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Is The Following Weight And HC Parameters Ideal For A 6 Month Old?
Question: QUESTION FOR PEDIATRIC NEUROLOGIST
My son is now 6 months. His birth date is 15th july 2014.
I have given weight and head circumference measurements, till now in medical history
I am concerned for his weight and HC parameters and growth.
Need to know the reasons and solutions for the same
Excel attached for charts
My son is now 6 months. His birth date is 15th july 2014.
I have given weight and head circumference measurements, till now in medical history
I am concerned for his weight and HC parameters and growth.
Need to know the reasons and solutions for the same
Excel attached for charts
Brief Answer:
Please answer the questions and I will be gald to get back
Detailed Answer:
Hi...I have gone through the measurements you have provided. I remember that in our last interaction I have asked you to follow up at 6 months of age with growth charts plotted, which you have rightly done.
A baby born with a birth weight of 2.74kg and at 6 months weighing 5.97kg is failing to thrive. Even the head circumference is less than 5th centile which means the head is small. But this doesn't mean he has a neurological problem.
I have few questions for you -
1. Did he cry well at birth without any assistance?
2. Di she accept direct breast feeding on the 1st 24hours of life?
3. Now he is 6 months - does he accept any objects given to him with his hands and exchange the objects from one hand to another?
4. Is he rolling over on his own?
5. Is there any family history of developmental delay?
6. How much solid feed and milk feeds does he take per day?
7. Do you add good amount of ghee in the solid feeds you are giving?
8. How many time does he pass urine per day (I mean good amount, not less volume)?
9. Does he crave for water?
10. Does he have loose stools frequently?
11. Does he have any recurrent skin infections?
12. Does he vomit a lot?
13. Does he arch his back backwards when he is sleeping or feeding?
Kindly answer all the above questions and I will be glad to guide you through and present you some solutions.
Regards - Dr. Sumanth
Please answer the questions and I will be gald to get back
Detailed Answer:
Hi...I have gone through the measurements you have provided. I remember that in our last interaction I have asked you to follow up at 6 months of age with growth charts plotted, which you have rightly done.
A baby born with a birth weight of 2.74kg and at 6 months weighing 5.97kg is failing to thrive. Even the head circumference is less than 5th centile which means the head is small. But this doesn't mean he has a neurological problem.
I have few questions for you -
1. Did he cry well at birth without any assistance?
2. Di she accept direct breast feeding on the 1st 24hours of life?
3. Now he is 6 months - does he accept any objects given to him with his hands and exchange the objects from one hand to another?
4. Is he rolling over on his own?
5. Is there any family history of developmental delay?
6. How much solid feed and milk feeds does he take per day?
7. Do you add good amount of ghee in the solid feeds you are giving?
8. How many time does he pass urine per day (I mean good amount, not less volume)?
9. Does he crave for water?
10. Does he have loose stools frequently?
11. Does he have any recurrent skin infections?
12. Does he vomit a lot?
13. Does he arch his back backwards when he is sleeping or feeding?
Kindly answer all the above questions and I will be glad to guide you through and present you some solutions.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello doctor,
I have answered your questions as under.
I am worried on his failure to thrive, and could not locate exact reason for the same.
Also, his weight increased by 180 gms from 13th dec to 26th dec, but only 60 gms from 27th dec to 10th XXXXXXX Could not understand the reasons for this.
Am also worried for his HC growth. Does his percentile is an issue? (My HC is 52-53 cms). Is this genetic or growth issue?
Anything you suggest for medicine booster for him?
1. Did he cry well at birth without any assistance?
Yes.. (actually what I remember doctor chatting that when he was pushed slightly to get down as it was ceasar, he started crying that point of time only)
2. Di she accept direct breast feeding on the 1st 24hours of life?
Yes.
3. Now he is 6 months - does he accept any objects given to him with his hands and exchange the objects from one hand to another?
Yes. he accpets the objects.Plays on its own. Keeps the same in his mouth. He picks up the objects on his own to play.He pulls clothes of his own or of others to keep the same in his mouth. He smiles and laughs. He observes others when someone is speaking with concentration
4. Is he rolling over on his own?
Yes.he does
5. Is there any family history of developmental delay?
No.nothing noticed.Not aware too.
6. How much solid feed and milk feeds does he take per day?
4-5
7. Do you add good amount of ghee in the solid feeds you are giving?
Yes
8. How many time does he pass urine per day (I mean good amount, not less volume)?
He passes stool once/twice a day.Urine it seems to be adequate
9. Does he crave for water?
Yes sometimes.
10. Does he have loose stools frequently?
Sometimes he has loose stools, sometimes stools are tight
11. Does he have any recurrent skin infections?
Yes. It seems to be. I notice small red dots on his skin sometimes. It seems to be like viral, as it is there for one-two days then go away. I have notice craddle cap (mild)again behind the ears and on his head
12. Does he vomit a lot?
No. He has cough. So sometimes he does vomit, when we feed him and he is crying. However not frequently
13. Does he arch his back backwards when he is sleeping or feeding?
Could not understand the question well. Can you elaborate this?
I have answered your questions as under.
I am worried on his failure to thrive, and could not locate exact reason for the same.
Also, his weight increased by 180 gms from 13th dec to 26th dec, but only 60 gms from 27th dec to 10th XXXXXXX Could not understand the reasons for this.
Am also worried for his HC growth. Does his percentile is an issue? (My HC is 52-53 cms). Is this genetic or growth issue?
Anything you suggest for medicine booster for him?
1. Did he cry well at birth without any assistance?
Yes.. (actually what I remember doctor chatting that when he was pushed slightly to get down as it was ceasar, he started crying that point of time only)
2. Di she accept direct breast feeding on the 1st 24hours of life?
Yes.
3. Now he is 6 months - does he accept any objects given to him with his hands and exchange the objects from one hand to another?
Yes. he accpets the objects.Plays on its own. Keeps the same in his mouth. He picks up the objects on his own to play.He pulls clothes of his own or of others to keep the same in his mouth. He smiles and laughs. He observes others when someone is speaking with concentration
4. Is he rolling over on his own?
Yes.he does
5. Is there any family history of developmental delay?
No.nothing noticed.Not aware too.
6. How much solid feed and milk feeds does he take per day?
4-5
7. Do you add good amount of ghee in the solid feeds you are giving?
Yes
8. How many time does he pass urine per day (I mean good amount, not less volume)?
He passes stool once/twice a day.Urine it seems to be adequate
9. Does he crave for water?
Yes sometimes.
10. Does he have loose stools frequently?
Sometimes he has loose stools, sometimes stools are tight
11. Does he have any recurrent skin infections?
Yes. It seems to be. I notice small red dots on his skin sometimes. It seems to be like viral, as it is there for one-two days then go away. I have notice craddle cap (mild)again behind the ears and on his head
12. Does he vomit a lot?
No. He has cough. So sometimes he does vomit, when we feed him and he is crying. However not frequently
13. Does he arch his back backwards when he is sleeping or feeding?
Could not understand the question well. Can you elaborate this?
Brief Answer:
I suggest some investigations - kinldy get back with them
Detailed Answer:
HI... I have a few findings and suggestions to make -
Findings -
1. Though your kid is slightly underweight and head circumference is lower than what is expected, his development is completely normal. So you need not worry about his smaller head circumference.
2. Active kid is a well kid even though his weight is slightly less than expected, so do not worry about it.
3. We need to work up your kid by some investigations for the cause of under weight - if everything turns out to be normal, you can be rest assured.
Suggestions -
I suggest you get the following investigations done and get back to me with the result please.
1. CBC - Complete blood count.
2. Serum Urea
3. Serum Creatinine.
4. Serum Electrolytes.
5. Liver function tests.
6. Urine routine with nitrites.
7. Echocardiogram of the heart.
I AM VERY SURE THAT THERE IS NO SERIOUS PROBLEM WITH YOUR BABY. BUT OT BE DOUBLY SURE I AM RECOMMENDING TO DO THESE INVESTIGATIONS AND GET BACK TO ME.
PLEASE DO THESE TESTS IN A GOOD REPUTED LABORATORY.
Nest time when you get back to us, please post a direct query to me so that I can be in follow up with your son. Only I will answer a direct query posted to me.
If you have any more queries regarding this, you are welcome and I will be glad to discuss and clarify your doubts.
Regards - Dr. Sumanth
I suggest some investigations - kinldy get back with them
Detailed Answer:
HI... I have a few findings and suggestions to make -
Findings -
1. Though your kid is slightly underweight and head circumference is lower than what is expected, his development is completely normal. So you need not worry about his smaller head circumference.
2. Active kid is a well kid even though his weight is slightly less than expected, so do not worry about it.
3. We need to work up your kid by some investigations for the cause of under weight - if everything turns out to be normal, you can be rest assured.
Suggestions -
I suggest you get the following investigations done and get back to me with the result please.
1. CBC - Complete blood count.
2. Serum Urea
3. Serum Creatinine.
4. Serum Electrolytes.
5. Liver function tests.
6. Urine routine with nitrites.
7. Echocardiogram of the heart.
I AM VERY SURE THAT THERE IS NO SERIOUS PROBLEM WITH YOUR BABY. BUT OT BE DOUBLY SURE I AM RECOMMENDING TO DO THESE INVESTIGATIONS AND GET BACK TO ME.
PLEASE DO THESE TESTS IN A GOOD REPUTED LABORATORY.
Nest time when you get back to us, please post a direct query to me so that I can be in follow up with your son. Only I will answer a direct query posted to me.
If you have any more queries regarding this, you are welcome and I will be glad to discuss and clarify your doubts.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok...Doctor...I would check for these tests.
Also, I would like to make you note that, since 10 days, we are trying to make him seat independently. He can sit for some couple of seconds like 5-10 seconds, but then loses his control. Is this ok? When can we expect him to sit independently?
Also, anything you want to comment for what i mention for his skin infections?
Also, I would like to make you note that, since 10 days, we are trying to make him seat independently. He can sit for some couple of seconds like 5-10 seconds, but then loses his control. Is this ok? When can we expect him to sit independently?
Also, anything you want to comment for what i mention for his skin infections?
Brief Answer:
Sitting inependantly is good by 7-8 months
Detailed Answer:
Hi...
1. This is too early to sit independently - s\but some babies do and those who cannot do are not to be seen as developmentally delayed. Sitting independently will be good by 7-8 months. So do not worry.
2. I asked about recurrent skin infections to rule out the possibility of immunodeficiency. Cradle cap is normal in this age.
3. In my 13th question I asked about arching his back backwards - to rule out the possibility of gastroesophageal reflux. What I meant was if he bends his back in extreme back ward position while feeding or sleeping. Hope you got it after I rephrased the sentence.
I will be awaiting the results of the tests. Please get back as soon as possible. But it not an emergency situation.
Regards - Dr. Sumanth
Sitting inependantly is good by 7-8 months
Detailed Answer:
Hi...
1. This is too early to sit independently - s\but some babies do and those who cannot do are not to be seen as developmentally delayed. Sitting independently will be good by 7-8 months. So do not worry.
2. I asked about recurrent skin infections to rule out the possibility of immunodeficiency. Cradle cap is normal in this age.
3. In my 13th question I asked about arching his back backwards - to rule out the possibility of gastroesophageal reflux. What I meant was if he bends his back in extreme back ward position while feeding or sleeping. Hope you got it after I rephrased the sentence.
I will be awaiting the results of the tests. Please get back as soon as possible. But it not an emergency situation.
Regards - Dr. Sumanth
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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