by David Lux » Wed Dec 01, 2010 3:38 pm
Debbie,
I would agree with you that charting would be better than the BMI. I just suggested BMI because it's something you can do easily. For the chart, I know that the charts are sometimes not adapted (you mentioned formula fed children, but we have adopted our daughter in China; same problem: usually Chinese children are shorter). What is important, according to our pediatrician is that the children are consistent: they should stay on the same curve. A large swing from the 90th percentile to the 5th would be, IMHO, a clear sign there's is a problem, that would need attention.
On your little girl, the poor one: it seems that she has some health issue and that can definitely interfere with her weight gain. Obviously if she's unwell, she would probably have reduced appetite, maybe she doesn't digest properly, she may have some occasional fever. The first thing would be to help her recover from those sicknesses and reassess the weigth issue afterwards.
For the cholesterol, I remember I have read in one of the McD books that cholesterol production was not reliable until after 2, and that was no problem, because the recommendation was to supplement with breastmilk until 2. Another reason to supplement was the increased need for fats, necessary for good nerve and brain development. Breastmilk, technically an "animal product", contains all the fat and cholesterol needed, hence the recommendation to supplement with breastmilk.
Of course, we can not assume that the cholesterol production suddenly begins on the second birthday. Presumably it begins gradually, earlier in some kids and later in others. I would think that the 2 yo threshold includes some security margin. So not supplementing a 15mo toddler's diet with breastmilk is probably safe, although I wouldn't like to experiment with my kids.
David