Concerned About My Child Being Underweight...4 Yrs Old and 27Lbs.

Hi M.,

You should try feeding him a lot of carbohydrate foods like pastas and breads. Hopefully, he's like my daughter and LOVES mac n' cheese, spaghetti, PB&J, fettuccini and top ramen.

My daughter was underweight while an infant and becoming a toddler because she had GERD. She would vomit after every single feeding and still does vomit sometimes if she gets too upset or just out of nowhere.

We switched her from regular milk to soy and she eats nothing but pastas, eggs, cheeses and things like that. She eats veggies also, but she's not too keen on them and I won't force her to eat something.

Hopefully some of that helps!

Hey M.! First question, are you and his dad on the small side? I ask because my 3yr 3mos daughter is about 26lb and also always hit milestones early etc.......her Doc use tobe concerned that she was so little until he really looked at my husband and I ...I am 5'2 hubby 5'6, both small frames..... anyway.....I would probably put him back on whole milk, and make plenty of the things he eats.....don't force him to eat if he doesn't want to, that makes worse problems......let him eat the same thing for a week if he wants......I hope it all works out.

I was the same way when I was a kid and the doctors did all of the testing and they cound't find anything wrong. Maybe he's just a little guy and there is nothing to worry about. I am still small for my size but completely healthy.

Not eating could be a power struggle between you andyour 4 yo. Can you make eating more of an everyday attitude in wich if he eats, fine and if not that's OK too. HE will eat when he's hungry.

I'd also feed him all the things that he likes especially high carbohydrate foods. And give him snacks frequently. He could have all the ice cream and juices that he wants. Rarely does a child not like mac and cheese.

His stomach may be too small to eat much. Stretch it out by feeding him more each day.

Never force him to eat. That's where the power struggle comes in. You say you will eat this and he says no I won't. It's a battle of wills and the child nearly always wins,

Make eating a pleasure. Be cheerful and undemanding when you're feeding him.Perhaps even tell him he doesn't have to eat this butdoing so will help you to be healthier. Tell him of all the good reasons to eat. Give him choices of food. Two choices are suggicient. Help him make lunch. Four year olds can make good dsandwiches with help.

Do other thingds to make him fee a part of the dinner process. He can help set the table, clear he table. Make suggestions for menus.

And above all remain calm and good natured as you do these things,

Hi M.,

My son had the same issues he was born 6lbs 13oz so, kind of small but, then fell of the charts. I was so upset I couldn't get him to eat anymore then he wanted to. The first thing I did was had a complete blood panel done on him to make sure there wasn't any health reasons for his size and then when that was ruled out i sought help from a nutritionalist from his Doctors office and she said don't push him to eat you could cause an eating disorder by forcing him. So, I would just put the food infront of him I tried to give him only quality food no crackers or things that were just empty calories. Absolutley no sugar because if I gave him sugar it would ruin his appetite later on so, he would end up eating less. Slowly he started putting on weight. Meeting with the nutritionalist was a great experience she told me how many calories he needed what types of food to meet his daily requirements for nutrition etc... I met with her once a month to monitor his weight. He's 2 now and in the 25% of his weight and that's huge for me. I have a friend whos son is also small smaller then my son even and she gives him pediasure when he has bad eating days. Milkshakes are a good idea maybe just a little vanilla icecream with a banana some peanut butter something that has protein and lots of fat. I hope everything works out.

Cyla, our daughter, was born weighing 8 pounds and was 21 inches long. She is now three (as of the 28th anyway) and weighs a whopping 24 pounds and is almost 3 feet tall. She refuses to eat fat inher diet, she prefers fish and milk products along with TONS of veggies and fruit. What we have learned to do is to throw in the fat where she will take it. At 2 she weighed 20 pounds....her brother weighed 21 pounds at 6 months (so you see my dilema....) Since she prefers milk products we get whole milk and whole fat milk products (these products are still good fat for the most part at this age)

So, to summerize, find something he enjoys eating, and then see what fat levels you can add that would be healthy, yet calorie induced.

Also, I want to note, the blood work may not be a bad idea, he may have an overactive thyroid that could be causing his weight loss. Dont force him to eat, just find something he will happily devour.

Good luck with this!!

M.,

I am a nutritionist. This is just as common as someone that over eats. I would be willing to give a free nutritional evaluation on you and your entire family. Lead by example and teach him what is good for him. Do not force him it will only backfire. If he is as picky as my son, you may have to go to supplementation.

Here to help.

L.
Nutritionist
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Hi M....
I have a friend who is a foster mom that takes care of medically fragile babies...2 of the little ones were almost failure to thrive. One of the Occupational Therapists said to start putting butter or margarine into anything that they eat. Also, if your son likes chocolate milk, use heavy whipping cream mixed into some milk and chocolate for the extra calories. At this point, because he is underweight, I don't think that you should worry about him getting too much fat or calories. I know with one of the little girls that my friend fosters, that it was a control issue with the little girl. She too wouldn't eat, and if you did force her (and that is a battle in itself) then it would only make things worse. So, little by little, the girl has learned that eating is ok...she still has a control issue, but not as bad as 6 months ago. Good luck...hope it gets easier for you. :)

get him involved with the dinner making process. If he can choose a meal, and help make it such as homemade pizza where he can help put the toppings on he should enjoy eating it. my nephew is like that and he drinks pediasure to help, but I think that your son is old enough to help with simple stuff and it will make him feel important if he helps.plus the reward is eating what he made. Get him involved with setting the table and so on. good luck with this, and congratulations on your upcoming marriage.

Hey Hey Hey!! Congratulations on your marriage coming up!!
I myself have a 15 yr old now, that also had the same problem. The doctor prescribed a high fat diet. Yes, he too was a picky eater. He got ensure with whole milk. Everything extra high calerie. (I thought it was rather unfair!!) LOL I couldn't eat high fat diet all the time.

My daughter is 4 yrs old and barely weighs 30 lbs. She was dianosed at 9 days old with cystic fibrosis. This is a genetic disease that affects the lungs and digestive system. There is a simple non-invasive test called a "Sweat test". Ask your doctor about it now!!! If your doctor does not listen to you, go to Children's Hospital in Seattle. They have a wonderful cystic fibrosis clininc there and they can do the testing. For more info on this disease go to www.cff.org.

If the doctor said to put weight on him anyway possible...why not try things he loves? Milkshakes, cheese, peanut butter...my niece and nephew have both done that whole barfing when they are forced to eat what they don't like. Is he taking his meals with you? Our son loves to eat what we eat, (granted, he's 1) avocadoes...
Hopefully, he'll bulk up!
My brother forces his kids, coerces, even spanks...not that I'm suggesting that you do the same. I just wanted you to know that you aren't alone!

Oh my gosh! My nephew was and is the world's pickiest eater. Until he was around 4 years old, he was always SO petite and little. Then all of a sudden he just grew! He loves peanut butter, pastas, basically anything that's a carbohydrate! If you give him anything he doesn't like, eggs for example, he will gag the whole time he eats them and vomit sometimes. You can't just force a picky eater to eat foods they don't like. I wouldn't stress too much. It just sounds like you've just got an overly picky eater. Just try giving him more carbohydrates and foods HE likes. Hope this helps!

Check with your Pediatrician, he should be old enough to drink Ensure Plus 1/2 and 1/2 with 2% milk. My son drinks 2 to 3 pediasures a day. It's expensive!!! You can buy Ensure Plus at Costco for a little under $32 for a 24 pack...versus a 6 pack of pediasure for just under $14. My son is almost 3, his Dietician said he can have the Ensure Plus mixture or use Carnations Instant Breakfast also to reduce the costs. My son drinks this many do to SPD (Sensory Processing Disorder). Good Luck to ya L:)

My son will be 3 in 2 wks and I have a similar problem with him. He is long but skinny. Ben has been the same weight plus or minus a pound since he about 13mo old. I get worried and have the doctor keep an eye on it but they say since he has shown signs of gaining a couple ounces every now and then they are not worried because it shows he is capable of gaining. They think it is due to him being so active from a very early age. Like yours Ben hit every milestone way early. He was cruising furniture by 5mo and walking by 7mo. I try to give him atleast 2 choices for each meal and let him decide. When he needs more then he is eating I will give him an ice cream cone filled with peanut butter since he loves it. I also found that some of the pediasure like toddler drinks work at times. There are days he just won't eat and you can't make him we just try to have patience and keep asking him through the day.

Good Luck!

My 3 year old daughter is a very picky eater as well. I found that I can get her to eat if I have something next to her that she wants. For example, We were at dinner the other night and she wanted a sip of my rootbeer. I told her to have a bite of pizza and then she could have a drink. To my suprise she ate 1 & 1/2 slices of pizza. Normally she would have picked a little cheese off the top and asked for milk.

I would go for a second opinion. I was extremely worried when my daughter wasn't gaining weight and I wanted her to get tested. Turns out she is perfectly fine. She will be 4 in April and is just now barely 29lbs. Her old and new pediatrician are not concerened with her growth as long as her curve is fine. If your son suddenly just went down on his growth curve then there may be a concern.

If you want to try something then use Pediasure that is what my doctor recommened to me when I wanted to try and bulk her up.

Hi M.,
My son is also below the growth chart and I've stuggled with his weight at time. He is now 7 and doing much better although still small. When he was 4 I placed him on Pediasure and it helped him get all the nutrience and put weight on him. Why don't you try it, my son loved the chocolate flavor kind.

i would get a second opinion before you do anything. while the growth charts are a useful tool for doctors to catch growth deformities, i think doctors treat them like the holy grail and if you're not on the chart, you are in big trouble. as long as your child is happy and isn't malnourished, what does it matter if he's on the small side?

the vomiting is a little worrisome but kids do whatever they can think of to get what they want. our friends' daughter would throw up just so she didn't have to stay in her crib.

if you're really concerned that he's malnourished, i would think the blood tests could rule that out. if he really is manlnourished and not just a small guy, a nutritionist could probably help you come up with foods that he'd like to eat.

most importantly, don't make eating a big issue as i've heard that's how eating disorders and weight issues start. kids eat when they are hungry.

good luck and don't believe for a second that doctors know everything.

You might also check into food sensitivities. Celiac( a wheat and gluten intolerance) has symptoms of weight loss, failure to thrive etc...it can also have vomiting, loose stools, or constipation. Or possibly milk allergy or lactose intolerance. another thought is a low level of growth hormone. My daughter is almost 6 and weighs 34lbs my other daughter is almost 4 and is 28 lbs.My almost 6 year old had to have a complete hormone panel done to rule out the need for growth hormones.Some of the pickiness might be that he has a food texture sensivity. I have also had my daughters doc suggest pediasure to increase calorie intake. I know that there are several suggestions in here and that you will know if any of them fit your situation. Check out celiac's online as well as lactose intolerance and see if any other symptoms fit the scenario.

Have you looked into Failure to Thrive? I don't know much about it, but I have a friend who has two daughters (out of four kids) that suffer from it and they are VERY underweight. So much so that she had her kids taken away from her because they thought she was not feeding them. Be careful... you should look into it. Sorry I couldn't be much help.

M.
Hey its another M.. I read your post and am glad to see that another couple like myself and my fiance. We have a 3yr old and have been together for 13yrs.
You have a good day
M.

My son is the same way! He is 4 Just turned jan 15th he is 29 pounds only 7 pounds heavier than my 1 1/2 yr old he doesnt want to sit and eat a full meal he just wants to snack all day. My dr told me as long as he is snacking on fruits and veggies he will be fine his dad is small. I also give him pediasure to make sure he is getting the vitamins he needs. He will grow out of it

M., I just wanted to let you know that you are not alone.. I also have 2 children that have been VERY small all of their lives!! My son just turned 13 and is 70lbs. and my daughter is almost 9 and has not hit 45lbs yet :( I have had all kinds of tests done, bone scans and blood work mainly (no spinal taps or anything)they can't find anything wrong?? The Dr. says they are just small kids. The only thing I can suggest for a picky eater is to try and make food fun. They have cookbooks and magazines with all kinds of ideas in them like turning hot dogs into bugs and veggies into monsters and stuff like that. I wish I kept some of those books :( It kept my kids out of the hospital. Good luck with your little one! T.

you don't mention it but does your boy seem worn out or lethargic? Were you worried about his size or eating habits before you went to the doctor? If so any blood tests should rule out or confirm any deficiencies.
My nine yr old just hit 35lbs and she is perfectly healthy. a little skinny but full of energy and no deficiencies at all

Bye all means do not force feed your child. I remember my mother doing that to me because the doctor told me I was to underweight. all it did was make an overweight adult.

Don't worry abou your son's weight. my daughter is 6 yrs old and she weighs 36lbs. My doctor has never said she was underweight just petite. He is just a small boy take advantage. I'm sure he doesn't grow out of clothes as fast as other children. I would very much consider a 2nd opinion. Hope this helps.

A.

Looks like you have alot of advice already. My oldest daughter (now 5) is underweight. From the begining I had nurses telling us that she needed to be checked. They looked for things to be wrong w/ her and found nothing. She was put on a High caloric diet. With ensure also. Never really changed her weight. Her Dr. Was not to concerned with it. Because he also is a think man and he said most of his children are as well. I myself was rather picky and thin. My daughter grows straight up. And she is thriving in her academics and motor skills.
It never hurts to have all the tests to rule out and put your mind at ease!!
Good LUCK!
K.

Hey M.,

I work at a pharmacy where we deal with a lot of children with different eating issues. I would talk to you doctor about giving him pediasure. If your doctor does do test and shows that he does have an actual problem with weight gain your insurance may cover the Pediasure. It can get expensive. They also have the snack bars as well. I think it would really help. At least you know he is getting all of the vitamine and minerals that he needs on a daily basis. The come in lots of flavors and taste like chocolate, strawberry, and vanilla milk.
Good Luck!

Hi,
Looks like you already have lots of great advice! Just wanted to share.....My little sister did not eat food until she was over 5. After that she only ate about 10 things. She didn't even try shrimp, pasta, etc. until she was an adult!

She wouldn't even eat baby food, cookies, chocolate nothing!
My parents had taken her to doctors when she was younger.

Amber ended up just drinking milk until 5. My parents would add protein powder to her milk that had vitamins. Although she was always skinny and underweight she was healthy.

She is still picky and skinny but healthy and successful at age 29.

Good Luck!