head circumference small and how much solids

[DrSally]

Hi, I just went in for my DS's 7 month appt and he is now is 18 lbs, 7 oz (50th percentile), and 27 3/4 inches(75th percentile). He was born 8lbs, 7 oz, and 21 inches and started in the 70th percentile for weight and 90th for height. I have heard that it is normal for BF babies growth curve to flatten out, so I'm not too worried about that. I BF before solids 2x a day--1/4 c cereal and 1-2 oz veg/fruit. I would like BM to be his primary source of nutrition for the first year, and solids to be complementary. Ped suggested 3 meals a day, but DS gets so much milk in the AM from BFing that he spits up the extra. I don't understand how they say you should wait until 6 mo to start solids (no one seems to, we started at 5.5 mo) and then want you on 3 meals a day at 6 mo as well. I got the impression that ped thought I wasn't feeding enough solids. Such mixed messages.

My major concern is that his head circumference was only in the 25th percentile (as it always has been, but I didn't realize it). Is it normal for a baby to be in the 75th percentile for height, 50th for weight, and only 25th for head circumference? Does this say anything about his brain development. He seems normal and has met all the normal milestones. Anyone have any experience with this? The ped said it was ok, but I can't help but worry.

[nfowife]

I started solids at 6 months, and did 2 meals at 8 months, 3 meals at 9 months. BF until 13 months and started whole milk with meals at 11.5 months. I didn't really see a significant change in DD's nursing pattern until I started the 3 meals and I'm glad I waited until 9 months because at that point it went down to 4 nursings a day and she started STTN as well (nursed on waking, before each nap, and before bed).
My DD was born at the 50th for weight and 75th for height. At about 6 months she went down to the 25th for weight but stayed at the 75-90 for height. Her head has always been in the 25th and has stayed. It's not a "grade", remember that. It's to measure your child's growth against themselves over long periods of time. A 25th percentile child (in height, weight, or head circ) is just as "normal" as a 75th percentile child, if they stay the same over time. I don't think it has anything to do with brain size or function, honestly. Some people have big old heads and some people have smaller heads. If he had a big decline or jump, it would probably be cause for concern but since he is staying on the same curve, it sounds good to me!

[o_mom]

Just ignore the ped on the feeding. Your son will eat what he needs to. We didn't even start solids until 7 mos and weren't to 3 meals until 9-10 mos. I would take it slow. You should be able to start finger foods soon, and that will let him self-regulate better. You can offer a finger food snack for lunch and if he is hungry he will eat it.

If his head has stayed the same percentile, not really a worry. Those measurements are hard to do at that age, anyway, since they try to rip the tape off.

[COElizabeth]

My DS has about a 5th percentile head circumference and varying but much higher percentiles for height and weight. It made me concerned, too, but our peds have always said it's not a concern. And I think I read somewhere that head size isn't that indicative of brain size (among humans, that is. Of course it is when you compare a person to a fly, lol!).

I wouldn't worry about how many solids he's getting now. Lots of babies are barely taking a baby spoonful or two once a day at your son's age, if they have started them at all. It sounds like he's doing great and feeding is going just fine, so I'd just keep taking it as your baby's pace.

Elizabeth, Mom to James, 9-20-02
and Charlotte, 11-04-04

[jillc]

Hi Sally,

Not to worry. :) Sounds like you're doing great. We did one solids meal at 6 mos, two solids meals at 7 mos, and three solids meals at 8 mos. DD was not a big solids eater, and I was lucky if I could get her to eat a couple tablespoons of solids at each meal. She was still nursing quite often, too, so the solids were just for the experience, anyway.

My DD has had pretty much the same measurements that your DS has - started off 8.4 & 20in long. 25% head circ. Stayed in the high % for weight & height until about 9 mos & then dropped to 75th-50th% for height & weight. Now at two years old, she's 50th height, 50th weight & her head size has always been 25th%.

Our doc said that around 18 months, if I recall correctly, they start to really approximate the true height & weight ranges that they will be as adults. For my DD, 50th height, 50th weight & 25th head all seem just right based upon my & DH's builds.

My DH's family all have small-normal sized heads. You wouldn't know it by looking at them, but I can tell they're a bit small b/c DH and I wear the same hat size, etc. It's not indicative of intelligence. :)

You guys are doing great.
Jill

[missym]

Just to back up what the other ladies have said... head size is really only a concern when it is below the 5th percentile and/or not growing along the curve. Even then, it doesn't necessarily mean anything is wrong, some kids just have small noggins! (DD1 technically has microcephaly because her head is very small and had slow growth, but so far no issues with development.)

Missy, mom to Gwen 03/03 and Rebecca 09/05

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[DrSally]

Thanks everyone for sharing your experiences and reassurance! It's good to know that they start approximating their true height and weight around 18 mo. I had heard that having a big baby doesn't necessarily say anything about their size as an adult, so it's nice to know when their true body shape starts to emerge. I guess the things I have read about head size and brain size prob just apply to the VERY outter margins--micro and hydrocephaly, and not those within a normal bell curve. It just seemed strange to me that the percentiles would be so different for, but it's nice to hear that it is not uncommon from others. I know I can let my imagination run away from me.

With regard to feeding, I've been trying to take my solids advice from LLL, Kellymom.com, and Dr. Sears. Seems like starting solids is different for formula vs. BF babies, but peds have one-size-fits all recommedations. Everyone says BM is most nutritious for the first year and solids are complementary, but you get the feeling the peds think you are underfeeding if you don't give 3 squares a day by 6 mo. If you did that, how would there be room for BM? I like the idea of finger foods for the 3rd meal, so he can self-regulate better.

Thanks again for all the input!

[DrSally]

Thanks for sharing. I guess microcephaly is just a descriptive word for small head, and doesn't necessarily mean anything will be wrong.

[chicagojo]

My DD was always in the 5th %ile or lower for head circumference, but 50th-60th for height & weight. Our ped was never concerned (pointed out that I have a rather small head myself!) and said many kids start out "disproportionate" but this can change over time. Sure enough, by her 2 year visit she was in the 5th-10th %ile for everything - she was just meant to be tiny and her head knew it before the rest of her body did!

[Rachels]

My nine month old is barely eating solids. He just started them in earnest a few weeks ago, and he's growing like a horse, using a few proto-words, and cruising. His head circumference is 25% and he's 50% for weight and height. All's well. :)

-Rachel
Mama to Abigail Rose
5/18/02
http://www.gynosaur.com/assets/ribbons/ribbon_amethyst_36m.gif
Nursed for three years!

and Ethan James
10/19/05
http://www.mothering.com/discussions/images/smilies/bf.jpg


"When you know better, you do better."
Maya

[DrSally]

That's interesting. It seems that the body eventually slows down to match the head, from the posts I've read. Funny, we never really look at the size of adult heads, but I guess they do differ!