Wednesday, October 20, 2010

Wednesday Weigh-In

Two weeks ago: 8.50 kg (18 pounds, 12 ounces), 30.5 inches
(We were out of town last week.)
This week: 8.55 kg (18 pounds, 14 ounces), 31 inches
Two weeks' change: +50 grams/2 ounces, +0.5 inch
Net change: +850 grams/30 ounces, +2 inches

Still not good in the weight department. Since the beginning of October, Becca hasn't gained any weight. (Two weeks ago she dropped weight, so this week's increase just bumps her back up.) She has, however gotten taller - 1.5 inches in 3 weeks, if you believe the measurements. (She's definitely taller, but I'm not sure I buy a 1/2 an inch a week...but who knows.) I'm grateful for the height increase, since we can't really make that up later like we can weight, but we really do need to see some more weight on her. Even when I am generous and use her adjusted age AND round her weight up, here's what the CDC BMI calculator tells me:

BMI Calculator for Child and Teen Calculate again:English | Metric

Information Entered

Age: 2 years 1 month

Sex:
Girl
Birth Date: September 14, 2008 Height: 2 feet 7 inch(es)
Date of Measurement: October 20, 2010 Weight: 19 pounds
Results

Based on the height and weight entered, the BMI is 13.9 , placing the BMI-for-age at the 1st percentile for girls aged 2 years 1 month. This child is underweight and should be seen by a healthcare provider for further assessment to determine possible causes of underweight.

BMI Range: Underweight


yellow underweight, less than the 5th percentile
green healthy weight, 5th percentile up to the 85th percentile
orange overweight, 85th to less than the 95th percentile
red obese, equal to or greater than the 95th percentile
(After LOTS of conversations with her doctors and nutritionists, we have all finally agreed that the BMI is the best measurement to evaluate instead of those silly weight-for-length charts that don't make any sense for her case.)

So, what do we do? Well, first off, we've got a prescription for a super-duper juice called Enlive. It's got some added protein and nutrients, but probably most importantly, it's got 250 calories per 8 ounce serving (unlike the usual 120-ish calories in regular juice). We are trying to get her to drink one juice box a day. This week's she's finished off one about every 1.5 days, so we're getting there. Becca loves juice, so I think this will be a really good way to supplement her oral feedings. We are also bolusing her 1-2 ounces of formula during the day if she doesn't eat at a meal. (Bolusing means that I give her a large amount in her button all at once instead of letting the pump give it to her over an extended period of time.) I'm still getting the hang of this, and she doesn't like it, which makes it difficult and messy. I have some hesitation with this technique because I want her to learn to satisfy her hunger by eating orally, but in the meantime, the kid's got to get some nutrition in her. We can't just bump up the volume on her night feeds because she tends to throw up in the morning when she's too full, and that really defeats the purpose!

She's not eating great (usually not even good), but I think the biggest issue is that she is burning so darn much energy! Really, I think she is busy even for a 2-year-old (and I've dealt with more than my share of 2-year-olds over the years), even though she can sit still and read books for 20 minutes or so. She is e.v.e.r.y.w.h.e.r.e and usually dancing, which means that she is stomping, spinning in a circle, waving her arms and squealing ALL AT THE SAME TIME. Hilarious. I'll try to get video for you. So, many of the calories that do make their way into her little body are expended through being a two-year-old...but that's what they are for, after all! And I'm not about to try to slow this kid down!

(On the positive side, though, I seem to be 10 pounds below my pre-Becca weight...not sure how that happened, but I'll take it!)

3 comments:

  1. I knew you looked skinny when I saw you at the mall! Lookin' good!

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  2. we are feeding charlotte by mouth for as much as she will take, but then we bolus feed her 1 oz of water and 4-5 oz of pediasure immediately following. this way, no matter what she takes in at the meal, she immediately feels full and associates eating with feeling full and also gets in needed calories. she has gained 1.5 pounds since august 20 when her tube was placed!!! we are so thankful. just thought i would throw it out there - she's not nearly as active as becca though so she isn't burning through her calories like becca is.

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  3. I just did the CDC chart- I fudged it a little because Zoe is only 23 months adjusted and it doesn't let you enter an age under 2. Her BMI was less than Becca's, 13.6- under 1st percentile. She weighs 21 lbs, is 33 inches tall, so I thought their percentiles would probably be the same. Still, that little message at the bottom about needing to bring her to the doctor was irksome.

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