26 answers

Poor Weight Gain???

Well the story is a long one but here are the basics.

Daughter was born 7.7 healthy.
Is now 14 months and has been labeled "failure to thrive" from doctor.
Doctor wants to get a sweat test to test for CF.

My daughter has been dropping down on her growth chart ever since she was 6 months old.

She is now in the 9% percentile.

She eats somewhat, but is pretty picky and doesn't eat a lot when she does eat.

I still breast feed. She drinks 1-3 pedisures a day instructed from the GI doctor (baby shake).

Not at all sickly.

Eats avocado at almost every meal.

Any ideas? I am lost???

2 moms found this helpful

What can I do next?

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My daughter was the exact same way. Was tested for CF, Celiac, growth hormone deficiency,etc. She pretty much only ate avocado, blueberries and cheese. At 18 months she had a bone density test that indicated her bone age was 3-6 months. Basically what that meant is she still has a lot of growing to do but completely healthy otherwise. At her 2 year appointment she still only weighed 20 pounds. She is completely active, happy, crazy. At about 19-20 months she started eating a lot more and is now actually a little chubby. She still eats avocado with almost every meal. :-)

All my kids (4 of them) were born between 7 and 10 lbs. but grew very slowly. At age 1, my youngest (and smallest) was only 17 lbs. and in the 0 percentile. At 18 months, she finally hit the 5th percentile. People just freaked out, but my doctor had known all of the kids and didn't worry. He knew she'd catch up, and she did. They're all perfectly healthy, happy kids. Two are still thin, two are chunkier, but that's heredity they all look just like various grandparents, aunts or cousins. As long as she's alert, energetic and otherwise healthy, I wouldn't worry.

I just read a question about whether or not breastfeeding was the cause - my two tiniest kids were bottle fed after 6 weeks.

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More Answers

I'll give you the physician perspective, but also from the perspective of a mom of 2 and aunt to a tiny girl who also failed to gain weight.
1. If your child has dropped 2 % curves on the growth chart, she needs lab testing. After all, if there is a treatable problem, wouldn't you want to know now? Labs include kidney function, blood count, urine testing, thyroid, CF sweat test, and any others needed. I have found kids with treatable problems who then thrived.

2. Nutrition: See a dietician for recommendations.
For all kids: Toddlers need 3 meals and 2 snacks daily. Grazing is not recommended because it sends the body the wrong signals and can cause long term food related and weight issues. Calories per day should be around ###-###-#### or more, but only a dietician can calculate specifically. Milk should be whole milk until at least age 2, I recommend age 3, and 16-20 ounces per day. At this point, breast feeding may be a supplement, but you may want to offer whole milk at meals. Other liquids mostly water, 2-4 ounces of juice at most (empty calories). Concentrate on healthy foods. Offer a variety at each meal and snack, some protein source, and at least 1-2 foods you know your child will eat. Do not fret if she does not finish everything on the plate or even skips an entire meal or eats the same thing every day, seeming to survive on yogurt and fruit. All toddlers do this. A portion is 1 tablespoon per year of age. You decide what and when the child eats, he decides how much and can get more if wanted. Use dips, cut food in sticks to pick up (even sandwiches, french toast, etc) and make it fun, and add nutritious calories, no junk food.

3. I do not recommend pediasure. You can make your own smoothie with much better ingredients and no added sugar - whole milk yogurt, fruit, soy milk, peanut butter or almond butter, etc. Remember this is a supplement or snack, not a meal substitute. The more sweet stuff you give kids, the less healthy stuff they will eat.

4. Toddlers don't really need restrictions on fats, but the fat calories should be healthy, naturally occuring like in nuts, avocados, olive oil, flax, whole dairy products. Even a child with poor weight gain does not need empty calories or junk food.

5. Remember, most kids who don't gain weight as the growth chart predicts do fine and have no health problems. My niece is now 7yo and thriving, but still small and thin - it's just her build.

Good luck and really consider a pediatric dietician asap!

2 moms found this helpful

My daughter is same age now and in the 5th percentile at her 1 year pediatrician visit. She hadn't gained any weight in 3 months! She was/is totally healthy and happy and otherwise fine, so I didn't realize there was a potential problem.

At my pediatrician's instruction, I have been offering her higher-calorie choices at every meal. Meaning - full-fat yogurt, cheese, meat (she will eat lunch meat only actually), ice cream, muffins (whole grain with carrots), and I started making whole-grain (from a mix) pancakes using whole milk and adding cheese and pureed squash (from a can).

I am a vegetarian and on the thin side and not a big eater myself so it didn't occur to me I wasn't offering my daughter enough high-calorie food. I was feeding her primarily organic fruits, veggies, beans and oatmeal and not much that had a lot of calories - so she was eating good food, just not enough calories!

I had to go through a phase of offering her like 8 different things at every meal but now I've figured out a few high-calorie things she usually will eat. She is very picky though.

Also, I wasn't offering her snacks during the day. I think that's a normal thing mommies do, but again, it didn't occur to me! So now we have 2-4 snack times during the day in addition to the meals. (She's in day care, so I send extra snacks to day care - yogurt, cheese, whole-wheat tortillas, etc.)

She has been back to the dr. and is gaining weight better - making progress now!

I hope this is helpful and I hope everything turns out well for your daughter!
R.

1 mom found this helpful

How much does she weigh? Everyone is different. My kids have topped 20 pounds by the age of 1, but my nephews are barely 20 pounds by 2 years old.

Pediasure would be the LAST thing I ever gave my baby. Too much sugar in those things (increasing their risk of diabetes) and complete junk, but it gives Peds something they can recommend.

Here's what I recommend, if there is truly a problem with weight gain either because of her fast metabolism or because she's not getting enough breastmilk, which is usually unlikely. You may want to get a good whey protein and mix it in a blender with a bit of molasses, goat's milk (way less allergenic than cow's milk and closer in composition to breastmilk, although some peds freak about goat's milk due to ignorance), PB8 (probiotic) and fish oil. You can make a bottle of this and then put the left over back in the goat milk container for later. Use within 2 days. Here is another idea that many moms do when they have breastmilk issues, due to implants, etc:

http://www.trit.us/children/recipes.html

Please do not worry. My son is breastfed as well (we do attatchment parenting), he's one-and-a-half and only about 22 lbs or so. Well below the charts! You know what though, he is very healthy! When he was born, he was in the 85%. THose charts are made for the average baby, and unfortunately that is not a breastfed baby. As long as you child seems healthy you don't have to worry.

try spinach linguini cut it only once in 1/2 and put clear clam sauce on it..or try olive oil and salt..sit down and have fun sucking up the noodles in front of her..worked on my son and has been working for my friends that i told to do that. pizza..is also good..cheese quesadillas..on corn tortillas..cut them up..make yourself a plate of food and sit on the couch and act like it's just for u...and see if she becomes curious..as for snacks..at that age my so loved blueberries..now he doesn't..also dried cranberries..
for ice cream i give him "So Delicious" made from coconut milk and agave..u can get it at Wholefoods ..same w/ the spinach linguini
don't let her snack or fill up on liquids..as for milk..well try chocolate vanilla almond milk in her milk..also sauces..sause things up..my son loves ranch dressing..ketchup..dipping..
also the threat of someone wanting his food makes him eat..i act like i want his food and then he gobbles it up..he is good w/ sharing we do it jokingly.
I tell my son he has to eat to grow and to be smart..also u can put veggies in a blender and sneak them into the pasta sauce.
sometimes i make my son a protein shake and mix fruit and ice cream and tell him its an ice cream drink.
he's not over weight ..he's tall for his age and is doing well..you just need to learn to be clever..find snacks that are healthy..at 14 months my son also loved hummus..black olive hummus.
peel some cherries for her..have it available for her..good luck! hope this was helpful

I would do the the doctor says but maybe see a nutritionist too for both of you. Since you said you were busy you may want to cut somethings out and really slow down and relaxc more. I don't know if you let your baby watch tv yet but my kids loved watching Baby Einstein when they were little and eating snacks in their high chairs at the same time. Things like noodles, yogurt, cheese, and cheerios or kix are great.

NUPLUS SIMPLY HERBS FOOD YOU CAN MIX WITH ANY JUICE OR PUT IT IN HER OAT MEAL OR SUCH.
I RECOMMEND THE BULK SIZE.

http://my.sunrider.com/joyoustea
click join(you will see a box of Nuplus to right of screen,
click box and it will tell you about the food. Want to know more please e-mail me. J.

amazing food

Hello LC. I have been seeing a trend lately, that breastfed babies are underweight, and it has sent a red flag in my direction. I'm not sure if breastfeeding has anything to do with it, but my son (who is only four months old) has his shots last week, and the doctor wasn't thrilled with his weight. He only weighs 11 lbs and 11.6 ounces, and is 24 1/2 inches. A friend of mine had her baby a week after my son was born and her baby is 15 lbs and 25 1/2 inches! Anyway, I was told he should have doubled his birth weight (7.8) by now. I'm getting concerned myself, because I exclusively breastfeed, and I know that I can't see how much he is taking in, and wonder if he is getting enough. I breastfed my first son and had no issues though, in fact, he looked like a sumo wrestler until he was about 2. I'm sorry I don't have any ideas for you, but I was just wondering if you, or anyone else thinks that breastfeeding might be the culprit. I'd hate for that to be true, but I'm worried as well about my baby's weight. On the flip side, one piece of advice I can give you is this - smoothies are awesome, and easy to sneak stuff (veggies, protein, etc) into. Not sure if your daughter likes them or not, but they're fast, easy, and as long as there's not too much sugar (either directly or from fruit/fruit juice) then they're relatively healthy. Best of luck to you :)

I do not have an answer for you, I am in the same boat. My daughter was almost nine pounds at birth. Now 20 months and 20 pounds. seems like she has been twenty pounds for many many months. She is sue for a check up in August and her doctor told me if has not put on some weight he would need to run some tests but didnt give me any names. So I wanted to ask you what this sweat test invloves and what exactly CF is? I know you asked for answers and I am asking you the questions .......sorry!

My little girl is picky some days others she will eat anything she just doesnt eat large amounts. Though it seems like she is eating all day long.
Her fathers side of the family all have petite woman so I am hoping that it is just stemming from "the genes"

Are the woman in your family very petite?

Its good to get further tests... especially since her weight gain has dramatically dropped over time.
I once baby sat a baby like that... BUT her overall development was 'off' too. And she had swallowing problems... and reflux. BUT her parents would not 'allow' the Doctor to further evaluate her... which was sad. Because something WAS wrong with her. Now at her current age, of about 5 years old, she is still behind in overall growth/weight and development. But yes, she is 'healthy.'

Thus, do go ahead with finding out what may or may not be 'wrong' with your daughter. It could be anything... or even just something minor. But evaluate all possibilities.

All the best,
Susan

It could be literally one of a hundred things....anything from CF, to a twisted intestine, to an allergy (like celiacs), to a parasite (worms, amoebas, etc.), to diabetes, to purely and simply just being dainty, to, to, to.

The way doctors work is from the common to the uncommon (when you see hoofprints, think horses...not zebras). Unfortunately, if it's more uncommon it will take longer. Geography also plays a big part in common v uncommon. Just as an example; malaria can take months to diagnose here in the states, because it's so rarely seen here...but is one of the FIRST things tested for in say, Costa Rica. And amoebas (which are fairly common in the water in Mexico) are caught a LOT faster in SoCal then up in Washington. Diabetes is something that very few people are "born"..but it gets diagnosed faster in small children and overweight adults than it is in a physically fit 20 year old...but a physically fit 20 year old CAN develop diabetes. There are just sooooo many variables & possibilities, that it is only common sense to start in what is MOST likely and work your way down.

The first thing that they're going to hit is nutrition. Then, if that doesn't solve it...they start running tests & evaluations. Generally, the more common something is for the age and region the faster the cause will be found.

Failure to thrive is not something that is usually diagnosed purely off of height weight charts (ummm...there's going to be a lot of difference in the typical Japanese baby's height/weight development than in the typical Norweigian/Sweed baby's development...even though it's fairly common for them to BOTH be born at 7-8 pounds). Being the blended country that we are our "charts" will have perfectly normal healthy development in the 1% and in the 99%. There will also be babies that are deathly ill in the 1% and in the 99%. Is there anything else going on? Lethargy, missing milestones, etc?

While good on on you for taking your daughter's health seriously (yay!), if she's showing every sign of being healthy, take this as an opportunity to "catch" anything that might be going on early. And don't be afraid of a second opinion. Doctors are the single most notorious 10th opinion getters in the world ;) If what your ped is telling you FEELS off, feel free to call up a different office for a well baby checkup/second opinion. Sometimes a second pair of eyes and an open mind can be invaluable.

Hi-

My daughter has also dropped on her growth curve to the 5th percentile(weight only; height seems ok)- we're not sure what is happening either or if it's something to worry about, but our dr. had us consult a pediatric endocrinologist who ruled out several things, including thyroid and celiac. also, they noted that height seemed more important than weight for determining problems- do you know if that's the case with your little one? my dr. is also ordering a stool analysis to check absorption.

Sorry I don't have answers but these are some other things that your dr. might consider.

Best wishes.

All my kids (4 of them) were born between 7 and 10 lbs. but grew very slowly. At age 1, my youngest (and smallest) was only 17 lbs. and in the 0 percentile. At 18 months, she finally hit the 5th percentile. People just freaked out, but my doctor had known all of the kids and didn't worry. He knew she'd catch up, and she did. They're all perfectly healthy, happy kids. Two are still thin, two are chunkier, but that's heredity they all look just like various grandparents, aunts or cousins. As long as she's alert, energetic and otherwise healthy, I wouldn't worry.

I just read a question about whether or not breastfeeding was the cause - my two tiniest kids were bottle fed after 6 weeks.

My cousin's baby was and remains super small. 10%. The mom is about 5'3 and the Dad is 5'6. She is 3.5 now and they did a scan of her wrist to determine if she was growing. She is fine. She is small for her age, but her parents aren't big. No mental delays. Hope this helps a little. Great good on the avocado!

Hi L C Sorry to hear that your little one isn't gaining weight light you would like her to. I have a few ideas, you may want to try. First at 14 months old I would stop the breast feeding and put her on whole organic milk, also give her pasta's most toddlers love it. Continue the pediasure, and watch her progress, for example, talking, motor skills, things like that. You said she is not sickly at all, that's a blessing, in the mean time enjoy your little girl, don't let worry rob you of the joy and fun of being a mom. I pray all works out well with your little princess. J. L.

Have her checked for food allergies, gluten intolerance and reflux. My son is allergic to both dairy and soy proteins. He didn't get robust and healthy and start gaining weight normally until I eliminated dairy and soy from my diet and his (I breastfed him also). He's really sensitive so I had to eliminate dairy and soy hidden in other foods too (like breads made with milk as an ingredient). Limiting my diet and his sucked but it was worth it. He's 2.5 now and he's still dairy and soy free.

T.

My 10 and a half month old son has always had a low weight, 3% weight percentile last time we went to the doctor (a month and a half ago), about 70% for height. He started out at like 40%, went down and stayed at 10% for a while, and then just dropped to 3%. He is super healthy (never been sick, even though he has been around many sick people and traveled by plane across the country three times), high energy, and very happy. I do breastfed, and does eat 3 meals a day plus snacks, but not huge amounts of food. Our doctor has never seemed worried. You said your daughter doesn't seem sickly, but the doctor labeled her failure to thrive. If she is healthy and has energy, and isn't fussy (she would be if she was hungry all of the time), then she sounds like she is fine and healthy. I think most babies gain too much weight because of formula, or they just aren't able to stop eating when they are hungry, so the percentile charts are off. We have stereotypes that babies are supposed to be fat, but I think they just need to be healthy.

Also, I do try to give my son extra protein to help him gain some weight, egg yolk (I think you could do egg white as well), tofu, cottage cheese, and beans. My doctor suggests meat as well, but we don't do that too often. Just some ideas for you. I don't think I would do pediasure. I would probably add whole milk as someone suggested, but I would also keep breastfeeding if I were you. I know there is also a Next Step formula for kids up to 24 months, maybe you could try that too.

My son was born 7 pounds 1 ounce and he continued to shrink down until he was in the negative range.... at first I was so worried myself. The pediatrician wanted to order all sorts of tests. I had to take time and do some thinking and some research for myself... was my son sick... was he fussy often.... etc. If I answered yes to these questions then more than likely he was having some issues. However, the case was no... so ask yourself these same questions.
During my research I also found out something new...something that made it all sink that he was more than ok. The percentiles were based on the child being HEAVIER than x% of kids his age... so right now your baby is HEAVIER than 9% of children her age. To me, the goal should be 0% .... that the desired weight is perfectly average. Once I figured this out I was appalled at the number of parents who wanted their child to be in the 90th percentile.. good lawd!! Do you know what that means??? The kid is fatter than 90+% of kids his age!
We have way too many obese children and way too many children with obesity related problems... please do not worry about your daughter's weight. She may be a grazer. I always make sure I have snacks on hand for my son... at all times. He nibbles all day and that is how he is. For me to try to put him on a schedule meant that his weight kept dropping because he didn't necessarily want to eat when the rest of us did. Keep everything varied... offer lots of veggies, fruits, meats, dairy, carbs, and the occasional treat.
I don't know specifics to your child, but my son is now 18 months at 21.5 pounds and 32 inches and VERY happy and healthy. His clothes fit length-wise, but I have to modify everything in the waist or they fall down. However, he's never had an ear infection, one minor cold and is always on the go and always smiling.
Feel free to email me if you have any questions or concerns. :)

My son is in the same boat! He's 15 months old, 32" and 20 lbs., which the doctor translated to 80% for height, 4% for his weight!!!

Our doc said to put butter on everything. My son only seems to enjoy eating fruit and mac & cheese and yogurt. We've tried many different things, which he will toss onto the floor.

I'm interested to learn what other mothers have done and what works. I'm not TOO concerned because my son is very happy and very active. I'd worry if he were lethargic and not able to run around, etc.

L.

Check out Dr. Gordon's answer and see if this helps....
http://www.drjaygordon.com/development/faqs/faq029.asp

Get a second opinion!
I don't know whether your current doc is supportive of breastfeeding, but you should look for another one who is supportive when you get the 2nd opinion.

You know your child best and if you think she is thriving, then she probably is!

Make her smoothies with fruit that she likes, and add a good spoonful of organic virgin coconut oil to the mix. You can buy it at Whole Foods.

Hi,

I would keep working with her doctor on ruling things out. Has she been allergy tested? We use Shaklee products in our household and I am a firm beliver in them. I've met many people and seen first-hand others' health change when they made changes to Shaklee products. Shaklee is the #1 natural nutrition company in the U.S. and has been in business for 53 years. It's a company you can trust for piece of mind. Our #1 reason for using Shaklee is that their products are completely safe. They do not compromise when it comes to safety. They do over 80,000 quality control tests per year and 349 contaminant tests for each batch processed. The second reason we use their products is that they work. They've spent $250 million in R&D, they have 60 scientists on staff, over 50 patents, 90 published studies in peer-reviewed journals, the company actually does clinical studies, and Shaklee is cutting-edge and innovative. They never follow fads. Shaklee has a meal replacement shake that would be much better than using Pediasure. It's a great source of protein, calcium, fiber, and vitamins. Also, they have a powdered vitamin for her age that contains 23 essential vitamins and minerals, a prebiotic, and the newest recommended dose of Vitamin D. Not only is our health affected by what we put in our bodies, but also by what we put on and around our bodies. I would definitely start checking the ingredients that are in your child's personal care products. Get to know the names of toxic chemicals. Shaklee has a baby/children's line that is free from toxins and other substances, natural, and partially organic. Have you considered switching your cleaning and laudry products? The Get Clean line of cleaning and laundry products are safe, natural, effective, highly concentrated, and earth-friendly. You can check out these products and more at www.greennutrition.info and register to win $200 of free products at www.freegreenproducts.info. Another suggestion is go eat organic as much as possible. If you would like a Healthy Kids book, please contact me. I'm here for any questions you may have also. I wish your daughter and your family the best.

C.

testing for cf huh.... my niece was born healthy at 5lbs and some oz. and shes 2 and just barely hit the 20lb mark. she has food allergies (eggs, milk, nuts) have you had your daughter allergy tested yet? they can do it by blood now. they also tested her for ciliacs disease (which is a thing where your body cant absorb gluten which keeps you from gaining weight i believe). that thankfully came back neg. have you talked to her dr about testing for that? i know they put my niece on a high fat high calorie diet. maybe try some whole fat yogurts, cheeses and a wide variety of fruits (peaches, pineapple, banana, kiwi, blueberries, anything you want.) and veggies (green beans, peas, corn, mixed veggies etc.), beans (refried etc). also let her graise durring the day. leave dry snacks for her (gold fish, cereals, unsalted pretzels, etc. now im assuming she eats what you eat for dinner so just try to get her to try a little of everything.

Homeopathy.

Good Luck
V.

You might consider in addition to her primary care Western medicin physician, taking her to a Doctor of Chinese Medicine as they look at things from different perspectives and sometimes the more angles you look at something from the better your chances of finding an answer. I go to Dr. David Karaba at East West Medical Group in Fullerton and absolutely love him. ###-###-####

Best wishes no matter what course you choose. My prayers are with you.

M.

My daughter was the exact same way. Was tested for CF, Celiac, growth hormone deficiency,etc. She pretty much only ate avocado, blueberries and cheese. At 18 months she had a bone density test that indicated her bone age was 3-6 months. Basically what that meant is she still has a lot of growing to do but completely healthy otherwise. At her 2 year appointment she still only weighed 20 pounds. She is completely active, happy, crazy. At about 19-20 months she started eating a lot more and is now actually a little chubby. She still eats avocado with almost every meal. :-)

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