature at this point. Every child is different and will grow at their own rate. Some will be chubby and some will be stick thin. It is the developmental milestones that really matter! They are the best indicators of growth!

[CeCe1975]

First off, Way to go momma!! You're doing a great job!

Secondly, I'm one of the ones that don't believe that dropping nursing sessions will make them eat more, at least that's how it is in our case. DD will be 2 1/2 on the 15th and still nurses on demand when we're together, which is evenings and weekends since I work full time. She can nurse a bunch one evening and still eat a good bit, and nurse the same the next and eat just a tiny bit. When she wants to nurse, she's usually dead set on it cause nothing will distract her. She's also on the tiny side, has been between the 3rd and 5th percentile since she's been born. It sounds like he's doing great!

[runningmomofmany]

How big are you and dh? How big were you each as children? My kids are small. My 11m weighs 17lbs, my 8yr old weighs 42lbs and is 40in tall. My 14yr old is 5 ft and 100 lbs. The good thing about hanging loss of kids if you get a pattern. My hubby was small,as a child and they tasker after him!

I do not think nursing less will make your little guy bigger! He is getting calories from milk too! Eating a bit more fruit, or whatever is not going to make up the calories lost to dropping the nursing sessions. Kids come in different sizes. *someone* has to be below the 5th percentile or it doesn't work ;)

[runningmomofmany]

And nursing always gets blamed! If he were above the 99th percentile and nursing that much the dr would have said he didn't need the extra calories from nursing!

[MommyShannon]

I cannot remember what DD weighed at 18 months but she was 23 lbs at 2. She nursed a lot including at night. I think that put her on the low end but not where her ped ever seem concerned. I completely agree with above about offering food more often. Once M decided she wanted to nurse it was hard to convince her otherwise. She would eat at other times separate from nursing. I got pg with DD3 when M was about 18 months so as my milk decreased she did eat more and more. It sounds like he is doing great though so I wouldn't be worried if he still just isn't interested.

[Woogelaide]

Latecomer to this thread... Adelaide is only a month behind and she's teeny, too. She's all about the boobie and doesn't like food much, either. Sometimes I feel like an old Jewish grandma chasing her around with food, trying to get her to eat. Doesn't work. She nurses, I dunno, 12 times a day, plus unlimited night access. It's a lot. She fell way off her percentile for weight. She was 90+ percentile when she was born. 9 pounds 10 ounces. She gained her birth weight back quickly and never lost weight, but she dropped from 90th to 60th to 40th to somewhere around 25th, while maintaining her 90+ percentile for height. Once she bottomed out at 25th percentile at around 8 months (I think?) she maintained that percentile for the last 10 months or year. Because she's maintaining her new curve, the pediatrician isn't concerned at all. Is Sawyer maintaining his curve?

[Woogelaide]

oh- and if I remember correctly, at her last appointment she was 21 pounds and 35 inches.

[katie]

Micah was only 18 lbs at a year, maybe 19 at 18 months? His pedi was also his Sunday school teacher from 16-24 months so she saw him developmentally during that time period and we did do weight checks/blood work because if his long drop off the growth chart from his highest 75% at 2 months, she never mentioned failure to thrive. He's still tiny (25 lbs at 3) and eats ALL the time. I didn't cut off nursing, I tried to offer healthy, good calorie rich foods to get him to eat as much as possible but I also didn't want to force him to eat if he didn't want to and make him not want to eat/give him issues that way.

[emma1978]

My ds is tiny... 23 lbs at 27 months old and he weaned at 13 months of age!! Thats when he stopped gaining too so i doubt it was my breast milk!

[TripMomma]

Jericho was 24 lbs at 19mo. He is still nursing, but I have cut it down. Now he nurses 1 time during the day, and 2-3 times during the night. If he is bugging me for "boobie" outside of those times I get him a snack and stay on my feet (if I sit down he will attack me for boobie and not eat his snack LOL.)

[Aelith]

Alice is also tiny - she's 20-21 lbs at almost 18 months. She's below the weight limit for 12 month pants and tall enough for 18 month pants

She nurses some nights all.night.long (other nights just to sleep and then again around 4 - 5 a.m.) and 3 - 5 times during the day. However, she loves food - she just doesn't eat a lot of it. She picks like a bird.