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Can This Pediatrician Relationship Be Saved?

Can This Pediatrician Relationship Be Saved?

By Amalah

Dear Amy,

I’m writing because I’m at my wits end. I have a 1.5 year old little girl. She was small when she was born (5lbs 8oz full term) and she’s been growing steadily since birth but has flattened out a little over the last few months.

She eats pretty well but can be picky and immediately stops eating the minute she feels unwell- this winter has been a battle as every two weeks she got an ear infection or a cold- nothing serious but enough to make her want to drink every meal and forget about things that are high in protein and she absolutely hates Pediasure.

Anyways, my concern is not about my daughter, but about our relationship with our pediatrician. When my daughter was born, they made it clear to me at the hospital that her low birth weight was my fault- the doctor told me that “obviously she wasn’t getting good nutrition in utero so now you really need to focus on fattening her up.” That was the first of so many comments about my child’s low weight and now they come from her doctor constantly. When we go to the office, she’s deemed totally healthy except she’s small. At her 1 year check-up, the doctor told me to feed her butter on everything she ate to increase the calories so she would gain more weight. I’ve told him that the babies in my family are smaller and my husband’s side is very small (babies and people). But he continues to prod me about what I’m feeding her every time we go in to the point now that I just feel attacked and on edge. On days that we have pediatrician appointments, I’m a mess. Now he’s ordered blood tests and the results came back normal (albeit the prealbumin levels a bit low) but we’re still getting so much pressure to force feed her ice cream and butter products. If he says to me one more time “focus on high fat high protein foods” I will go insane. What does he think I’m doing?

I don’t doubt that our pediatrician is doing what he thinks is right. He obviously feels that she is too small and that it is important for her to gain weight. However, I’m concerned that his constant attention to her weight is a red herring and that the focus is not just wasting our time and money as a family, but is killing our relationship to our pediatrician and the medical system in general. I’ve spoken to other parents with children of similar size and growth patterns. I had assumed that our pediatrician’s concerns meant that she was an anomaly but I meet parents every day that say their kids were/are the same. Some of them said that they were actually worried but their pediatricians said it wasn’t a big deal.

So here’s my question: Should I change pediatricians? How important is our relationship to this doctor? I never really had a pediatrician as a child or a family physician so I’m concerned that I don’t understand how important this relationship is to my daughter’s health. Is it just a thing where we go in and see the doctor occasionally and grin and bear the fact that we don’t love him? Or will this relationship just get worse over time?

I just can’t help but think that my frustration about the issue is a) now stopping me from being objective and b) not going to get better.

Any advice about pediatrician woes would be much appreciated.

Change pediatricians.

I mean, what else is there to say? Your daughter is fine. She’s just small. Your pediatrician has essentially CONFIRMED that she is fine and is just small thanks to extra check-ups and tests. But clearly his bedside manner is driving you bonkers and that alone is a perfectly justifiable reason to change pediatricians.

What the hospital told you (“it’s your fault”) was complete B.S., and a horrible thing to say to a new mother — who OF COURSE is going to take that deeply to heart and worry that she’s already failed her child for life because AS WE ALL KNOW, people LOVE to tell pregnant women everything and anything they are eating or drinking is wrong and bad and why aren’t they thinking about the baaaaaaaaby instead of their selfish craving for a hot dog.

But I don’t doubt for a second that the hospital said that, because they said essentially the same thing to ME about my 9 lb, 15 oz, full term but not overdue baby. “We have to test his blood sugar,” the nurse told me. “Babies aren’t supposed to be that big.” When I insisted that I’d passed my gestational diabetes test, she actually snorted a laugh at me. “We’ll see,” she said, super condescendingly.

His blood sugar was FINE. He was FINE. He was just BIG.

So I don’t doubt that your daughter is also just fine and you’re doing the best you can to get calories in her, the way parents of picky-but-typical-weight-babies do. (My huge baby gave me more feeding/weight gain stress that EITHER of my two 7-pound babies did, by the way.)

And really, changing pediatricians is not a decision you need to justify to me or anyone else. This guy drives you nuts and won’t drop this one issue and you’re having ANXIETY about visits. Move on, really, and don’t worry about it. I remember feeling so pressured during my first pregnancy to OMG FIND A PEDIATRICIAN and it felt the same as picking a daycare — super momentously important and also permanent, like I wasn’t allowed to change my mind if it didn’t work out.

Ha ha yeah mom-of-three now and I’ve changed pediatricians multiple times. Once because the practice dropped our insurance. Another time because they repeatedly failed to correctly diagnose my child’s UTI and we ended up terrified and at a specialist’s office because of the misdiagnosis. I’ve also switched between doctors within the same practice for a variety of reasons: This doctor thinks Cry It Out is appropriate for newborns and won’t stop suggesting it. That doctor tends to interrupt you a lot and doesn’t fully listen to your questions. That doctor is really chill and I like him while that other doctor gets mad if I tell her that no, sorry, my kids refuse to drink skim or 2% milk so I let them drink whole milk and I’m sticking with that decision, okay, lalalalalala?

Our current pede practice has eight different doctors. I see us now as having a relationship with the practice and not necessarily with any specific doctor. I trust that I can always get an appointment if my boys are sick. They will be operating on time and will bill our insurance correctly and fill out forms when we need them. My kids will get their vaccinations as needed and the doctors and nurses will work hard to make visits as pleasant and non-scary as possible. And they will give me good advice and recommendations without making me feel defensive, judged or panicky.

Your doctor isn’t working out on that last one.  Go back to the parents of other fine-just-small babies and children and ask for pediatrician recommendations. Stick up for yourself and your own instincts.

About the Author

Amy Corbett Storch


Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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  • Nancy

    March 16, 2015 at 12:12 pm

    please change doctors! or practices if necessary. my 5 year old has rocked the 5th percentile in height and weight from day one. it is obviously genetics. Our current doctor is very comfortable with her weight and makes me feel comfortable with her being so tiny.

  • Ally

    March 16, 2015 at 12:27 pm

    Both my girls are super tiny (never on the charts). Our pediatrician has never been concerned. He always says if they stay on their own curve they are good to go. He tends to be more concerned with dramatic changes. Having a pediatrician that you really like is such a great thing. I didn’t care for some that we have seen, and now I just stick to one in particular. 

  • IrishCream

    March 16, 2015 at 12:31 pm

    Change, and don’t look back! If you’re feeling judged or attacked by your pediatrician, it’ll make it harder for you to bring up the random questions and concerns that you will have over the years. It sounds like your doctor is, frankly, kind of awful. You’ve been a saint to put up with that bedside manner this long, and you’re entitled to move on and find a pediatrician with whom you feel comfortable and whose judgment you trust.

    I also have tiny but healthy kids who’ve gone through long periods of no weight gain. All I had to do was explain my family history, and my pediatrician was no longer concerned. In the absence of any other symptoms, it should be that easy! Good luck and hang in there.

    • Melissa S.

      March 16, 2015 at 1:33 pm

      Hi IrishCream, your child did have times of no weight gain? I ask because my son has gone 4 months now and he’s been stuck at 19.5 pounds (he’s 2). We’ve gone to so many specialist and they haven’t really helped. We’re about to give up but I still have this nagging feeling because he hasn’t gained. I get him being below the charts, but no gain is scary. Should it be? 

      • SusanEm

        March 16, 2015 at 8:03 pm

        Both of my kids are pretty small (5th or below). My 2 year old son has had no weight gain in the last few months. My 5 year old daughter gained a whopping half pound in the last year. They are getting taller, just not heavier. All other development is normal and nobody’s worried about it. (nobody that I’m listening to anyway)

      • IrishCream

        March 17, 2015 at 9:38 am

        Melissa, she has had several periods with no weight gain. She’s a fits and spurts kind of kid. She went about a year without gaining a pound between 3 and 4 years (but did grow taller). She was otherwise energetic, developing normally, eating small but consistent quantities of healthy food, so I wasn’t stressed. (And nor was our doctor.)

        My three siblings and I were all 5th percentile for height and weight until after puberty, and went through those same periods of slow or no weight gain. We had a different family doctor by the time my little sister came along, and he put her through several months of increasingly invasive tests to find out why she wasn’t growing. Found nothing, and she’s now 30 years old, 5’6″, and average weight. That was repeated with one of my nephews 20 years later…he’s now 15 and small but healthy. It’s just how people in my family grow.

        All that is to say that I personally wouldn’t be worried about only four months with no weight gain, especially in the toddler years when their activity level increases and many kids are exchanging baby fat for muscle. I am not, however, a doctor, and I’m not giving medical advice, just sharing my own experience! Hope that is helpful.

        • Melissa S.

          March 17, 2015 at 1:44 pm

          Yes it is helpful! We’ve seen a cardiologist, and gastrologist (sp), all to no avail. The gastro thought he was back up…..but for 4 months?! I’m going to give up for now. He’s totally normal otherwise. Thanks for the responses!

  • Carolyn Allen Russell

    March 16, 2015 at 12:32 pm

    Yes, change doctors! Because this one sounds awful, and what if something DID happen where you needed important medical advice from someone you trusted? You clearly don’t trust this guy! And that would be a terrible time to try to find someone new that you like. I’m not super picky about my doctors (we were randomly assigned a pediatrician and he just happened to be wonderful, so we got really lucky! It’s not like I went and interviewed anybody or put a ton of thought into it) BUT it’s important to me that I feel comfortable asking questions and confident that the advice I’m given is accurate and safe AND it’s important that your doctor believes you and trusts that you are being accurate with the information you are giving, as well. If you came in with a concern about your daughter’s health, would this doctor believe you and follow up with it? Or would he dismiss your concerns without checking anything and send you home? I don’t think you need to find a doctor that is your BEST FRIEND or life partner or anything, but I think life is a lot easier when you can trust one another and don’t have to fight for competent (and KIND!) care. Life is too short to deal with awful people, anyhow. Find someone who won’t make your life miserable and will be supportive of your daughter and her growth 🙂 

    • Melissa S.

      March 17, 2015 at 1:43 pm

      Yes it is helpful! We’ve seen a cardiologist, and gastrologist (sp), all to no avail. The gastro thought he was back up…..but for 4 months?! I’m going to give up for now. He’s totally normal otherwise. Thanks for the responses!

  • Kendra

    March 16, 2015 at 1:25 pm

    Change your Pediatrician! My daughter isn’t even on the weight charts at this point and our doctor isn’t concerned. She is obviously growing so he said she is healthy and we would only need to worry if she stopped growing. And I was even smaller than her when I was her age so obviously genetics. Those charts are total crap.

  • Victoria

    March 16, 2015 at 1:50 pm

    Absolutely change. Now, rather than later. I had the EXACT SAME experience when my daughter was born, where she was small and not on the charts. She breastfed fine, was a great eater – until we started getting the same advice. Add butter and cream to everything, add chocolate to her milk, as much cheese and nut butters as she will eat. We had already been to specialists for bloodwork and a terrifying Cystic Fibrosis test, so we listened and fed her all the fatty extras.

    Then, when we tried to get back to healthy eating – it was not happening. Over 4 years later, she is still a horrible eater, preferring everything with added butter, cheese, cream, sugar, etc. On the advice of our doctor, we created a picky eater.

    I changed pediatricians before my second, who was almost exactly the same in weight and gains – but our new doctor consistently said “as long as they gain even a small amount of weight between visits, they are healthy.” So we focused on healthy, nutritious foods – and he gained weight fine, even more than my first ever did. Our new doctor is also supremely calm about everything from weight to ear infections, which makes the kids and adults calm too.

  • Shannon

    March 16, 2015 at 2:23 pm

    Listen to your doctor…really listen to him before you change pediatricians. It sound like you have concerns about the message and how it was delivered


    The message is that your doctor, who is an expert in children’s, health is telling you there is reason to be concerned about your daughter’s weight. Spend more time learning about those concerns. Ask for a referral to a nutritionist. Then, if as a team, you all agree she is healthy and small and you still don’t like the way the messages are delivered…then change docs.

    • MR

      March 16, 2015 at 3:22 pm

      No, I’m sorry, but as an “expert” in children’s health, this doctor needs to know that the delivery of the message is just as important as the message itself. This doctor is rude and condescending and flat out saying things that are false. Stating that it was obvious that baby wasn’t getting adequate nutrition in utero?? That’s total crap, and a good doctor knows that mother shaming is not going to deliver the message. This OP absolutely needs a new doctor IMMEDIATELY. There is absolutely no need to stay with this doctor at all. If there truly is a problem with her child’s weight, then a new doctor will concur, but no person should ever stay with a doctor that is rude and condescending. There are other doctors who can deliver the same message while still showing respect for the patient, and they should absolutely be rewarded with OP’s business.
      I also have a daughter who is very small – she was 5lbs 11ozs at birth, and almost fell off the growth chart completely. We worked with her doctor, and we did do the whole butter and liquid heavy whipping cream thing, because she absolutely needed it. The difference is that my doctor has always been polite and respectful, and listens to me. I was the one who brought my concerns to him. He listened and supported me. And when, after she had started gaining, I was worried that she wasn’t gaining enough, he calmly reassured me and pointed out that “while she may not be big, she is obviously thriving. The charts are guidelines. They do not fit all children.” OP, change pediatricians!!

      • MR

        March 16, 2015 at 3:28 pm

        OP, one more thing – there is also one more simple point I learned in our process with our daughter – a child who is not getting enough to grow will not continue to meet milestones. They grow physically first, then they grow mentally. So, if your daughter is continuing to meet her milestones developmentally, then she is just small. If she is behind on her milestones, it is possible that she needs more calories. My daughter had a health issue that was contributing to her weight issues, and once we started supplementing, she grew significantly in only a few short weeks and rapidly advanced in her milestones. It was incredibly obvious that she NEEDED those extra calories, and is why I get a little paranoid about making sure she is getting enough. I will never forget the change in her in only a few short weeks.

      • Cheryl S.

        March 17, 2015 at 11:31 am

        First, while pediatricians might be “experts” on the books, they should also know that every child is different.  They don’t know everything.  (Believe me, my daughter had a sinus infection as a baby for approx 6 months.  Until I insisted that she be put on a long course of antibiotics — 3 weeks– the “expert” kept telling me she just had the sniffles and I should calm down.)

        Even if there is a problem (weight or anything else), if you can’t discuss that problem with the doctor, you need a different one. OP is having anxiety just having to go to the office.  She needs a new pediatrician. The sooner the better.

    • IrishCream

      March 16, 2015 at 3:37 pm

      I’d have more concerns over the fact that the doctor has not given her a reason for his concerns. All tests have been normal and she’s a healthy toddler…if he has specific reasons for his concerns, that’s great, but small size and slow but consistent growth are not in and of themselves a medical issue.

      If she finds a new pediatrician and after an exam and family history, they too are concerned, then absolutely, she should learn more, see a nutritionist, etc. 

  • Jeannie

    March 16, 2015 at 2:57 pm

    I, too, have a small daughter — she is heading towards five and last year grew three inches and gained a SINGLE pound. She also took over three years to triple her birth weight, something that should take a year.


    My doctor has always been fine with it. She grows on her own curve, she eats, she’s meeting all her milestones no problem. I’m not a huge person either, so my doctor is apt to just shrug and say — it’s just genetic if she eats ok and is growing at her own pace.

    As for the doctor issue … if you don’t feel comfortable, change. I love my doctor and trust her, and I need to have that for my own comfort and for my confidence in her. If you don’t have that — there are plenty of other doctors out there.

  • Ashley

    March 16, 2015 at 3:28 pm

    I completely agree – Change docs ASAP! Doctors opinions can vary widely, even in the same practice. Our first doc told me that at 2 months old my baby was “obese” because of the difference in percentiles between height and weight even though he was born large and never lost weight. We changed immediately. The next doc we saw from the same practice said he looked great at his 3 month appt and his weight was due to “the miracle of breast milk.” MUCH more my style 😉

    It’s so important to know and trust your ped. Don’t stay with someone that makes you feel inadequate or uncomfortable. Also, if you feel like he’s taking you for a ride to spend your money… Well, he probably is.

  • Sara

    March 16, 2015 at 7:48 pm

    Just to provide a slightly different perspective…I am a pediatric health care provider (full disclosure). I agree you should have no hesitation to change providers if you do not feel comfortable with the one you have. Going to a check up is anxiety-provoking enough for our children, we don’t need parents to be upset as well! So by all means, doctor shop. It won’t hurt your kiddo as long as you are getting records transferred so she doesn’t miss any important vaccines or follow ups.

    That being said, I think it is important to keep your daughter’s growth on the forefront of your mind. A low prealbumin is seen in malnutrition. You yourself said she has flattened out. I would be interested to know how much flattening out she has done, and what that means for her. If she has dropped 2 standard deviations on her curve or if she has not gained weight, or if she has not experienced skeletal growth that follows her curve (which I’m inferring maybe she hasn’t from your use of the term “flattened out” but obviously I don’t have the whole picture) then I do think you shouldn’t ignore it.

  • Jeanne

    March 16, 2015 at 9:28 pm

    Isn’t it so reassuring to hear everyone agree with what you’ve been intuitively feeling?! Definitely change peds. Our Ped is really fantastic – my daughter was 38W, born at 4 lb 15 oz. Like many of the bebes in the comments, she didn’t even hit the charts at her first visit. She’s growing fine, and isn’t eating butter 🙂 

    Always trust your intuition!

  • c

    March 16, 2015 at 10:28 pm

    Have you considered a family practice? My OB is also a family physician, so she sees my son too.

  • Lisa R

    March 16, 2015 at 11:03 pm


    If it truly is a problem (being a mother of a small girl who grows almost not at all makes me think it isn’t a problem) then another dr will notice and can make you feel comfortable even when dealing with it.

    I had a very similar thing, and luckily we moved so we had to get a new dr. Not even one word about weight at our new place! Love it.

  • Operation Pink Herring

    March 16, 2015 at 11:20 pm

    My daughter is also super tiny. I celebrated when she hit the 3% at her last well vist. My regular ped, who i really like, has always been pretty concerned about her weight, to the point of giving me a handout from the 80s that suggested adding Karo syrup to her milk and lacing all her food with margarine. Yeah, no thanks. i didnt worry as much because she’s my second, and my first is a very picky eater who has gone weeks eating essentially nothing and is still always in the 75-90%. Shes just big. Second is just small. You cant MAKE a kid eat. Anyway, my real point: at our last visit we saw a different doc because our regular one was out on mat leave, and he was totally unconcerned. He said, yup, shes been on the 2-3% curve for a year, youre not going to change that. As long there arent dramatic changes and we continue to do our best getting her healthy, high fat/high protein foods, no worries.

    Hope you can find a new doc that isnt so obsessed with weight!

  • turbocharger

    March 17, 2015 at 12:28 am

    God yes, change doctors!

    And to be on the flip side, I have an abnormally large, but otherwise healthy baby and had a doctor suggest we put her on a diet. At 3 months old. And she was exclusively breastfed. She was 10lbs 8oz at birth and just kept growing on the 98th percentile until around a year and now she’s begun slimming out. Doctors don’t know everything, and the relationship that you have with them is incredibly important.

    Picking a daycare was similar to what Amy said, I agonized over it, and after 2 months it simply wasn’t working and the trust was broken. So we switched. It’s a much better place for me to have my baby during the day because the communication is open.

    Trust your momma gut and switch. Do it now.

  • A doc

    March 17, 2015 at 1:01 am

    I think either you bring yourself to ask the doctor why he is so concerned and really listen to the answer, or you find someone you can ask that question of more comfortably.  Your relationship with your doctor matters, as does his/her with you; if you don’t trust him, it shows, and it will affect how you are treated.  Because we are all human.

    I have to comment on the last paragraph – the 8 doctor practice sounds lovely but you are being very naive if you think that any primary care practice, however well run, will always run on time.  Kids get sick.  People burst into tears.  Life doesn’t always fit into tidily scheduled appointment times.  You want a doctor who will listen to you when things fall apart unexpectly? Be prepared to recognize that waiting room time is the same as exam room time…and before anyone jumps in with the suggestion that docs develop more realistic booking schedules, I refer you back to “kids get sick”.  We fit them in.  We skip lunch and get home late to our own families.  Bring a book.

  • Caroline

    March 17, 2015 at 10:06 am

    Oh, definitely change doctors. Thing is, this will come as a major shock, but there is no actual law that you have to see a paediatrician regularly… There are certain times it’s recommended (6 months, 1 year), but for regular vaccinations, a nurse can give those, or any regular GP… ideally a slightly older GP who is, let’s say, not obsessed with obsessing on ridiculous things…
    My youngest baby was 5.2kilograms or 11lbs8oz. Yes he was. No, I did not have diabetes, nor did he. He was just… ridiculously big. My older 2 were both over 4.5kgs so I have a history of large babies, but ANYWAY… if your daughter is growing steadily, if she does eat regularly, a reasonable range of nutritious foods, if she seems well in herself with no worrying tendencies or obvious problems, then… she doesn’t need a doctor specialist The baby police will not get cross with you if you simply do not take her back there. You do not need all those tests, they cost a bundle and… one more time… there is nothing wrong with your daughter. She is petite, lucky her. One day she may be 6 foot, who knows? Or she may always be small and slender. Babies are all different, much like people generally. And when you do want to see a paediatrician for a particular concern of YOURS (not on his say-so), find another one… get some recommendations. Guaranteed this relationship is not working and he who pays the piper, calls the tune… you are the piper!

  • Cheryl S.

    March 17, 2015 at 11:25 am

    I would definitely change docs.  If there is an issue with your daughter’s weight the new doc will deal with it as well.  

    You should not be getting anxious just to take your kid for a well visit. Get out of there and get a new doc.

  • Mona

    March 17, 2015 at 8:10 pm

    My sons are on the opposite end- always over 95% for height. They also weigh more than my peers’ children, though they are not heavy at all. I’ve asked our pede about their size several times- he assures me each time that they are just BIG, and proportional. As a chubby kid, I guess I just need the reassurance, and he always makes me feel comfortable that they are growing well, appropriately for their (giant!) size. I feel like your pede should help reassure you that things are as they should be- it’s stressful enough being a parent.
    Change doctors, your well visits should be pleasant and reassuring.

  • christina

    March 19, 2015 at 3:19 pm

    Change Drs…. my son is also on the low end of the charts. When I asked my dr if we should be concerned, his answer was perfect. “They are just charts, someone will always be in the 90th percentile and someone will always be in the 10th” If she is growing and happy, I’d say thats one healthy little girl.

  • Natalie

    March 19, 2015 at 4:10 pm

    CHANGES DOCTORS FAST. What a dick, first off. Secondly, pediatricians, although equipped with much more medical knowledge than the most of us, thanks to their medical school education and general experience, are still getting paid by YOU for their OPINION and service. You are in control. You are the mother. You wouldn’t continue to pay/use a mechanic that insulted you because you don’t wash your car enough or some stupid opinion based argument of theirs….it amazes me that we as a country (including myself up until recently) continue to allow doctors to question our abilities as parents. Every doctor is going to have their personal beliefs and opinions that differ greatly, the fact that your doctor is looking past the point that your child is healthy and happy but doesn’t “fit the mold” (because what child does??) and is trying to guilt trip you is beyond disgusting. Not only that, but I would personally be concerned of this doctor staunch beliefs on your baby’s weight…who’s to say he won’t report you to authorities because he’s a nut job who thinks you’re not feeding your child enough. Also remember YOU are the mother and that your gut is always right. Clearly your girl is healthy and happy and just the fact that you’re so concerned about all of this shows you’re a great mom.

  • Jenn

    March 20, 2015 at 8:23 am

    Another pediatrician chiming in here, and I have to echo what Sara said above. By all means, if this pediatrician has poor bedside manner and is not explaining things well and is making you stressed out, switch pediatricians. BUT, you mentioned several red flags in your question that would justify concern and medical evaluation for your daughter. Small but growing is different from small and not growing. Dropping percentile lines (while maintaining the same weight) is a concern. If you are not getting enough nutrition, weight flattens out first, then height, then head/brain growth. You want to catch it and correct it when it is “just” weight, rather than waiting for poor brain growth or delayed milestones, which could have longer term negative impact. So, your pediatrician is right to raise alarm, but perhaps not right in how he is conveying the message. In addition, you mentioned that your daughter has mostly been on a “liquid diet” due to colds, etc. This is understandable, but raises the risk for malnutrition. In particular toddlers at this age who are drinking mostly milk are at risk for anemia, and it can be severe (I’ve seen serious complications). Mostly juice has its own set of concerns, due to protein deficiency. So, checking labs was totally justified. Those labs showed low prealbumin, which is how we measure malnutrition — solid evidence that she needs more intake. I don’t want to sound harsh or scare you, but it does sound like this needs to be followed carefully (perhaps by a nicer pediatrician). Although, to reassure you, 15 months is a common age for this sort of trouble, as toddler grow in independence and mobility, their intake drops and their calories burnt rise, plus colds on top of that can make it worse. It usually sorts itself out in a few months, but a good pediatrician would still watch carefully to make sure things get back on track.

    • Kat

      March 20, 2015 at 3:17 pm

      Really cool to see two experts weighing in (Sara and Jenn). We actually don’t have a pediatrician, we have a “family doctor” who sees me, my husband, and our three year old son. He is the same doctor who provided my prenatal care (and connected me with specialists when we needed them towards the end of the pregnancy), he was there when our son was born and he continues to be a great resource between visits. The key for me was finding someone who would care for our whole family, and was confident and comfortable in calling experts when we needed something more specific. I trust him because his response to my questions always seems logical and supportive. He explains what care he’s providing, and listens to my questions. He keeps up to date on current practices (like adding healthy fats and protein to a diet rather than butter or sugar – from what I understand that’s just empty calories) and he respects my opinion and intuition as a mother. I view him as a partner rather than someone who just “examines” my child. So, yes, the relationship is extremely important, but if you don’t have a good one, move on and tell your new doc what happened with the old and why the relationship didn’t work. Ask them to double check your kiddo, and go from there!

  • Jenn

    March 20, 2015 at 8:28 am

    And, Amy, I think the problem with your nurse was also an issue of tone rather than message. Big babies are definitely at risk for low blood sugar, even if the mom didn’t have documented gestational diabetes. It can be missed. If there is concern, better to check a blood sugar than have a newborn with hypoglycemic seizures or brain injury. It happens. Most doctors/nurses are trying to do the right thing for you and your child, even if their bedside manner is lacking.

  • Christy

    March 22, 2015 at 9:31 am

    These percentiles create so much stress! If your child is in the 5th percentile for both weight and height, isn’t that perfectly proportioned?  My two year old is actually skinny, 99th percentile for height and 20th for weight. This is out of proportion and all my pediatrician said was basicly get her to eat whatever she will but keep it healthy, don’t feed her junk just for the calories. My pediatrician is awesome.

  • s

    April 6, 2015 at 4:17 pm

    We also had Dr. Issues but we asked for referrals for continued genetic low growth. My son had severe reflux and would stop eating when sick. This was treated with medication for years. My son eventually had a bone age done, two years behind chronological age through pediendrochronolgy at a children’s hospital. This is after being followed by Pediatric gastro from before your daughters current age, allergy, ent, audiology. I also called birth to 3 for a feeding evaluation with an occupational therapist. There are feeding resources through American speech language hearing association. We also had an evaluation done through the district. The pediatrician transferred our case after two specialist reports basically contradicted him. Our specialists basically told us to have him eat what he wants when he wants. We got an alternAte to pedicure through our insurance. Our gastroenterologist and endocrinologist are great. Again, we have been seen at a major children’s hospital for years. No blame, really friendly. They have their names for our school to contact them with any feeding questions. You might also consider getting in with a specialty clinic who deals specifically with this issue if possible. Our Dr. Trains doctors from around the world. They have a much better handle on this. Our pediatrician just does his shots and routine illnesses.
    Hope this helps. I wish you luck. So been there.