86% and then some...
Today AJ had his follow-up with Dr. G, his GI specialist. To say we were nervous and wanted to avoid going are understatements. I was so nervous when he was being weighed I felt sick to my stomach.
Current Weight: 19lbs 7.6oz
Total Gain since 7/9/08: 13.5 oz
As we waited for his specialist in the exam room, little tears began to trickle down my face as I hugged my little man. They soon stopped, as I realized, as I had so many appointments before, that Dr. G may not be happy with his gain.
Dr. G said he was happy with the gain. What?! That is the first time I've ever heard that. AJ's birthweight at 3 lbs 8oz was "ok" size for an infant born around 8 weeks premature (that is his estimate). GI sort of gages the growth based a child's birth size/etc when premature. He is content with his progress so far. AJ is 86% of his ideal weight. Meaning, he is considered a tad under-nourished. He was quick to reassure me that it is nothing we are doing wrong, it is just where AJ is. The goal is to get him to 90% of his ideal weight. That is only 4% more than he is now, so that is a very realistic goal that AJ will accomplish naturally as he continues to grow.
Given that we have tested for parasites, abnormal calories absorption, and celiac disease, I was at a loss. What else could be wrong? Over the last few months, AJ's Dad and I kept saying, "AJ's just small." "We've tested for all things possible, he was a premie, he has cerebral palsy, his birthmother was 4'10", Guatemalans are small in general." We had no desire to have an endoscopy done, or upper/lower GIs, and most certainly not a G-tube.
*Note: Children with cerebral palsy burn twice as many calories as a "typical"child does. So while AJ's walking is truly a miracle, as was his crawling, pulling up, etc., in the back of our minds we were seriously worried about how it would affect his weight.
Dr. G said no scope, no GIs, no nothin'. Music to our ears. He's just small and is growing on his own chart. He's closer to the 3% on the normal boys 0-36 month growth chart, but we are not putting too much merit toward that chart, as AJ's chart for his own weight vs. height is what we are focusing on.
We are now able to give him water. What? You weren't giving AJ water? No, we weren't. When we began seeing Dr. G and his staff, we were told not to give him water or juice, as those are "empty calories". AJ has an intake of 1500 calories a day. For a long time, most of his calories were coming from whole milk mixed with carnation instant breakfast (CIB). In the last few months they have added heavy cream to the mix. His pediatrician recent expressed concern about his fluoride intake, so we asked GI if we could give him water. I now need to take a look at our house records to see if there is fluoride in our well. If not, then I'll have to buy the nursery water with added fluoride from the store.
Here is a summary of our care plan:
Continue with high-calorie diet (add oil/butter to everything)
Continue with 1 complete multi-vitamin per day
Change liquid intake to either 7oz whole milk + 1 oz heavy cream OR 7oz milk + 1 packet CIB 3x/day
Goal of 24-26oz liquid daily
Give water between meals, avoiding 1/2-1 hour before meals
Follow-up 3 months
To celebrate that GI is finally accepting his gain, and that we won't be stressing over every bite/meal he eats, I picked up lunch on the way home. I thought only one place was appropriate...McDonalds.