Boys always develop slower than girls

Dear Dr.Donya,

I have a nephew who is 13 months old, weighs 8.2 kilograms and is about 78 centimeters tall.

He doesn't say anything except "mama", "papa" and "mamam" for eating. When he plays with his parents, he responds well; for example, when they say cicak (gecko), he always looks up at the wall.

He can't walk without assistance, he can't crawl and when we put him in a sitting position he can't reach the things that we put in front of him.

Since he was six months old, he has often been sick and vomits. The doctor said there is something wrong with his digestive system. Although the doctor gave him medicine, the same symptoms reappear the following month. Is there something chronically wrong with the boy and could this sickness be affecting his development?

He has a good appetite and his mother is always giving him a variety of food (porridge with chicken, fish, spinach, tempeh, etc.), yet he has only gained a little weight. I might mention that from his birth until he was five months he developed at a normal rate.

He has only two upper and two lower teeth up to now. Is this normal?

As his mother and I are concerned about his state of health, we would very much appreciate your advice. Thank you kindly and best wishes.

-- Poppy

Dear Poppy,

Boys always develop slower than girls. His height is fine, but he is a little underweight, although we shouldn't just look at that. From what you have you told me about your nephew, he is on schedule with his developments as he is talking. He says only two words to start with, but he will talk more, and probably by the time you get my reply, he will have been speaking more.

About walking, can he stand by himself? Or does he stand when he is holding on to something? At this age they mostly crawl instead of walk. He cannot reach for an object or he doesn't want to reach? Can he hold a bottle or a cup?

Regarding your question about his development, there are several factors related to it:

A child's development consists of:

* gross motor skills, such as walking, sitting, etc.

* fine motor skills, such as picking up small objects, etc.

* language

* social skills

It is difficult to tell if he is developing too slow or not. His gross motor skills are in the normal range if he can stand up by holding onto a table. His language seems fine to me. How about his social skills? Can he recognize his mom, dad or nanny? Does he like to play with other children? Fine motor skills concern how he uses his hands, such as picking up small objects or holding a pencil or cup. Can he do these? If not, he should be evaluated by a pediatrician.

About his eating habits, every child is different. Some tend to have a low metabolic rate, while some have a higher rate, like adults. Some overeat but never have a problem with being overweight, while others eat little but still get chubby.

His teeth are coming in at a normal rate.

--Dr. Donya