DD, 2, dropping centiles - too much milk?

[Flossie69]

DD is 2.1, and has always been diddy - has followed the 25th centile since birth. She has always been a good eater - I feed her to appetite, and never fuss when she has had enough. Somedays she eats less, and some days she eats so much we have commented on how can she still be so little! Developementally there are no problems. She still has a bottle of milk first thing in the morning and just before her bath.

So, at her 2 yr check up, the health visitor measured her height, and said she had dropped to the 2nd centile! Her advice was to drop the milk bottles, as these were filling her up, and preventing DD from eating a good breakfast. I had not stopped the bottles as I thought the milk was good for her.

So now I am torn - DD absolutely loves her bottles, but I guess they will have to go at some point. So I suppose I am asking for some advice and perspective. Should I worry? Should I drop the bottles or not? And if so, how? And should DD be having vitamins? She wont entertain milk from anything other than a bottle, though she will happily drink anything else from any other container - sports bottle, open cup, glass etc

Any help / advice gratefully received

I would ignore HV - she's likely to be getting lots of good nutrition from the milk - at least as much as she would get from breakfast.

If she's healthy and happy, just let her be - don't create any issues around food that don't need to be there. My DTs (nearly 3) are just the same - some days eat loads, other days aren't bothered.

Thank-you, Bomb. I suppose I wouldn't have as much of an issue (nor would the HV if it wasn't from a bottle - which I know you are meant to drop when they are 1!!!

Oh, I shouldn't worry about that

She'll drop the bottle eventually! Also, did the HV measure both height and weight? Because it's not really a problem if DD is on 2nd centile for height / weight as long as she is in proportion.

I was a bit surprised when HV said that DT1 was on 91st centime for weight - but he was also on 98th for height, so in proportion, iyswim.

We didn't get to weigh her, as it was at the end of the appt, and DD was fed up with being asked to perform lots of tasks, and got very upset when her height was measured. So she just would not stay on the scales............ But from we could get, she seems to be still on the 25th - but she certainly doesn't look fat.

We have a follow up in 3 months, to see where she is.

How do they eventually drop the bottle themselves - how does this happen - and when?

Hi op

you and a few others may not like what I'm gonna say tbh. My mum is a nutritional therapist and has strongly advised me since ds was born, never to give him cows milk as a regular drink. Many reasons basically. mucus stimulation, links to increasing risk of type II diabetes, links to heart disease, high chlolestorol, breathing problems...the list goes on. Research it yourself and don't always go with what these health visitors tell you. nurses, which are what hv are and have to be before they qualify, are extremely poorly trained and educated in nutrition. They go by basic facts such as milk has calcium in it, give it to kids as soon as they're weaned.

You may be interested to know that actually the closest to breast milk is donkey milk, amazingly enough. Cows milk is high in protein, very high in fat, and kids who drink it tend to have snotty noses, get coughs and colds a lot and have a poor appetite. I've seen my friends giving it to their children regularly and then wondering why the kid pours with snot constantly and won't eat a good dinner. I have another friend who's ds has been diagnosed with potential rickets from a severe calcium deficiency..even though he is given milk as his main drink. Try your dd on almond milk (high in calcium and great vitamins) or just plain water. Getting her off the bottle will also stimulate her appetite as it's a well known fact (publicised on supernanny also) that children around the age of 2 who still have bottles and dummies don't tend to eat brilliantly. 2 is too old to have a teat in your mouth, especially when they are trying to speak and communicate effectively. You did say dd was diddy and hopefully once you get her off the bottles you will notice a real difference in behaviour. Giving food at random times other than set meal times will also encourage her to eat more. If dd is tiny naturally I wouldnt freak out too much about it as some kids are (my ds is really skinny but eats very well!)

Take it easy on yourself and what I've advised you on comes from the mouth of a professional person who knows about nutrition in babies, small kids and adults, I hope it was helpful x

Hi StMoritz I will certainly look in to that. Her behaviour is not any more problematic than any other 2yr old toddler. She does have a dummy, but only at nap and bed time. The milk she is having is SMA toddler milk. And re giving food at random times - she is very good at snacking!

Just something I have thought of - why is 2 yrs too old for a teat - don't some Mum's breastfeed pas this age?

Does anyone think giving vitamins would be beneficial?

your little one seems to have the same appetite as my ds, you could try reducing the amount of milk in the morning bottle graually if you wanted to try and do away with it, my ds just stopped wanting his at 12months but he still has a drink of juice before bed in a flask cup...

i think its good she drinks that amount of dairy, my ds is dairy free now but hes on calcium drops because i couldnt get enough calcium in him, its very important that children have enough milk

It is interesting that no-one is saying that at 2.1 yrs she shouldn't be on a bottle anymore............

It's exactly the same drink, regardless of whether it is served in a bottle or a cup. I can't see how the HV can be right unless your DD is also not putting on weight. It is possible that previous measurings have not been all that accurate and your DD's moving from 25th to 2nd percentile has been more gradual than you think. Are you and your DP quite short? - that would be a more likely explanation of your DD's diddiness.

Did the hv use a measuring mat? It is quite difficult to get an accurate height measurement, even when they use one tbh.

Hi Hazy measuring mats were used previously, but this time it was one of those vertical things with a slider that comes down. DD was none too pleased with it, and it was difficult to get a reading. I was initially dubious about the result, but when at home, I measured her against where she reaches on our fridge freezer . If she was still on the 25th centile, when she plays with the magnets on the freezer door, I would smack her head opening the fridge door!! As it is , I can just open it over her head. Not scientific, I know.....

I haven't been worried up to know, as she seems heavier when I carry her, and she is needing new clothes, though not very quickly. She is in 18-24months now - these are generous on her. She had a pair of shoes size 4 last November, and these are still fine!!

Cecily - no, neither of us is tall - I am 5'3", and DP 5'9".

Dd1 was referred to the paeds when she was nearly 2, as the hv deemed she was failing to thrive, and dropping in centiles for height, she even mentioned growth hormones. At the appointment she was weighed and measured, the hv had cocked up the height measurements and the paed said with this and the fact that dh and I are both short there was no point in dd1 being there.

I wonder if you could get someone else to measure her?

That's really interesting stmoritz I have a dairy free toddler who's health is far better than her older milk eating/drinking sister! Am seriously considering reducing her intake especially as there r milks out there now that r nutritionally tailored to be suitable as drinks for children. She is asthmatic and suffers with eczema which by sound of it won't be helped by dairy :(

I had opposite problem, when my DD was 2 she drank nothing but milk, as she didn't like juice/ water and this made her weight soar, she was average and went above the 100 centiles ( in fact she became 2kg over) HV told me to drop milk which we did, it took ages but we got there but her weight didn't drop, so I was told by HV to look at her diet ( she was 2.5-3 at the time, and I assumed that meant put her on a diet!!!) I refused and HV said that she would "take this further " ie social services, I'm very upset at this point, so made small changes to her diet and found her calorie count was well under what she should be anyway, I also requested to see a pediatric doctor, which we did and he said not to worry about her weight as children's metabolism don't always kick in till there 5!! And low and behold 6 months later weight has dropped to the 95th centiles and eats anything she likes! So my advice is keep the milk as its a food source and adds to her calories, so if she's underweight it will help, but do what you feel is right, as us mums know best.

I would dispute that milk actually causes mucus problems, however large volumes of any filling liquid can reduce the appetite a bit.

I would suggest swapping gradually to normal milk, toddler milk is unnecessary and has added vanilla flavouring which may encourage them to drink more. I suspect if you offered it in a cup she would drink a bit less of it too. If you are concerned, and she may just be petite,( I have a 5.4yo that is maybe 15kg if that and can wear 2-3clothes) then ask your GP for a referral to a dietitian.

Dietitians are state registered professionals, nutritionists may have brilliant, little or no training (I could set up as one tomorrow, I am also a registered HCP but it is not a protected title, just look at 'Dr'Gillian McKeith) - they are the best people to give you specific advice.

I was going to add, that if you are concerned about weight and diet, it might be an idea to be referred to a dietician (as opposed to a nutritional therapist - which is like a complementary therapist). We see one with ds and she is great.

Thanks, everyone. I think I will start by gradually replacing her milk with normal milk, then swapping to a cup. But even now I am not sure, because if she starts drinking less, she will get nutrients. I guess no one ever said this parenting lark was easy.............

Hi. When Dc are measured lying down on mats their length is greater than the height measured when standing up, I assume due to gravity. That would explain partly the drop in centiles for your dd's height. Also as already said above as neither you or Dp are tall, your daughter wouldn't be likely to be tall either .

Could you try giving the milk in a cup or a bottle? I think the thing with bottles is that they are quite comforting - I know for DS (who does still have a bottle before bed) he is all snuggled up with me, cosy and warm from the bath and I'm sure he drinks more milk than he probably needs because of that.

I feel that they can regulate how much they need more easily from a cup or straw or sippy cup.

I"ve minimised DS's morning bottle because he was eating only a small breakfast, but I can't imagine that a bottle at night, potentially 12 -14 hours before their next meal could have an impact?

Maybe try reducing the amount slowly rather than removing it all in one go.

We've just dropped DS2's evening bottle because someone in the pub said we ought to we thought it was time. He had been having about 7oz morning and night. We just went cold turkey on the evening one (because he's a cold turkey kind of guy). Anyway, ever since then, he's been ravenous - which surprised me, because I also thought the evening bottle wouldn't make much difference. He's 22 months, but quite a chunky chap, so I wasn't bothered about the weight issue.

FWIW, the main concerns about bottles seem to relate to toddlers who control access to the bottle themselves (eg have them in their cot or wherever, and sip them over time, which is bad for the teeth). If, like DS2, they drain the bottle in 3 seconds flat and it's then taken away, then I don't see why it's a problem.

DS is breastfed and he's always snotty

I think the problem with teats is that they drip milk onto the teeth whereas with breastfeeding the milk goes straight to the back of the mouth and down the throat immediately.

Have you come across the book My Child Won't Eat? I've heard it's extremely reassuring about DC finding their own patterns.

We had a similar situation with our DS when he was around 13 months old (down from 25th centile at birth to 0.4th for both height and weight); we asked for a referral to a paediatrician, as I got sick of the umming and ahing of our health visitor and the lack of clarity on whether there really was a problem or not. The paed felt he was having too much milk so we did cut back and it did help his appetite a lot. In fact, what really helped was moving his morning milk to after his breakfast, and to a cup. He still drinks milk in the morning sometimes (he's 2 next month) but often takes a few sips and then just forgets about it in his rush to play. I think it being in a cup made it more like a regular drink to him, rather than something special, so he drinks it if he's thirsty or fancies it, but otherwise just leaves it. We still give him a cup of milk in the evening, but he often doesn't drink much. He'll ask for it sometimes, but not always. He's still tiny compared to his friends though!