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A friend of mine called me today and told me that her super cute 15-month-old just had a doctor's appointment and his height and head circumference are off the charts with regards to percentiles (greater than 100%) and his weight is at 95% and her pediatrician is worried about it.

Now my friend is contemplating switching him to low fat milk (per the pediatrician's suggestion). I suggested that low-fat is definitely not a good idea.

Can you point me to information about Paleo diet for infants (and whole milk vs. low-fat milk in particular) that I can provide her?

Many thanks.

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Oh, hells no! This lowfat milk for kids (and grown-ups too, imo) crap has got to stop. – Happy Now Sep 17 2011 at 21:07
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Sounds like the baby's brain is bigger than the doctor's. – Travis Culp Sep 17 2011 at 21:21
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Is the weight at 95th% for height or for age? A child who is at 100th% height and head size for age and 95th% weight for age is actually relatively lean. By the way, percentiles are asymptotic, which means you can't be greater the 100th percentile. – Ed Sep 17 2011 at 21:29
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And to further clarify asymptotic, it means it gets closer and closer to the 100% mark but never gets there because the remaining distance is infinitely divisible. – Katherine Sep 17 2011 at 22:07
@Katherine, I probably misused the term "asymptotic." A population percentile is practically but not truly asymptotic. Somewhere there is a toddler with THE biggest head in the world. This toddler is AT--not approaching--the 100th percentile. – Ed Sep 17 2011 at 22:13
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13 Answers

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Here's a link to a great article about low fat diets in childhood being a set up for heart disease later in life. http://www.westonaprice.org/childrens-health/dietary-recommendations-for-children-recipe-for-future-heart-disease

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Thanks. Much appreciated. – Paleo Mom Sep 18 2011 at 3:37
weston price site also explains why raw is best, anyway. enzymes aren't killed off. – Lisa Sep 18 2011 at 16:30
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Tell her to ask the pediatrician if low fat milk is so good for the kid how come human breast milk has 54% saturated fat? Is it because God or evolution are not that smart and dont follow the opinions of narrow minded "experts"

The kids head may be growing because of a growth spurt. Of maybe from the use of products that contain toxins for the developing child.......or maybe even undiagnosed hydrocephalus ( seriously doubt this) but a doctor needs to think before jumping straight to the Ancel Keys CW responses. After you discuss this with the doc.......Then fire the doctor. Total epic fail.

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Could also add in there, that until recently babies were breastfed until at least 2-years-old unless the child chose to self-wean sooner (instead of the current AMA 1 year recommendation) and the WHO average is 4 years. At 15 months I would think that baby still needs to get as close to that 54% as possible regardless of size. – Happy Now Sep 17 2011 at 21:18
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neurogenesis and pruning of neurons requires massive amounts of SFA substrate. God and/or evolution are not idiots. Just the pediatrician in this thread. – The Quilt Sep 17 2011 at 21:24
If whole milk is 4%, what would be a good substitute? – Happy Now Sep 17 2011 at 22:00
I don't give my son milk yet but I give him whole jersey yogurt and I mix in coconut cream or coconut oil right in I the yogurt. No sweetener unless it's some berries I put in myself. He loves it and grabs the spoon himself and licks it up. I bet you could do the same thing with whole milk. Bligh when quilt said 54% he meant 54% of the calories not of the volume which is what 4% whole milk is indicating. Human milk varies in fat by volume Between about 3-8% (the low end probably showin up in undernourished Mothers. – Aughra Sep 18 2011 at 2:18
BeingVenus - great that you mix in coconut oil and coconut cream in yoghurt. I have a 13-month-old who loves yoghurt (he still gets breast milk but no cow's milk). I mix in coconut oil with everything I can but haven't tried it with yoghurt. I will give it a try now and will recommend it to my friend too. Thanks. – Paleo Mom Sep 18 2011 at 3:27
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My pediatrician recommended the same thing, though my girls are off the charts tall and only 70-80% on the weight (they are tall and lean, and have only whole milk and whole yogurt for dairy). I told her I disagreed and I thought her assessment of the science was false. Then I started spouting studies. Medicine in Massachusetts is practiced extremely conservatively so I doubt I will find a more erudite pediatrician accepting new patients. She's good for what I need her for - I'll handle the nutrition, thank you.

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This is a bit OT, but I'm wondering about your opinion of MA Medicine. I just moved here from NoCal and have been truly horrified. I was expecting so much knowing this is an educational epicenter for medicine. I feel like I'm fighting a loosing battle with Harvard educated docs who don't understand education<>intelligence and that their education represents a very, very small portion of scientific knowledge. Any words of advice for living in this market would be greatly appreciated! – Marie Sep 18 2011 at 1:34
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Thanks. Just out of curiosity, what was your doctor's reaction? I don't to talk about nutrition with my doctor any more -- I asked her about vitamin D levels for my 13-month-old (my Vitamin D was low and was wondering about baby's level) and she recommended OJ... – Paleo Mom Sep 18 2011 at 3:36
My kids' doctor thinks I'm a lunatic. It is tres conservative out here, not a lot of room for imagination. Yankees, you know. – Evolutionarypsy Sep 20 2011 at 23:27
PaleoMom - It's hard with kids - you don't want to stick them, don't want to have vitamin D be too out of line with K2 or other complimentary vitamins - I keep my kids out in the sun midsummer and in the middle of winter, several days a week, give them a D gummy. (There are better D drops you can order online, I'm sure!). – Evolutionarypsy Sep 20 2011 at 23:29
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OMG, OMG, this question made me flinch! As the mother of five kids, NONE of whom were under 9lbs at birth (smallest 9lbs even, largest 10lbs 8oz), i have gone thru this EXACT same thing! ALL of my boys were - at this age - off the charts for head circ / height / weight (pick two or three). My oldest daughter was over %100 for height at one point but under %50 for weight.

Mine self weaned from breastmilk between 6 months and 1 year. I fed them meat, eggs, veggies, and a small amount of fresh fruit and NO COW's MILK. Their doctor predicted horrible things.

End result: these kids (now ages 4 to 9) are all now slender, active, well-within-range children. They are not Paleo but are low-carb, low-processed-crap.

My advice would be to not feed the child any milk at all. A 15 m/o can eat exactly what mom and dad eat chopped into small bits. If your friend insists on milk I'd recommend full fat whole milk - organic if possible.

I'd also recommend that your friend just not bloody worry about it. Seriously. Kids wax and wane all over the 'official' charts. Unless the kid is becoming overweight (and it doesn't sound like it), then I'd just blow it off.

To give you some perspective: my oldest, whose head circ and height measured off the charts for his first two years is now a SHORT-ish 4th grader but he's just been awarded a certificate for making the highest score possible on his standardised reading test.

Tell your friend that that big head is there for a reason, LOL. It probably houses a big brain and that brain needs FAT! ;)

Best of luck to your friend and his baby!

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Thanks - great feedback! – Paleo Mom Sep 18 2011 at 3:31
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Milk is not problematic for majority of kids. Its probably that wheat + milk combination is problematic. Also, goat milk is superb. – majkinetor Sep 18 2011 at 8:36
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Congratulate your friend on having a happy, healthy baby -- and remind her that the milk nature provided for human babies is more than 50% SATURATED FAT and high in cholesterol as well -- Check out these studies as references

Hornstra, G., (2000). Essential fatty acids in mothers and their neonates. American Journal of Clinical Nutrition, 71, (Supplement). S1262-S1269.

Salvati, S., Attorri,L., Avellino, C., Di Biase, A., and Sanchez, M. (2000). Diet, lipids and brain development. Developmental Neuroscience, 22, 481-487.

Margaret Lahey LIPIDS: THEIR POSSIBLE ROLE IN DEVELOPMENTAL DISORDERS Bamford-Lahey Children

The advice to give infants and toddlers low-fat milk products was shot down years ago -- and I wouldn't trust a pediatrician who still gave such outdated and useless advice.

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Thanks, Firestorm. I will send these on to her. – Paleo Mom Sep 18 2011 at 3:40
Thx for the papers. – majkinetor Sep 18 2011 at 8:37
Not 50% sat fat, only 7% fat by weight, of which 50% may be saturated. – wmertens Sep 19 2011 at 8:20
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That sounds idiotic in so many ways, but most especially, as Ed points out, because if the child is off the charts for height and only 95th %ile for weight, then that implies he is leaner than average. So even if low fat milk would help with fatness, which it doesn't, the boy isn't fat, he's tall. (Gee, maybe we should lower his nutrition, so he stops growing so much?)

About the point of what it means to be "off the charts", it's true that a percentile can never be more than 100, because what it indicates is that the child is taller/heavier than 100% of age peers. But you can still be off the charts in the sense that the chart doesn't list infinitely many values. So they cut it off at some point, but everyone above that is still at the 100th %ile.

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Exactly. I said "greater than 100%" in my original post to indicate that he is above whatever the number is where they draw the line. Thanks, Ambimorph. – Paleo Mom Sep 18 2011 at 3:39
I'm thinking they meant off the curve. It is physically impossible to go beyond 100% on the chart itself, but he could have a growth spurt that doesn't follow that little curve they have drawn on those charts. – Happy Now Sep 18 2011 at 6:28
It does sort of sound like the doctor is advising making the kid less healthy so he stops thriving so darn much, lol. – sam Sep 18 2011 at 16:39
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My kids have always been 98 percentile or higher on all the height, weight, and head circumference charts. My 3 yr old is 45lbs but is so lean you can count his vertebrae. My 12 yr old daughter is now 5'11", 200lbs, wears a size 8 and looks fantastic.

Your friend needs to find a different pediatrician. Kids need saturated fat.

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Luke, my co-author, thought the doctor's advice was ridiculous enough to do a short skit as follows:

Dr: I see here that you're child seems to be growing extraordinarily well. Let's put a stop to this!

Responsible, bemused mother: Um, what's wrong, again?

my 2 cents is about the difference between conventional and organic. The only conceivable benefit of conventional, non-organic skim milk over conventional, non-organic whole mild comes from the fact that many of the petrochemical toxins are fat soluble and of course with skim milk having no fat you don't drink them.

On a relatec note, the bovine growth hormone (bst) and the 10x over normal elevated insulin-like growth factor levels that milk from bst-treated cows contains could cause unusual growhth in children. And that would be present in the skim portion of the milk.

I posted a piece on raw milk's unique benefits here: http://drcate.com/raw-milk-why-mess-with-udder-perfection/

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The fix.......dot drink milk at all unless its raw. And I just avoid it all and use heavy raw cream. 100% pure fat. – The Quilt Sep 19 2011 at 0:19
Thanks for the laugh. In my family, we all react strongly to foods that we shouldn't be eating, so that makes it easier to abstain...I can't eat any dairy except butter, but my kids do fine with raw goat milk, and fermented and/or aged dairy, such as raw cheeses, kefir and yogurt. – Rogue Nutritionist Sep 19 2011 at 4:14
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This is just wrong!

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This is the dumbest thing I've ever heard. Breastmilk ONLY - NO COWS MILK. EVER.

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even if it's raw?? – Futureboy Sep 18 2011 at 6:52
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Someone once told me most docs get about 90% of their training in the medication department, and a few weeks on nutrition. Not sure how true that is, but I'd look it up. Sounds like something goverment sponsored (like who grain cereal) to be honest.

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yep, that's about what I got with my tuition money – Dr Cate Sep 18 2011 at 21:18
I've been told that they get literally a few HOURS of training in the four years of schooling. Anything outside of that has been learned on the doctor's own initiative. Getting nutritional advice from your average M.D. is no better than getting nutritional advice from any average person. – Rogue Nutritionist Sep 19 2011 at 4:20
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Note about cows milk:

I find it intriguing that some cite Mery Enig and her advice about fats but if something is knows about Weston Price Foundation that is their positive attitude about raw cow's milk. Looks like some people here like to find support for whatever preconception they have in their mind, and it could be found, for pretty much everything one claims.

Nothing wrong about good [fermented] milk. Industrial milk is disastrous on the other hand. Goat milk is god send. Kefir is first thing introduced to babies in Asian countries.

Its far more probable that wheat promotes dairy toxicity due to its 'adjuvantic' properties.

Personally, I am using very high fat dairy as main thing for my baby but only fermented milk.

http://www.goodykefir.com/tag/kefir-scientific-research/

http://www.westonaprice.org/childrens-health/raw-milk-safe-for-babies

http://daiasolgaia.com/?p=1302

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Some people(not my family) do well on raw cows' milk. I think we all are so individual, we can't say a food like raw cow milk in inherently bad for everyone...I know some very healthy and food aware families that thrive on it... – Rogue Nutritionist Sep 19 2011 at 4:16
I agree. It looks like people with autoimmune disease may benefit from removal. But that is on try-and-see-how-it-went basis. No test can tell you that, and I am highly suspicious on intolerability tests. – majkinetor Sep 19 2011 at 8:07
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No one needs cows milk and of course, the adage 'human milk for baby humans, cow milk for baby cows' is a worthy aspiration. However, for many varied reasons, mostly misinformation and lack of support, human babies are very lucky to be breastfed for more than a few weeks post birth, despite World Health Org recs of 2+ years. So then I guess it's about offering the least damaging substance. Raw cow milk might be one option. Goat milk another. But it's not preferable. (apparently ferret milk is the closest thing to human breast milk that there is...but I can't imagine being able to get that in any kind of ethical and sustainable way!)

Suggesting that any child should consume 'low fat' anything is horrifying but not uncommon unfortunately. Is your friend aware that post 12 months, milk is NOT actually necessary in terms of nutrition if the child is eating a good diet?

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