19-Month-old Hasn't Gained Weight Since 12-Month Appt. Is This a Problem?

E. ~

I wanted to let you know that just because the child is on Medicaid does not mean that they should not be seeking a good pediatrician. BOTH my child are/were on Medicaid (because we are/did adopt). IF your in-laws live in the Metro Detroit area, I have a WONDERFUL pediatrician... She is at Willow Pediatric in Clinton Township... Give them a call, if your in-laws are near by.

Also, if they are REALLY concerned, have them go to the ER and they will have a doctor look at the child. The ER will not turn them away!

Secondly, the agency or attorney that they are working with to adopt the child, should also be able to offer them assistance. (If there are any questions about the adoption process, please feel free to ask me, I might be able to help.)

Hi E.,
I'm not sure there's a reason to stress. The chart I have says that the "average" weight of a 19 month old is 25 pounds. So he sounds average. You didn't say how tall he is. He may just be tall and skinny. As long as they are offering him healthy food options and as long as they are aware I wouldn't worry about it. That being said if they feel in their heart that there is something wrong or their doctor isn't good they should switch. When both of my boys started walking they didn't gain a whole lot of weight either. They were to busy running and playing....lol. Good luck.
Chris

Every child is different as are all people. We don't all gain a lot of weight and are just small. If they are really concerned I would contact the pediatrician even though they don't really like the one they have now. I am sure if there was a reason to be concerned he or she would have mentioned it. They might want to look on line for recipes that a child that age would be drawn too. I doubt that they will be in trouble with the law due to him not gaining a lot of weight as suggested by one of the other Mom's on here. I love this site but we come here for help to ease our stress and worry not to be made to feel bad or scared. Good Luck.
K.

He might do better "grazing" meaning having food available to him at all times that he can just pick from a plate as he's wandering around. We did that for our picky eater. We would put a small plate out on the coffee table in the living room with dried fruit, cheese, and crackers and also have a cup of whole milk with a bit of carnation instant breakfast in it. It took awhile but after about 6 months or so he stopped looking like a bobblehead doll. :-D

Also keep in mind that Weight is not the only indicator of growth/health. If his hair is shiny and growing, his finger nails are growing at a normal rate, his eyes are bright and inquisitive he is likely doing just fine. He might just be a petite child.

As long as he is offered food repeatedly not just 3 times a day, your are being a good caregiver. I have a great niece but I am much older than 32, who weighs 23 lbs. and is 24 mos. She was born to a single parent who found it easier to give the bottle rather than solids after 6-8 months. The mom just puts her in a high chair and lets her feed herself, while she watches tv in another room. When we watch her, we make eating a social event. She is a picky eater so we often only get 2 good meals into her. She is very active, happy and will respond to your speech but her vocabulary is limited. Just keep an eye on what he eats and report it to a good pediatrician. My great niece is on Medicaid as well and I do not believe her pediatrician is giving her the best quality of treatment either.

Its totally normal for a child to not gain much weight between their first and second birthdays. My daughter was wearing size 2T at her first birthday and actually slimmed down to 18 month clothes at around 15 months and then went back to 2T around 18 months. She stayed in 2T clothes the rest of that year. She was always in the 100th percentile for both height and weight as a baby, but is now in the 50th percentile. My pediatrician warned me not to freak out as she slimmed down that year and said the worst mistake parents can make is to keep their child fat like when they were a baby. It is normal for babies to be chubby, but not toddlers. So sounds like your nephew is right on track.

Five lbs at birth.....was he a premie? If so, then you would need to go by the weight of his age had he been born on time, not the standards of a full-term 19mo old.
Once they start moving, they do slim down quite a bit, but I think they typically do gain a little in that timeframe as well (less fat, more muscle tone), though not anywhere near at the rate of the non-movement times.......
Nothing to freak out about, but it is something that should be discussed with a NEW medical professional. Even if the child is on Medicaid, that's no excuse for sub-par medical care. Find another practice that takes Medicaid before final custody is established.

I would call and talk to the nurse. They tend to be more aware of the patients than the Dr.
Also I just wanted to let you know that my 2nd child did not gain any weight between her 12 and 18 month check-ups. She started walking during that time and became very active.

Tell your in- laws that everything is gonna be just fine. My son went through a phaze like that when he was much younger. He was almost a 9 pound baby. Later, from about 4 months old to 9 months, he only gained 9 oz. I watched his growth percentile slide down the chart and was very concerned. My Pediatrician kept reassuring me that everything was fine until he dropped down to the 3rd percentile. Then she said "He looks and acts completely healthy but, let's see a "specialist" just to be safe." We were sent to an endochronologist to have some tests done and see what we could do. We explained to the specialist that Steve was constantly hungry, ALWAYS moving, we fed him everytime he acted hungry until he was full and wouldn't eat any more. I should also say I was breastfeeding full time until baby foods were intorduced. We also told her that he was constantly active, always moving some part of his body, much more active than either of my girls. Any way, after talking with her and running all kinds of tests, her diagnosis was "Failure to thrive, we weren't feeding him enough AND just looking at my husband and myself we should never have children that small." Specialist, my foot! I even asked if it could be a high metabolizm and she told me she would have to run more tests. WHAT WERE WE THERE FOR? When I told the pediatrician what she said "I'm so sorry to put you through that. She obviously didn't listen to anything you said. You never have to see her again. And look...Steve gained 3 pounds since his last visit!!" Definitely keep an eye on the little guy but, don't freak out. I'm sure everything will be fine. My little guy is now 4 years old, still insanely active, and just as normal as can be with his weight. God bless your inlaws. They sound like amazing people.

I wouldn't be as concerned about how much he weights (although 21 lbs at 19 mos is probably not enough) as I would be concerned that he had not gained weight for 7 mos. What drs. primarly look at is a steady weight gain...even if it is slow and even if the child is small. I would not "freak" out about it... but they should work to get more healthy calories in him. Avodaco is a good source of healthy fat, if he isn't drinking enough WHOLE milk, they may want to try pediasure or a toddler formula that has more calories than milk.

My cousin has very small boys...she is small too. They are in about the -2 percentile for weight... and they still weigh and weighed more than 21 lbs at 19 mos. her little guy is 20 mos and weights about 24 lbs.. (I know only 3 lbs...) he is still very very small...but he is healthy. So... I guess, this little guy could just be small...but he should still be gaining something.

He has failure to thrive and needs to be hospitalized so the cause can be determined. He needs to see a doctor, it's a crime not to get him to a dr.

I think it could be a problem. My 22-month old has only gained about 5-6 ounces since her 12-month appt...and she's a little over 19 lbs. She's not even charting for weight at her age, and I doubt your nephew is either. While he may be active (and so is my daughter), you mention that he's a picky eater. Maybe he has food allergies, and he's not being a picky eater...but rather having issues with the foods he is eating so he just doesn't eat, or only eats the things he knows won't leave him feeling badly. Also, for kids with food allergies - - - eating is not something they "enjoy", especially if it always involves things that make him feel crappy. (Kids are smart, even at this young age.)

I say this because we (us and the pediatrician) were concerned over my daughter's weight and size...our gastro doctor did an endoscopy on her and found that her entire GI tract was lined with "dots" from internal allergic reactions. We had to go through all the allergy testing and found out that basically she was allergic to almost everything I was feeding her!!! (Dairy, soy, eggs, legumes/peanuts, wheat, beef, turkey, and sesame seeds!) She's ANA to legumes (green beans/peas), so this could have been a very serious situation had I forced those foods on her more. In addition, she was diagnosed with Eosinophilic Esophagitis...which should improve by avoiding all these foods she's allergic to. We'll have another endoscopy this month to check the progress of steroids and avoiding the offending foods. That being said, when you see what all my daughter is allergic to, you can see why it's difficult for her to gain weight - she mainly eats fruits, veggies and ham/chicken/pork. There's not a lot of fat/carbs in her diet.

Hopefully I didn't overwhelm you, but when I read your post it mirrored what I have gone through with my child. I hope he can get in with someone else to be examined because the sooner you isolate the issues, the sooner he'll be able to thrive like the other kids his age. Good luck!

It is not always easy being a parent and sometimes you just have to be "mean".

He is allowed to be a picky eater. I teach healthy workshops. In my Mac N Cheese Again?!, I let parents know that it is worse to allow children to have sweets, little or no protein, fast food, etc than to let them go hungry for awhile. When they are hungry, they are more likely to eat the good food in front of them.

Also, our bodies are very smart. When we give our bodies good nutrition, they don't crave the bad things.

From what you've told me, he is mal nourished. It doesn't mean he isn't getting food, just not the right food.

My hope is that this helps you, your in-laws, and your grand nephew.

Many blessings,

M.