3V0354.2

3V0354.02 Doctor Visit (1/11/79)

Peggy went to see Dr. Merman on the 2nd. He found her to be in good shape, but on the small side. At 17 lbs. 13 oz. and 28 inches, she is in the 10th percentile for weight and the 25th for height. Except for the first month, in which she gained 2 and a half pounds, Peggy has consistently gained more slowly than the other children. Dr. Mermann asked what she ate, and expressed concern that she might not be getting enough protein. He suggested we should try giving her milk from a bottle (in order to assure a pint daily) since she probably could not do that well drinking from a cup, and give her cereal twice a day, with meat and vegetables at lunch (perhaps pureed leftovers from the previous night). Eggs every other day, or even daily. What has happened since then ?

Cereal – based on nutritional information, Peggy normally eats 2-2.5 “servings” each morning, sometimes as many as three. This includes 1/3 – 1/2 pint of milk and supposedly provides 40% – 50% of recommended protein. The supplementary bottle was not a success – she chewed on the nipple but drank little or no milk. As for drinking from a cup, she can manage to swallow several tablespoons of liquid she likes, such as orange juice. she apparently is one of those breast fed babies who just don’t recognize cow’s milk. We are trying yogurt (apple crisp no – too highly flavored[Robby didn’t like it either] but plain grape she liked and ate almost the whole carton) and pudding (first taste of vanilla, so-so). She likes cheese (cheddar) and eggs (scrambled). All in all, she doesn’t seem too badly off. Once she gets a bit skillful with the cup (orange juice) we can try milk again by cup. Already she has picked up the cup herself and drunk from it after having been helped to drink. She is already showing signs of self-feeding. Mostly she uses her fingers, a messy job if the food is cereal or yogurt, frequently while waving a spoon in the other hand. When shown how to use the spoon, or even reminded verbally, she WILL take it and dip it in the food and even eat from it correctly but soon she returns to the familiar fingers. At dinner she is generally happy to have her dish with a little table food on it (rice, noodles, potato chunks, bits of meat, mashed vegetables) for her to work on herself; and at other times she apparently prefers to have her dish or whatever on her tray rather than on the table. Sometimes she fusses a bit or is reluctant to eat any more until the food is moved to within her reach.

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