18 Months Needs More Calories!

i don't think you need to make her meals any different than the rest of the family, just let her get more calories during the day.

leave a little "buffet" in her play area when you are at home. veggies, fruit, bread, tofu chunks, cheese chunks, kidney beans, etc.

my little one was a little skinny, and we let her graze during play time.

My Dr. suggested adding Carnation Instant Breakfast mix into my daughter's milk. You can do it both at meal time and snacks between meals. Good Luck

you know, those percentage charts are HIGHLY unfair to smaller children. it is exceedingly unfair to compare children to other children their age because each child is different!

i would ask you these questions:
is she healthy?
is she happy?
does she eat well?
doe she eat 3 meals plus snacks?
does she drink plenty of water?
does she have a bowel movement at least once a day (or every other day at most)?
does she have wet diapers (unless trained)?
does she have good color in her skin?
are her eyes sparkly and full of life?
is she growing at her own rate, gaining weight, even if its mere ounces?

those things will probably tell you a lot more about her state of health and weight than any doctor could. to say that her weight has fallen to the 10th percentile only means that compared to other kids her age, she is lighter. so what? did she gain weight or remain at the same weight during that period, or did she lose weight? if shes losing weight, obviously, do something. add a higher fat milk, cheese, peanut butter/nuts, those types of things have higher fat content, and especially with nuts, healthy fats. offer her bigger servings. maybe she would eat more if it were offered.

however, if her weight has remained the same, or gained, even if its just an ounce or two, i would just remain unconcerned. who cares if she doesnt 'measure up' compared to her peers. shes healthy for HER, not for someone else. you will screw up her balance and her hunger cues if you make her eat when shes not hungry, or make her finish her plate when she is full. you know ?

i have a friend who is petite, her husband is TALL, but skinny as a rail. ALL THREE of her children were just like yours; always under weight compared to their peers. they are perfectly healthy, and even eat junk food now and then. there is nothing wrong with her kids. they are just who they are with the body structure that they were made to have.

those charts are just so unfair. i would pay more attention to the actual number of her weight, and height, and making sure that she is gaining or at least staying the same over time. as long as shes looking good, acting good, and energetic, shes fine. if shes starting to act wierd, her body looks sick, then start worrying. especially when you and your whole family are making lifestyle changes to be healthier, i wouldnt mess with a good thing. remember that any addition in calories should be with fruits, veggies and beans/legumes. those will keep her healthy, while adding anything she may need in her diet. dont be tempted to add junk food :P but you probably already knew that.

by the way, those beans also would have higher calories and yet healthy ones!! :) split peas are a great soup base. add veggies and meat to it, and presto, you have a GREAT stew! :)

Hi! We had this same problem with our now 13 yr old, when he was a year old.

This is what we did: we made an appt with the pediatric dietician at the children's hospital here. What she had us do is mix in fats with all his foods. One tablespoon of fats is equal to 100-130 cals. It really adds up when you do it with every food.

We'd mix either corn, olive, canola, vegetable oil,or melted butter into all his foods. Applesauce would get melted butter, pancakes would be slathered with butter, noodles would be tossed with butter. Toast would be buttered. Absolutely every item of food would get a "fat pat." Oatmeal would have a pat on top.
Kids need fat: adults need some. Kids need fat for their brain development, fat pads on the soles of their feet, and palms of their hands, and for body growth. Their developing bodies are so different from ours: they need the stuff!

We'd also give a high calorie snack, of at least 100 calories, right before bed: like 1/2 cup of whole fat ice cream, or an ice cream bar. We fattened with fats, not starches.

So, maybe a pediatric dietician is your starting point. If you want more ideas, just let me know.

Just add Pedisure during the day, lots of calories & vitamins!

Percentiles are only a comparison to other children at the same age. They have NOTHING to do with what a healthy height/weight is for any particular child. If your daughter is growing, then I would not be concerned. Yes, whole milk for kids at this age, I agree with. But, if all kids below the 25th percentile were fed butter and cream so that they gained weight, then the whole scale would move up and the smaller kids would still be "below average".

A headline recently read "Public concerned: 50% of hospitals ranked Below Average!!". That what AVERAGE means - 50% above and 50% below.

Pediasure which is the kid version of Ensure supplemental drinks is good and found at most grocery stores near the babyfood isle. Also check out SuperBaby Foods cookbook by Ruth Yaron. It has calorie and nutrition tables for infants and toddlers, recipes and more. You can find it at most bookstores or at www.amazon.com/Super-Baby-Food-Ruth-Yaron/dp/0965260313

If you're really at a loss go back to your pediatrician and have her/him refer you to a nutritionalist who can put together a whole diet plan for the entire family that will help each member make their goals. I know you and your husband are trying to maintain your weight, but if it's affecting your child's health, you really will have to make two meals, or change the entire family's diet so that everyone's needs are met. I think the nutritionalist route may be the best for you, in that they could probably get some real good recipes ordered up for you that will keep everyone on track.

My 3 year old son has cystic fibrosis so his docs always stress calories, calories, calories. They told us to use scandishake. It comes in a pouch and you mix it with milk (we used whole milk for more calories) and it packs on the pounds. It comes in chocolate, strawberry, and vanilla and you just have to call and have your pharmacist order it. You don't need a prescription for it though. You may have to spell it for them and explain to them what it is. Our pharmacy had never heard of it but they found it through one of their suppliers and now I just have to call and get a box of it. I believe 7 pouchs come in a box for about $11.00 but it has been a while since I have ordered them so don't quote me on that.

Hope this helps!!!

J.

Becky and Alyssa said exactly what I was going to say. I would agree, also, with always keeping in mind that you are not just addressing immediate needs. You are building eating habits and attitudes to last a lifetime. And olive oil, coconut oil and butter are valuable foods for every stage of life. Additionally, they are delicious on vegetables and whole grains, so the child is learning to love these things which should be the foundation of a lifetime of healthy eating. I would really stay away from processed fake-foods. Even our common sense tells us that good nutrition doesn't come in a can of liquid or powder mystery-stuff. So while oatmeal, brown rice, broccoli, squash, sweet potatoes, green beans, peas, chicken, fish and so much more are delicious as is or seasoned with herbs, broth, etc... for the adults in the house, they are all great with oil or butter on them for one who wants to increase calories. Actually, if you continue with healthy portions, they are more of an aid than a detriment to weight-loss, too. But it is hard to wrap our minds around that, so most of us are afraid to prove it. Another important benefit is that she will be getting the healthy fats that her body needs during this phase for the development of brain cells and much more.

I also agree that you really may have nothing to worry about, as some have pointed out that your child's personal health and growth patterns really don't need to match some chart in the dr.'s office. But you don't really sound worried, so I didn't get much into that. Adding healthy fats to the diet is a good idea for anyone at any time. So it is good advice even if you are perfectly happy with her growth.

I have a scrawny toddler, too.
Are you offering lots of whole milk dairy items? It doesn't have to be junk food. Whole Milk, Brown Cow brand yogurt with Cream on the top, whole milk cheese and triple cream soft cheese, butter. These provide healthy calories.
A little trick we have is to mix the protein mix that I drank while pregnant into his Milk. I like Jay Robb brand Vanilla or Chocolate mix. It is sweetened with stevia, not sugar, and will bump up the protein content of the milk by about 25%. I use a heaping teaspoon in a sippy cup and shake well with my finger over the spout.
We live near a dairy, but you may be able to find a similar item in your grocery- yogurt cheese! It is similar to cream cheese in texture but has a very sweet taste due to the milk sugar. I mix in a strawberry or some banana in the morning for breakfast, and baby boy eats it out of a bowl with a spoon.
Oatmeal with cinnamon, brown sugar and butter is a good toddler food.
Also "dipping sauce"- he is obsessed with dipping, so it is a good way to add calories to every bite. Mine likes ketchup, gravy, sour cream, salsa (really!), applesauce. You can try ranch, etc.

I try to think of all the whole dairy products as "baby food" and don't taste them, so I don't remember how much I like them. I stick to my low fat and skim products.

Add carnation instant breakfast to milk-use whole milk for her. Add extra syrup, butter, etc to her stuff only. Put cheese on as much of her stuff that you can. Make sure you are offering 3 meals and 2 or more snacks each day. She could not be getting as much of the fats and calories that she needs because of the recent changes in your diet. You don't need to makea seperate meal for her. Just need to add different stuff to her plate.

I'm in the same boat. My dd is 12mos. and tiny! We were told to smother everything with butter,sour cream etc..I don't make special meals for my daughter. I feed her what we eat for the most part. I do offer her BIG snacks throughout the day though so she basically eats alot of small meals which is a healthy thing. She is on Vit.D milk, I can't make my daughter eat but I try and offer her the best. I look at it like this unless they are sickly underweight who cares they have their entire life to worry about getting fat. You could feed her alot of McDonalds, icecream,that sorta thing.

I asked also about supplementing with Pediasure but our dr. said to hold off on doing that because then she will learn to fill up on liquids and still be a poor eater.

She can eat what you eat, plus have a nutritious snack between meals. My kids liked peanut butter on graham crackers, for example. She can also have whole milk when you drink skim--assuming she does OK with milk. Offer nutritious foods and let her decide how much to eat. If you start trying to stuff her with food she may become resistant, so relax and don't let it become a tense issue for you. Hope this helps! And congratulations on your own success--woohoo!

You can add butter or olive oil to her food. They are high is calories and easy to add to just her portion.

We had the same problem. You really don't need to feed your kid heavy cream and butter at every meal in order to make up the calories. An 18 month old child has a modest daily caloric intake to begin with so adding a couple hundred a day is doing a LOT. What we did was add a healthy snack or two a day and that worked wonders. A smoothie made with full fat yogurt, toast with peanut butter, chips and guacamole, etc. Those all worked. We also added powdered milk to things that powdered milk can be added to....oatmeal, mac and cheese, etc to boost the calories of those.

Those simple steps helped a great deal and did not require us to change the diet of the entire family to still meet this child's need. Good luck!

Sounds strange but I had friends in this situation and they would just add things like olive oil to their food, like peas with olive oil and salt and pepper. Adding butter is also a good option. My friend would also make some things ahead and store them in the fridge at the ready to supplement regular meals, like macaroni and cheese made with butter. Good luck.

My 17-mo-old has the same problem. Our dr said to buy Pediasure. It has a lot of good, healthy calories, along with a lot of vitamins and good things. You can get a big box at Sam's Club, but they are expensive. Otherwise just give her cheese, put chocolate in her whole milk, give her candy for treats, etc. I know, I have a hard time trying to have her eat healthy, but also get it a lot of calories. Good luck!

Hi S.,
I'm a registered dietitian, and I have patients like this frequently.

I've read a few of the other responses, PLEASE do not put large amounts of butter, sour cream, heavy cream on everything. Yes it is true that children under 3 years old need more fat than the rest of us, however, most of the fat should come from healthy fats such as olive oil, canola oil, nuts and nut butters if no allergies, fatty fish (no more than 1 serving a week). If you put butter on everything now, you are setting your child up to prefer the taste of butter rather than the actual taste of the food. Too much butter and saturated fat can cause high cholesterol and early heart disease. If you have doubts about this, please make an appointment to see a registered dietitian.

First make sure she is drinking whole milk at meals. Whole milk does have saturated fat, however, with an otherwise healthy diet this amount is not too much. Or you could try giving her formula made for 9-24 months, but if she's already been drinking whole milk, she may not like the taste of formula. Offer her snacks between meals that have some carbohydrate and protein in them such as apples and peanut butter, cheese and crackers. Try not to let her fill up on milk or juice between meals, because that will make her less hungry for food at meals. Keep offering her a good balanced diet with lean protein sources, whole grains, plenty of fruits and vegetables, and dairy.

Best wishes!

ask your pediatrician to refer you to the children's hospital feeding clinic. They can evaluate your child and give you guidance. They helped our son in the same situation.

You can still cook healthy just give her some extra high calorie snacks and sides with her meals. For example give her pudding cups, peanut butter, cheese, whole milk. Replace empty calorie snacks/meals with higher ones. Like instead of dry cereal (cheerios) give her oatmeal. They come in single servings and are flavored, most children love them. Stay away from crackers and other dry low fat/low calorie foods. Pedia-sure may also be a good idea. It is a milk type drink for children that gives them extra vitamins and calories. They also have nutritional powders for chidren that you can add to their milk, flavored or plain. Good luck and I'm sure she's fine. At 18 months she probably just lost a little weight because she's so active. Moreso than when she was a year and just starting to walk.

Maybe just offer her more meals than everyone else, you and DH eat 3 meals a day, give her 5 or 6 - basically a meal between meals....some people call them "snacks" but if you are wanting to keep her eating healthy things, I would just make them mini meals - include protien, carbs and fruit or veggies, small portions, of course, but still good stuff.

Although I am not a Dr., but I do have a little skinny mini who has always been low on the percentiles, and at her 2 year check, she was 25% for height and 10th for weight, no-one said anything about it at our Dr.. I think your Dr. may be overreacting, kids start to "shoot up" around 18 months, and if being under the average for weight is not hurting her developmentally anywhere else, and she eats well and has energy, i wouldn't worry too much about it. Some kids just have a higher metabolism and lower appetite than others ( if only us moms had the same problem, HUH?).

Good Luck,

Jessie

My toddler is also little, 2nd percentile! She saw the doc yesterday and he said not to be concerned as long as she's eating and drinking. I agree with most responses, add some additional healthy snacks. I like the pediasure idea too and will probably try that out. We eat fairly healthy at our house, too and I want my children to grow up making good food choices. I always try to do cheese or PB and fruit/crackers. The doc did warn against drinking too much milk...can suppress their appetite. Don't worry - I was small at that age too and am now 5'8, so it doesn't necessarily mean she will always be tiny. It is hard though, now that they are so active it is even harder to get the weight on. Mine is so healthy aside from the weight issue that I am not concerned. Good Luck!

I also completely disagree with slathering everything with butter, sour cream, ice cream, etc.... The eating habbits she develops NOW will follow her the rest of her life!!! You don't want to be the reason she becomes overweight!

Continue feeding her HEALTHY things. Just offer her a couple extra snacks during the day. RAISONS, APPLES, BANANAS, CRACKERS, YOGURT, ETC. HEALTHY being key. (Ice cream is NOT healthy.)

Our daughter was ALWAYS in the lower rates but our doc never told us to change what we were feeding. She would range anywhere from 5% to 25%. Now at 4 1/2 she is averaging 50%. Our meals consist of about 75% organic. We eat salad 6 to 7 days a week WITH our lunch: NO fast food, no pop, very little juice (maybe 2 times a month...), etc. So, even with a healthy diet, as she grows older it evens out.

As long as she is eating a healthy diet and drinking plenty of water, I would just continue with what you are doing. Kids ALWAYS lose weight after becoming mobile. They will even out again. Don't be discouraged. If you are offering her healthy choices, you are doing a GREAT JOB!!!

Congratulations on the weight loss!!
I your little getting whole milk? If not I would try that first. You also try giving her a high calorie snack like pudding or milkshakes.

My daughter has an illness that requires her to eat a diet that is high in calories, fat, and salt. I too am trying to lose. In the beginning it was difficult to balance but we met with a dietician and got the following suggestions:

Create one meal for everyone but add some extra ingrediants to your daughter's meal before serving it to her. There is no need to put large amounts of these items. A small amount adds extra calories.

Things to add to her food:
cheese
butter
cream
a sprinkle of Olive Oil

We put a dollop of Ranch dressing (not light or fat free) on her food or on her plate for her to dip her food in.

We also add 1/2 a can of Ensure Plus or a packet of Carnation Instant Breakfast to her whole milk.

And maybe most importantly... Don't give her a beverage until she needs it. We used to give her a sippy cup of milk with her meal. She would fill up on the milk and not eat much food. Now we give it to her later in the meal. We keep it out of sight because once she sees it she wants it.

Full fat dairy and make sure she has a morning afternoon and evening snack.

Are you giving her whole milk? Also snacking with crackers and peanut butter which is a carb and a protein between meals. There is a big brain study that said fat is necessary for those under three for brain growth, so whole milk is recommended. Hope this helps.
M. in Wisconsin

How about full fat dairy products for her...like whole milk, cheese and yogurt? Those things she can have as side items to whatever you're already having