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Children's Health

Head Circumference and Poor Weight Gain

07/28/2010

Question:

Hello, I am concerned with the overall growth pattern of my 6 month old son. He was born full term at 40 weeks, weighing 6 lbs, 6 oz and 20 inches long - no complications. Since then, his growth development is as follows:

4 days: 6% weight, 84% height; 20% head circumference 8 days: 6% weight, 89% height; 11% head circumference 22 days: 7% weight, 82% height; 19% head circumference 2 months: 14% weight, 61% height; 15% head circumference 4 months: 4% weight, 79% height; 9% head circ. 5 months: 1% weight, 81% height; 8% head circ. 6 months: 1% weight, 76% height; 3% head circ.

I am concerned that his head circumference has dropped from 20% down to 3%, along with his overall drop in weight. He is meeting all his milestones and is a very happy, active child. My husband`s head is on the small side; mine is average. I am very thin; my husband is average.

Do you think we should be concerned about his drop in weight and the head circumference? Currently our child is breastfeeding every 2-3 hours while awake, with 2 small meals of solids during the day. When I am at work he drinks approxiately 5 oz every 3 hours. He seems to mildly sensitive to milk in my diet. When we tried introducing a little soy formula he seemed to develop some mild eczema. I really appreciate any advice you can give! Our pediatrician`s only advice was to wean him to formula.

Thank you!

Answer:

First, breast milk is best. I would not strongly advocate a change to formula if you and your son is satisfied with breast feeding. At six months, introducing fruits and vegetables is also acceptable.

The overall dip in head size is something to monitor. Is the baby's soft spot still open? As his developmental milestones are being met, I am somewhat reassured but requesting your pediatrician order a skull x-ray may put your worries to rest.

Additional information on early closure of the sutures (growth plates of the skull) is available at: http://www.ninds.nih.gov/disorders/craniosynostosis/craniosynostosis.htm.  Information about small brain size due to poor brain growth is available at: http://www.ninds.nih.gov/disorders/microcephaly/microcephaly.htm.

These sites are for your information only; with normal developmental milestones, as these websites state, a physical problem is unlikely.

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Response by:

Sarah Sauntry, RN, MS, CPNP-PC
Assistant Professor of Clinical Nursing
College of Nursing
University of Cincinnati