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doc4kids
doc4kids , Pediatrician
Category: Pediatrics
Satisfied Customers: 455
Experience:  General Pediatrics and Pediatric Emergency Medicine
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My daughters bmi went from 85 th to 50th...is that bad?

Resolved Question:

My daughter's bmi went from 85 th to 50th...is that bad?
Submitted: 3 years ago.
Category: Pediatrics
Expert:  doc4kids replied 3 years ago.

doc4kids : Hello. How can I help? If you are available for a chat, we can discuss your concern in real time. Otherwise, I can just leave you a reply.
Customer:

I'm here!

Customer:

I was wrong it was actually from 85 to 63.

doc4kids : This is not entirely straight forward. A BMI anywhere between the 5th and 85th percentile is considered a healthy weight. We expect children as they transition from infant to toddler to school age the become more lean and therefore would have declining BMI. How old is she? Over what time frame are we talking? Is she active? Does she have medical problems that might give reason for a decline or any other symptoms to suggest a concerning cause for the change?
doc4kids : I was typing on my phone. I didn't see you enter the chat. I am going to change to my computer. I'll be right back.
doc4kids :

I'm back, sorry about that

doc4kids :

Still 63% is ok. Over what time are we talking?

Customer:

She is 4 yrs 9 months. I will give you her whole history..at her well baby at 4, she was 34.4 lbs(45%) and 38 inches (14%) bmi (85%) the other day she was 36.4 (34%) and 40.25 in (19 %) bmi (63%). NO HEALTH issues that we know of. Is this a normal change in height weight and bmi? She is a picky eater! Some days she eats everything in the house and some days she just picks!

Customer:

She went in January and February and stayed at 36 lbs but she had gained some when we went the other day.

Customer:

Excuse me she lost a little at beginning of Jan, she was 35.8, then back to 36 at the end of January! But really in November she was 36 lbs already! She just actually kinda stayed at 36 until last week.

doc4kids :

That is totally normal. I have two picky eaters too. Weight gain at this age is much slower and they often are using calories for linear growth (height). If you look at the expected growth trajectory, it plateaus after age 2 and is increasing but at a slower rate.If she were losing weight or dropping weight percentages without the height increase, I would be more concrned.

Customer:

Ok! I know when she was 3.5 her height went from 35% to 18% and every visit we went rogers they measured height, but at her 4 yr checkup her Dr said she was just settling in to her expected height and it was fine since she stayed at 14-18% for 6 months. He said they grow really fast until they hit 2-3 then they either slow down based on genetic height or continue. To grow tall based on genetic height.

doc4kids :

The percentages of height and weight answer the question of "normal." As the 50% roughly means that half of her peers are bigger and half are smaller. At this age, she should start sticking to a percentile but as I said this too is variable as they achieve greater height the weight can suffer a bit, but still normal.

doc4kids :

Her Dr is correct.

Customer:

Her dad is 5'8 I'm 5'7 so he's only like 20% and my mother is 5'3 so we didn't expect her to play professional nba or anything!

Customer:

So as long as she doesn't fall off the chart we are ok?

doc4kids :

There are many things she can do in that range. I am 6'3, I have to watch clearances all the time.

Customer:

She got a tooth knocked out at daycare last week mad she had to have it extracted and stitched up and is on a soft food diet for a while, so I'm sure I cannot expect another slow down in weight bc of this correct?

Customer:

I meant can* expect her weight to slow down a bit bc of that.

doc4kids :

under age 2 we say if they drop 2 growth curves (ie 50-25-10) we have concerns, but if they are still growing taller, its hard to put too much into the one number. Even if she maintains a height percentage or drops a little, she is likely still growing taller.

doc4kids :

And yes a bump up or down is expected with illness or dental trauma but, like the stock market we are lookiung for trends over an extended period.

Customer:

So since her height has gone up and not dropped a little like her weight, it's ok?

doc4kids :

yep and, again, consider the trend.

Customer:

I meant she's continued to grow in linear height at same pace/a little more!

doc4kids :

yes.

doc4kids :

Did I answer your question?

Customer:

Thanks a lot! I worry about those percentiles too much! Her ped was my ped and I'm in my 30s and he says he doesn't rely to much on this he goes on the overall picture, like if they grow no height and no weight for a year, he said he would be worried!

doc4kids :

I agree. A wise man.

Customer:

I meant he doesn't rely to much on percentiles!

doc4kids :

It's your job to worry. Its his job to reassure (or investigate if it's really a problem)

Customer:

My mom reassures me she weighed 33 pounds In the first grade(which is tiny!) and she always says when they are hungry they eat and when they are not they don't!

Customer:

When u said it's his job to investigate if there is a problem...u didn't mean u think there is a problem with her right?

doc4kids :

Yes, as new parents it's easy to want to impose an adult eating habit of three "meals" a day. It's probably healthier to just make healthy choices available to her all the time and allow for some flexibility there.

Customer:

Yes, you think there is a problem?

doc4kids :

No, sorry. I absolutely don't think there is a problem. I meant generally. In pediatrics, we spend probably more time discussing normal growth, normal development than we do with painful, invasive or involved evaluations.

doc4kids :

I got behind in responding to your inquiry. A limitation of texting or chatting

Customer:

Oh ok! Phew!! I thought you meant yes! Sorry! Thanks a lot!! You are awesome!!

doc4kids :

an my slow typing. My wife mocks me for it.

Customer:

So you don't think there is a problem.

doc4kids :

No

doc4kids :

I dont think there is a problem

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Customer: replied 3 years ago.

I'm sorry to bother you again but she was 40 inches 15%,does that change you answer...I read it wrong..she is still 1% higher than she was a year ago!

Customer: replied 3 years ago.

9 months ago not a year ago


 

Expert:  doc4kids replied 3 years ago.
I still would stand by my previous assertion, this is not a problem.
Customer: replied 3 years ago.

Ok! Just checking cause you said "if she was losing weight or dripping weight percentiles without the height increase you would be concerned" you meant "height increase" as in growing in height not IncreasIng In HeIght percentIle, and the concern would be if she didn't grow any in height (stayed the same height as she was at her well baby check) right?

Expert:  doc4kids replied 3 years ago.
yes
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