Monday, July 14, 2014

Crowd-sourcing a well baby check

Dearest mother bloggers,

I have this little baby girl. And by little, I mean absolutely petite beyond all imagining.

Don't let the food face fool you, she's teeny. Look at those nowhere-near-squeezed-by-the-Bumbo legs.
See? She's a wee little mite of a girl. And yeah yeah, though she be but little, she is fierce, there's just something off-putting to me, her mother, about how very wee she is.

My other two boys are not big kids by any means. I think they're in the 35-50% range for weight and height, and always have been. But Evie Doll, as she is usually called around these parts, is very much the likeness and scale of a living baby doll. Which is of course adorable, but when you're breastfeeding, is a little anxiety-producing as well.
Evie Doll, meet baby doll
Dave thinks I may be barking needlessly up the worry tree when we are, in fact, in a verdant alpine meadow above treeline, but I want a second opinion nevertheless. Of the internet variety. (Please note: her doctor who delivered her and has cared for her since birth has absolutely zero concerns and reassures me at every check up that she is growing perfectly on her own little curve.) And so I turn to you, gentle readership: have any of you had tiny babies? Were they exclusively breastfed? Did you try supplementing with formula to put weight on? Did they simply grow into healthy, petite toddlers and kids?

Here are Evie's stats:
  • Born at 38 weeks 4 days (I'm a lucky girl - 6 lbs, 6 oz and 19 inches long - my smallest by more than 2 lbs and my shortest by 3 inches!
  • Dropped to 5 13 after birth, regained birth weight by one week old
  • 8 lbs, 11 oz at 2 month well baby
  • 11 lbs even at 4 month well baby
  • 13 lbs even at 6 month well baby
  • 13 lbs 6 oz today, on the eve of her 7 month birthday
  • 3% for weight and 5% for height on WHO chart, from birth until today; no change in percentile
  • repeat ultrasounds during pregnancy because she was measuring small (that makes one of us) and for "short femurs" (I didn't even know that was a thing to worry about but, you betcha I got my google on hardcore that night after the tech let that little gem slip from her lips)
Is this normal? Am I crazy? Should I take her to reverse weight watchers and see if they can inject her with some of the fat she left behind in my torso region?

Some other factors which may contribute to her slimness are the presence of a 5 foot tall aunt, her godmother actually, on her paternal side, and the fact that Her Ladyship sleeps 11 hours a night (don't hate me, I earned this one) without a feed. She nurses 6-8 times per day with occasional table food offered as she shows interest. I know breast milk is denser calorically so I'm hesitant to load her up on too much crappy rice cereal, though I have been known to mix some with avocado oil and an avocado, much to her disgust and horror.

An anxious, first time  veteran mother thanks you kindly.

And so does this girl.

47 comments:

  1. Sorry your first comment has to be from someone who has no advice, but I NEEDED to comment to say she.is.so.adorable.

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  2. I too cannot give advice as we have gotten excited when any of our 4 drop to land at the 90%ile of those size scales (ALL were huge and have stayed huge...) However, it does appear that she is growing quite fine and looks very healthy. So what if she is small? Enjoy having a tiny little girl. When they are bigger they outgrow all of the cute baby clothes and then the grand hunt for age-appropriate clothes that fit begins. Clothes designers seem to feel that baby girls should be immediately given over to sexy looks.....
    I LOVE her little rolls and dimples, which to me, says that she is very heathy and happy. Just keep doing what you are doing and love on her--she is growing fine from the look of her! Hope your worries fade in prayer~

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  3. Please don't worry about dear Evie! I have had 2 tiny babies (4.13 at 38 wks and 6.9 at 40 wks). I exclusively breastfed them both for ~6 mos and nursed them past 1. Since they followed their own perfect little growth curves, the ped wasn't worried. As long as she IS growing, fear not!

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  4. Both of my kids were bigger babies, and my oldest has been at the top of the charts pretty much ever since (I blame her tall father). My second lost weight around 4-5 mos. The dr had told me to keep an eye on it at her 2 month well-baby visit, since her growth had started to plateau a bit, but I didn't worry at first, since her sister did the same thing and then shot up. I had been nursing exclusively, but (per dr.'s advice) started supplementing formula just to see if she was still hungry. Apparently my supply had seriously decreased.
    I would think that if she's still eating well, still going through a normal # of diapers per day, and since she's been consistently at this curve, she's probably just petite. She IS growing and if your dr isn't concerned, I think you're okay. :)

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  5. Don't even worry. Not a BIT. Someone has to be in the smaller percentiles, right? Her ratio is beautiful and she's maintained it throughout her entire life. That shows she is small but growing at a predictable, lovely pace, an excellent sign of health. My tiny baby stressed me out so much, but he is just a totally healthy shrimpy shrimperson. You're doin' good, mama.

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  6. My son (2 yrs) has only recently made it onto the charts at all. He takes after me; I was never more than 4% my entire childhood and was often off the charts. One of my twins is also still not on the charts; the other is at 2%. (They are 8 months.)

    I was formula fed as a baby, my boys have all been breastfed.

    She looks quite healthy to me ... a lovely, petite little girl! :)

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  7. Two out of three of my boys have been teeny. They were not even on the growth chart until they hit about 3 years of age!! They followed their own little curve off the chart and our ped. never worried at all. He always told us that as long as they do not drop off "their own curve", they are fine. My kids are still small, healthy and active and eat a ton, but small. I would not worry about her.

    She is adorable!

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  8. You are all so wonderful!! How can there even be a word for how wonderful you are?

    God bless the internet.

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  9. Look at that sweet baby chub, happy demeanor and awesome sleep! She isn't hungry and she is healthy and just absolutely perfect. Worry not mama! While mine are all behemoths, my dear sister in law has petite babies and they are all just fine even though they are always at the bottom of the averages. You're doing a great job feeding that baby!

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  10. can I just say, I love this, all of this! adorable girl, and wonderful bloggers, and helpful readers... love it!

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  11. My 3.5 year old boy weighs 28 pounds. My 3.5 month old girl weighs 17 pounds. Whatchya gonna do? Happy and healthy is all that matters...enjoy your sleep! :)

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  12. I have never had a teeny baby, and I suspect I never will. But I'm pretending like I can comfort you to confirm what all the people who actually have tiny babies are saying: don't worry!!! If she had suddenly dropped to the 4th percentile, or been a huge baby at birth and a tiny baby now, or was screaming through large parts of the day and night, perhaps there would be cause to try something new. But this lovely lady has clearly been tiny from her zygote stage and has consistently remained so, and she sleeps like a champ! So I say no worries. And I am obviously an expert because I have three walking children and one who is currently rooming-in (my belly). :)

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  13. I have nothing to contribute to the discussion of her health, but I just had to say how beautiful she is! Absolutely precious :-)

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  14. My first 2 were 50-90%, ignatius has held steady at 2-3%percentiles since around 6mo. My doctor keeps telling me he "looks" healthy, and not sickly... And plus, he's super active! Do not worry unless you think something is actually wrong with her developmentally or she looks ill. She's beautiful!

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    1. ... And I always start solids late and nurse til they're at least around 1yr old.

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  15. Evie sounds just like my Stella only a year younger (seriously, almost exactly a year apart!). At 2.5yo, Stella is still petite. I exclusively breastfed her for over 6 months (nursed for almost 2.5 years). She didn't take to table food until a couple of days after her first birthday. She, like Evie, was at 3% on the WHO charts on a good day. She's youngest of four and what she lacks in stature makes up for in personality ;) My kids also have celiac disease and milk allergy. I had to give up gluten too because Stella was so sensitive to it. As long as Evie is meeting developmental goals when the time comes--speech, sitting up, crawling, walking, etc--but remains small just keep feeding her healthy foods and encourage her, have no worries :) And, I'll add...Evie is beautiful!

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  16. She's perfect!!!! I just consulted with two friends of petite daughters... Mabry just turned 1 and is currently 15lb and was only 10lb at her 6month appointment and the other one- Reagan- turned 1 a month ago and is currently 13.8lbs. Both were formula fed after 6 months. Both are perfectly healthy.

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  17. My first was a wee slip of a thing (well, after 9 months--she was in the 50th %ile until then). She actually fell off the bottom of the chart at one point. But they were never concerned as long as she was trending along her own upward curve. No worries! Bump up your own fat intake, if you want, but don't stress.

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  18. My son has been in the 0-5 percentiles for weight for most of his short life (he's 13 months now--and hit the 10th percentile at his 12-mo checkup!). He was a slow gainer during his first couple of months... believe me when I say I would have been THRILLED with some of your daughter's numbers. I had tons of anxiety at the beginning, and we did supplement with some donor milk to help fill daycare bottles when I didn't pump enough at work, but we never turned to formula, and our doctor never suggested it. One of the pieces of advice that I kept getting was to look at the baby, not at the scale: and "Evie Doll" looks SO healthy. Look at those cheeks and arms! Gah, so cute! She's just a petite little lady, and as long as she doesn't seem to be asking for more food, I don't think you've got anything to worry about. You certainly wouldn't be doing her any favors to start pushing more bottles on her when she's not hungry--that's not a good relationship with food to establish. Also, remember that the percentile charts are based ONLY on healthy babies: they represent the full range of "normal." So being towards the bottom of the scale doesn't mean unhealthy--it just means little! And there ain't nothin' wrong with little.

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  19. I was born at a totally healthy weight (7 lbs 10 oz), was exclusively breastfed, and dropped to the fifth percentile by my first birthday, then slipped to below the 1st percentile once I was relying solely on food. I was only 22 lbs when I was 4-years-old, and only 48 pounds at 11. Of course, my mother FREAKED and was always trying to get me to chug those foul-tasting Ensure weight-gain shakes. In the end, I wound up a perfectly normal 5'4" with a completely normal BMI. I think in modern times the doctor would have told my mom to switch to formula, but the fact is, i was just a picky eater with a small appetite, but super healthy. If your daughter seems bright and chipper and is meeting all her milestones, I wouldn't fret. She may just be small by constitution. Or small as a baby and then grow into a fairly normal height. You have to remember that someone has to make up that low end of the growth curve, and most of those babies are perfectly healthy.

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  20. With those stats, she sounds perfectly fine to me. Yes, she is small, but SOMEONE has to be small, you know. And she IS gaining weight and staying on the same percentile. Dropping percentiles is concerning...staying on the same percentile is fine. Plus. it's not like she's skinny. I mean she has a roll on her thighs, chubby cheeks, creases around her wrists, chubby knees. She's tiny, but she's not skinny, SHe's adorable!!

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  21. My girl are little for their first 2 years or so. I wish that I could remember the exact stats on the older one but I do know that she was around the 5th percentile for weight and 15th for height on her 1st birthday. At her 4 year old well child visit she was 40% for weight and 80% for height. Her brother wasn't quite as dramatic but followed a similar trajectory. Baby girl had to be weighed three times at her 1 year checkup because no one believed that a baby that looked as good as she did could weigh so little--17lbs 8oz. Like everyone else said, as long as she is tracking on her own particular growth curve with no sudden changes, then she is fine.

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  22. She's perfect! She's beautiful! She fits right in with my crowd! :) Three of three born Pandolfo children have been petite like that. Our nursing/solid food eating was about the same as yours and my kids are all doing great. You have nothing to worry about!

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  23. Oh your Evie and my Declan are a little match made in heaven. Emphasis on little. Declan was born at 8.4 lbs and has only gained 4 pounds in 3 months...definitely the skinniest of all my babies, with the exception of my first. I am still worried about his weight bc he was dropping percentiles but just recently started staying on the curve, so I feel better. My first baby was always on the 5 % curve until he was ten years old! Now he actually had a little pot belly at 11 :-) Declan also sleeps through the night (like for ten hours straight since 2 months old) so I think that also keeps them skinny, but if they are sleeping through the night, they must be satisfied, right?

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  24. I was convinced my oldest's skinniness was due to breast feeding. Then we got a foster daughter who was bottle fed. And skinny too.

    I didn't worry so much when my second bio came around and was just as skinny with a combination of nursing and bottles.

    There's a growth chart/curve for a reason. Someone's got to fill in the bottom parts for it to be a sampling of all the babies.

    My kids have ranged from 5% to 50% on the weight end and 5% to 95% on the height end. It's all a range. Enjoy how much lighter the car seat is to carry :)

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  25. I've got a tiny baby! At his 6 month appt he was around the 0 percentile for weight. That induced quite the panic. We were exclusively breast feeding, but he started nursing less and less. We ended up supplementing formula because he wasn't nursing well. Now he's thriving. Still tiny for 9 months, but doing just fine. It sounds to me like Evie is eating fine. I vote keep going the way you're going. :)

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  26. Therese was and is soooo petite. She's almost 4 and can wear 2T and 3T but in a pinch can fit into her (not petite) baby sister's 18 MO sized clothes. She was almost exclusively bf her first year (because she didn't care for most solids) and dropped as low as the third percentile for weight but has always followed her own curve. She's little, but healthier than most kids I know!!! I'm sure your cutie is just fine!!! She looks filled out but petite, which was just how Therese was!!!

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  27. she is healthy and just absolutely perfect. ... a lovely, petite little girl! :)You have nothing to worry about!

    PinkQueen

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  28. Your milk is perfect for her and she is the perfect size! Please please please don't waste any more energy worrying. I remember La Leche always asking "is she content? Is she doing new things this week that she wasn't doing last week?" And reminding me that THAT mattered more than size. When she is older and gets all the great shoes on clearance because her feet are size six, she'll be grateful she's so small. :)

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  29. My daughter was in the 20% for height & weight until she was about 6 months, then plummeted off and never looked back. Exclusively breastfed until she weaned herself at about 1 year. She is now a gorgeous 12 year old and is still very petite, but eats like a horse, is incredibly healthy, active, champion swimmer, and smart as a whip. She's just in the 1% for height & weight (going into 7th grade, but looks more like a 4th grader.) I don't worry about her, the docs don't worry, no one has ever been worried except some lady in underwriting at our insurance company who was all freaked out that she was so tiny and wanted to know if we'd done endocrine screening, genetic testing, etc. to find out "why" she was small. I gave her a good earful about the childhood obesity epidemic and does she lecture the parents of large kids as to why those kids are off the charts the other way? Trust your gut, trust your doc.

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  30. Sounds like my little Nicholas. He is very petite but I'm not worrying about it because he IS growing, albeit slowly, and he's healthy. I think he takes after my side of the family. I was never even on the charts and my siblings were either not on either or very low. She's beautiful, by the way!

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  31. Oh, ps. I do understand the anxiety because Nicholas is exclusively BF too and Ive worried about whether he is getting enough but Ive decided to stop worrying based on his adequate pee and poo :)

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  32. I have four girls. The first one was quite large, 95% weight. The second one was always tiny, 5% for weight. They are fairly average now. The first one is average, about 50%. The second was is still quite small but eats a ton and has always been fine. She just seems petite. She has a small waist and has a hard time keeping pants/skirts up but she's always been like that. She just grows on her own curve.

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    1. And they've all been exclusively breastfed, no formula supplementation for any of them. Nothing wrong with formula but I just wanted to point out that they've all been bf and they all have grown different.

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  33. Thank you so much for posting this - I am in the exact same boat right now! My 4-month-old (first baby) is only barely 11 pounds at 4 months. She was 50th% at birth, then dropped to 20th% at 2 months and 3rd% at 3 months. She's barely maintaining that 3rd% now. I think a lot of it has to do with the fact that she's such a good sleeper, like your baby. She's just finally growing out of her size newborn clothes. I thought it was funny that you call her "Evie Doll" - people are constantly coming up to me and telling me that my Felicity looks like "a little doll." I think it has to do with the fact that she's so skinny. She is developmentally right on track, and even advanced in some ways, so the doctors say they're not worried, but that hasn't stopped me from worrying :)

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  34. As long as you trust your doctor, you have no need to worry. The fact that she is staying consistently in the 3rd percentile sounds to me like she is just fine.
    My 3rd baby started falling off the curve and has had weight issues since she was around 6 months old. At one point, we actually went 6 weeks without her even gaining an ounce. She'll be 2 next week and we're finally back to a healthy weight. It sounds like your baby is doing great!

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  35. Evie doll is such a perfect name for her! I have always thought she looks like a doll!

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  36. Check out this link for the growth charts the World Health Organization (WHO) developed after quite a bit of research done on babies who were breastfed. This was done a couple of years ago and isn't widely used yet.

    http://www.cdc.gov/growthcharts/who_charts.htm#The WHO Growth Charts

    The growth chart used by most peds was made based on babies who were fed formula or an unknown mixture of breastmilk and formula. Overall, with the WHO chart there seems to be a greater range of 'normal'. You can take Evie's info and plot the points yourself and note the differences and similarities in the curves. This is not diagnostic, just interesting. Lots of moms show concern about weight gain, and this gives a better representation of normal.

    Toward the bottom of the page you'll see the charts for Boys and the charts for Girls, one each for Weight-for-Length and Length-for-Age. I don't remember the specifics, but I think the babies for the WHO chart (the breastfed one--the CDC chart is for the babies whose intake was not tracked) were exclusively breastfed for six months and breastfed for at least a year.

    And I agree with the others-- she is so, so lovely!:) More snuggling...less worrying!

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  37. My exclusively breastfed boy was also super, super tiny and even fell off his growth chart at one point - the doctor still wasn't worried, even then. I didn't try to make him gain wait, I just made sure he stayed healthy. He was and is fine - and so is adorable little Evie.

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  38. I write as grandmother of one of the tiniest babies I've ever seen (who is now 8 years old). 'Bunny' was born full term, right at 5 lbs, and lost a few ozs. after birth. She was exclusively breast fed for months, and the doctor said she was fine (she was) but her parents worried. She still weighed less than 15 lbs. at one YEAR of age. She has just turned 8, and she's healthy and lovely and bright and a bundle of energy. Loves and does really well in gymnastics! She's a bit shorter than some of the girls her age, but one would never really notice (nor does she). Growing like the proverbial weed and the most "typical" little girl you can imagine. And by the way, your precious little one is BEAUTIFUL. Oh, those eyes!

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  39. A PS from Nancy-grammy: Bunny measured small all through the pregnancy too; her mommy didn't even look pregnant until the last month or so. And during her first year well baby visits, Bunny usually wasn't even large enough to be ON the charts!! A few growth spurts during her toddler years and later just seemed to take care of that... and now she is solidly within normal range.

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  40. Back in the old '80s, the growth charts in pediatricians' offices were usually produced and distributed by formula manufacturers. They were calibrated to formula-fed babies, who tend to weigh more than breastfed babies, thus giving the impression that the breastfed babies were underweight. And just what does a doctor suggest to the anxious mother who's just found out her baby is "underweight"? Supplementation with--that's right--formula.

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  41. No advice to give, but wow she is beautiful!

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  42. As long as she's consistent on her growth, even if she's small on the chart, she's FINE! If she's happy and eating, she's FINE. I have 5 kids - all different shapes and sizes. If the doctor also says she fine, she's FINE! You have a cute, little, petite girl. If it makes you feel better, my sister has twins (a boy and a girl). They were only a few ounces apart at birth, but her son is now 90% percentile on the charts and her daughter is like Evie - tiny and something like 10th percentile. They eat exactly the same, exclusively nursed, no formula, same food and everything now. He's big and she's just petite.

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  43. I see you have many people giving advice so I won't chime in as well, however I will say, I know EXACTLY how you feel! Both my girls are on the smaller side and I am constantly stressing over whether they are eating enough at each meal/nursing session. Even when my pediatrician and husband (who is a doctor) say they are doing fine. So I totally feel ya! Your daughter is adorable!!! and she looks just fine :) and much bigger than both my girls looked at 7 months!

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  44. I'm super late to the comment party I see, but I'll just add my experience anyway :) My 5 year old Jack was 3 months premature and is still super tiny- at the 3rd percentile for his age. Most preemies "catch up" by age 3 or 4 and he just holds his own on that lonely 3rd percentile line. We tried everything- adding calories to formula, drinking pediasure, adding loads of butter and coconut oil to everything he ate etc...and there he stays.
    Some kids are just little! And hey, someone has to hang out on that lonely line on the growth chart so that all the other kids can be at the 90th percentile. (Seriously, how is every other kid up at that line? Math is not my strong subject but I'm thinking those lines need adjusting! :) ).
    I'll also add that it can go the other way- my second boy was born at the 3rd percentile, but at age almost 2, he is a giant. So, you never know.
    Sorry for your worry- I know it all too well, but your sweet little girl looks totally happy and healthy! So I hope you can lay some worry to rest. <3

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  45. Seriously, she is the most beautiful baby! And you've got tons of advice I know, but my girls have always been on the smaller side - means they fit in those clothes for longer ;) It's kind of fascinating to see how differently the twins grow since they nursed THE EXACT SAME AMOUNT but Elizabeth has always been smaller than Mary Claire. Once we finally got her on the charts (she's always been around the 3rd percentile for weight), she stayed steady. Good luck!

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