Today we had a follow-up appointment with Dr. Yazdi. We were feeling pretty good heading into the appointment for a few reasons. First, his 15 month appointment with the pediatrician on Monday had gone very well. According to the pediatrician, Jonathan had grown since his last appointment but had also settled on a growth curve. OK, so the growth curve was the one percentile, but that's still encouraging since he hadn't even been on a curve until now. The pediatrician said he would remove failure to thrive from his medical record going forward. Second, we had met another family at Julia's preschool whose son was about the same age and same size as Jonathan. Obviously, seeing someone else with another pint-sized son was encouraging. Third, we had made great progress on his feedings. The commonly accepted "norm" is that children need 100 calories per kilogram of body weight, which in Jonathan's case is somewhere in the 700s. With our food journal we're pretty confident Jonathan was getting well over 100% of what his body required.
The gist of our appointment was that Dr. Yazdi was disappointed (for lack of a better word) in Jonathan's weight gain since he has been getting enough to eat. His opinion is that either Jonathan is the type that requires more calories or there could be something else going, like a growth hormone deficiency. So, we're supposed to try and give him even more food and see an endocrinologist. Considering Jonathan is a very active kid, I can see that he might need/burn more calories. The boy never stops moving. If he's anything like Stacey or me though, gaining weight won't be easy. He could just be small and have a very active metabolism like his parents. I think if anything is wrong it's more likely to be something that an endocrinologist would find. If he's getting enough food and everything is proportional, just small, this could make sense.
A third possibility still is that everything is normal. His sister was referred to an endocrinologist a year ago but we never went. Since that time she has grown as expected so our pediatrician said on Monday that she didn't need to see one anymore (she was measured for weight and height before she got the flu mist). Maybe he just didn't grow in the past few weeks but will grow when he wants to. He just went through a growth spurt prior to this period of time, albeit it was the first time he consistently got food, so maybe he's done for a little while. Growing doesn't happen in a linear fashion.
We'll probably get him checked out by the endocrinologist just to be safe. Other then that, we're feeling pretty confident he's getting enough to eat overall. We're just buying time until he is a little bit older and can take over eating and drinking entirely on his own.