Slow Weight Gain and Breastfeeding Patient History Brady is a 7-month old boy br
ID: 3509435 • Letter: S
Question
Slow Weight Gain and Breastfeeding
Patient History
Brady is a 7-month old boy brought in by his mother 1 month late for his 6-month well visit and his pediatrician has concerns about his growth. He receives well childcare through a clinic at his mother’s workplace. His weight consistently plotted on the CDC Growth Chart, has decreased from the 75th percentile at 4 months of age to the 10th percentile at this visit. He is being referred for an evaluation of failure to thrive. He is the second child for these parents. He was born at term after vaginal delivery and uncomplicated pregnancy. He has been exclusively breastfed, with initiation of solid foods at around 6 months of age. His mother feels as if her milk supply is adequate and has experienced no change in the volume of breast milk. She is able to pump while at work. He has started food and has no feeding difficulties. He has met all developmental milestones. He has maintained his height and head circumference. He has had no vomiting, diarrhea, or irritability. His mother is 54 inches tall. His father is 59 inches tall. His physical exam is normal.
Mothers Concerns
She originally didn’t have any, but has become concerned due to the attention being paid to her son’s weight.
She is curious about the richness of her milk.
She would like to know what supplements either she or her son should be taking.
Questions
Is this baby’s growth pattern abnormal?
How do the CDC Growth Charts differ from the WHO Child Growth Standards?
What advice would you give his mother?
What other questions should you ask, and what physical findings should you look for before making a diagnosis?
What do you think about the referral for failure to thrive?
Would you provide any additional nutritional guidance?
Explanation / Answer
According to conditions all things are right and still there is slow weight gain and child feed on mother milk. Then something is wrong with nutritional value of milk. Mother should take quality food and as the baby is older 7 month additional supplement may be provided as Ceralac and other supplements.
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