39 answers

REALLY Low Percentiles, Should I Be Worried?

My son went in for a "well-baby" checkup the other day so that I could fill out the paperwork for daycare. My son is 2, and he's apparently in the 3rd percentile for weight, 5th percentile for height, and 6th percentile for head circumference. Should I be concerned? The ped recommended feeding him more often, but I can't force him to eat...?! If I give him snacks he won't eat his meals, though he generally eats pretty well whatever we put in front of him at mealtime (unless we give him a snack in which case he acts like he's not hungry).

He is a happy, seemingly healthy little boy, who is very active, so I'm not sure whether I should worry or not.

Several of you have asked--yes, I used to be petite (now I'm just short!), and his dad is thin as a stick. I'm only about 5'3, but in my family the women may be short, but the men are always really tall (generally well over 6 ft). My husband's family is of average height (hubs is the tallest of his immediate family at 5'11"). I suppose the one that was freaking me out the most was his weight--it seems like he should weigh more than 23 lbs.

What can I do next?

So What Happened?™

Thanks for all the reassurance...it's one of those things--you might KNOW that there isn't a problem, but you still get nervous. (Or maybe that's just me.) He seems to eat just fine (he's hardly even picky!!) and he seems pretty happy, and is VERY active (sometimes too much for mom!) so until that changes I'll assume that he's where he's supposed to be. :-)

Thanks again!

Featured Answers

Hi,
Sounds like that he is a very happy and healthy child, as long as he is hitting all of the important milestones like talking, fine and large motor skills, I say no worries. I have a soon to be 3 year old who has been in the lowest percentile for weight, height and head since he was 1 1/2. I don't worry though, I am only 5'2 so he may just be a shorty like his mom!!!

Good morning, B.! I have a 6 month old son and we have been battling the same "issues" since his birth. What I have been told is that as long as he is healthy otherwise and meeting development milestones, not to worry about what the percentiles are. Important thing is that he continues moving up the percintile chart. Like you say, offer him meals, snacks but you can't nor should you force him to eat!! It has been difficult for me because I feel like I should be doing something else, but I don't know what that could be. We have a 2 y/o daughter who has ALWAYS been in the 90-95 percentile and I haven't done a thing differently with the two of them?!?!

I'll be thinking about you!!

More Answers

I know a lot of parents keep up with the percentile ranges. I guess I am more old school, being an older Mom. I'm kind of like you, can't force them to eat, most eat when they are hungry. We had a party when my daughter finally hit 50 lbs when she was 7! She is very active and rarely sick. Figured something must be going right. Follow your heart and your Mommy instinct.

1 mom found this helpful

Kudos to all your ladies who responded with the "he's just fine". I agree...if he's eating and thriving then don't worry about it. First of all, remember that you need to compare your child against ONLY your child! This isn't a race to see who's kid is the biggest...my daughter is off the charts and I'm not "slimming her down"...rediculous to start that pressure on a 3 yr old...she's a big girl...her bone structure is bigger than her brothers but she is not fat. My 3 yr old daughter wears size 8 dresses while my 5 yr old son is still in slim 5 pants.

You said, "He is a happy, seemingly healthy little boy, who is very active" what more would you want? Celebrate it!

Don't worry about where the other kids are or the "norm". Look only to what is normal in YOUR family. My mom was a slender framed woman (my son got that), I'm a bigger boned woman (unfortunately my daughter got that). Don't obsess over it, society throws too many pressures on us to fit into a certain mold. Love your child for who he is and move on from there. If you are worried about self esteem issues with him, put him in sports or play activities that will accentuate his talents or build (i.e. gymnastics, soccer, swimming, running, art, theater or even dance) Not everyone will be an NFL football player, nor would they want to be.

1 mom found this helpful

B.,

I wouldn't worry about it. My son just turned 2 also and is 100% for height and 75% for weight. I knew he was tall but the weight % shocked me cause he hardly ever eats. He mostly drinks milk and is just not interested in alot of food. Kids haven't developed the "I'm bored what can I eat" that adults have. They know when to stop. If you're really worried I would just make sure he gets plenty of whole milk. It seems to be working w/ our kid!! Good luck!

I agree whole heartedly with these ladies. Not only that, I believe that this bad advice from the doctors caused my life long battle with weight gain. I was premature at birth and had various health problems when I was young. The doctors told my parents to force feed me. Eventually, it caught up with me and at one point I gained 100 pounds in 2 years. I started my first aerobics training program when I was about 9 years old and I've fought the battle of the bulge all these years since.

S.

You really should discuss this matter with the Pediatrician. This isn't exactly something that you should be trying to get opinions about. He could be a normal but small boy, especially if it runs in the family...or he could have a growth problem. There's no sense in coming here to ask a bunch of mothers who may not know all the details and family history. I know as parents we try to keep up with numbers, and I know as a nurse, that those growth percentile ranks are important, however, it's not something to get all worked up about. If your motherly instinct tells you something is wrong, then go with your gut and get answers from the doctor. Good luck!

My question to you is, is he growing? If he has always been very petiete, don't worry so much. The only reason for concern is if there is a drop in growth or no growth at all. The percentile is just where your child lies on a average of all childeren. He is on the smaller size. If he is active, eating well, you are doing great! Maybe at snacktime give him a smaller portion. He's a litte guy, so it's not going to take much to fill him up. You don't want to fill him up, you want to give him extra nutrition, and tie him over till next meal. Be sure to give the snack to him at least 2 hours before a meal. Hopefully then he will be hungry again and eat his meal. You're doing great mom!

I would not worry a bit. My daughter has been on the very low end almost since birth. As long as he is eating good and you feel that he is healthy, I don't think it matters if he is on the low end. My daughter is 15 months old and she eats like a horse...sometimes snacks, meals, and more. She has always been in about the 2nd or 3rd percentile as far as weight. Her Pediatrician told me to feed her cream and butter. I thought that was a little extreme, but sometimes I'll make her some oatmeal with whole milk and she eats mac and cheese which has both! I think she just got the metabolism that I wish I had and maybe that's the case for your son as well, especially if he is really active. Hope this helps...you sound like a great mom! :)

Are you and your husband tall or short? He is proportioned, which is a positive sign. If your ped was not worried, I would expect he is fine. He's a happy and healthy boy, I would not be concerned on size alone, as long as you and your husband are small as well. If you are both tall, I might worry.

I have 2 kids who have always been on the upside of the charts and have always asked if they were obese silly to ask. my son is very tall for his age and has no body fat on him so I wonder how do they come up with these percentile its based on weight height and head circumfrance and then averaged on a chart.Ok that is fine so I then ask the pediatrician you will let me know if you suspect a problem I don't want my children to be obese.My hsuband is tall and i'm short.Don't be worried children grow in spurts.If there was a problem it is good to still continue for well baby checkups so for an issue can be identified early.SAHM of 2 and 1 more on the way

I would not be worry. Both my boys are in the low percentile for the everything. My Dr. assure me that my boys are healthy. He told me that it's just a chart with what they considered to be national average. He also said, if my kids where sick all the time he would be concern. But, my kids are not. And my kids eat a healthy diet and eat all the time. I also been told that boys usually hit the growth late. So, I would not be worry at all.

Hi B.,

Try getting him on a normal eating schedule:
Breakfast, lunch, dinner and 2 snacks.

For instance
7:30 - 8:00 am breakfast
10:00 - 10:30 AM snack (something small like crackers and some water or juice)
12:00 - 12:30 Lunch
1 pm - 3 pm nap time
4:00 pm snack (or whenever he wakes up from nap)
5:30 pm - 6 pm dinner time
8 pm a bedtime snack
and then bedtime routine Bath, Bottle (sippy cup), book, bed.
These times may not work exactly for you but tweak where needed and you get the idea.

For the meals offer a main course, a fruit or veggie.
The main course can be like mac and cheese, noodles, chicken nuggets, etc. Offer milk at the meals and juice or water at the other ones. Hope this helps, W. B.

I have a little one that we also have to try to keep weight on. I would try the Pediasure drinks. Some milk shakes, maybe with a little protein powder in it. I also agree with the other ladies that it really good to pay attention to the percentiles. They just stress you out anyway, and we as mommies have enough on our minds! Good luck!

I have 3 kids and 6 grandkids. All but one of them was on the high side of the charts all the time, then we had the little one who was always tall, but won't gain weight for anything. She's now almost 4 and still only 20 pounds (her 4 month old sister is 16 pounds already and they can share the same shorts!).
If your son is eating and growing I wouldn't worry, I had a doctor tell me once that kids go through eating spells anyway and will eat very little sometimes and eat like crazy another. I've found that's very true a child's nature is to eat when they need to, if he eats little bits just make sure its healthy, normal is different for each child!

I wouldn't worry about your son being in the lower percentile ranges, especially since he is happy, healthy, and active.

My girls, now 12 and almost 17, were always down around the 5 percentiles when they were younger. Even now both are petite. The doctor told me with my first one that really shouldn't be concerned with the numbers unless she showed signs of not growing.

As far as the eating when my girls were younger, I let them be "grazers". In other words I let them eat "mini-meals" whenever they were hungry (anywhere from 6-8 times a day). They didn't eat very much at any one time (not even at mealtime). The foods that I did let them eat were all very healthy for them (lots of fruits, vegetables, yogurt, cottage cheese, peanut butter toast, unsweetened cereal, etc.). At "regular" mealtimes they ate balanced meals. Some of their favorites were macaroni and cheese, tuna noodle cassarole, chicken and vegetable soups, things that were easy to eat. Now that they are older and have a bigger appetite, they eat very well. They are not picky eaters either--both will eat nearly anything served to them and aren't afraid to try new foods. Just the other night we had turnips for the first time and one even took seconds and thirds!

It sounds like you are doing a great job and I hope that this helps ease your mind a little!

well, generally if the kids are under the 10th percentile we get concerned. but how big are you and dad? if smallness is genetic it generally isn't a big deal. and make a 2 yr old eat? HA. i mean, try, of course, but don't be surprised if it doesn't work. the only advice i would give is to give water, NOT milk, with his food and snacks, milk fills them up so much faster and then they don't eat. milk also causes microbleeding in the intestines if it's their only food source, so they get very anemic. and if he seems healthy, is still peeing and pooping regularly and it looks normal, and no weight loss then just try to supplement but don't freak out. good luck!

First of all, I wouldn't worry. These numbers are just ranges and your son is on the chart.
Second, don't turn food into a battle or control issue. it sounds like he eats when he needs to eat. You may want to offer a bit more food at meal time or evaluate if you can provide more calorie dense healthy foods.
Last, three meals a day is not necessarily the best eating schedule for everyone. You son may eat more with 5 or 6 small meals than at 3 big ones. For some folks it manages blood sugar better too,

Hang in there, be flexible and just keep his overall health in mind. Also, you don't mention if you or your husband are petite.

B.,
i agree with the other ladies - don't worry! i will say that my son is in the 97th percentile in weight, and the 95th percentile for height. his head circumference is right in there too. he's a BIG BOY. he's as big or bigger than the three year olds at his daycare. but he doesn't look fat - he just looks like he's closer to 4 than 2! he had his well-child checkup (2 years) today too. his dr. was very pleased and said that the thing to look at is that those numbers are close to each other. you'd have more of a problem if he was in the 50th percentile for height, and the 5th percentile for weight, for example (or vice versa). i would say as long as his pediatrician isn't concerned, you have nothing to worry about (assuming you trust your son's doctor). when all else fails, what i do is google it! i'm sure he'll be fine :) and look at it this way, you're saving money - my son is already in a size 6 diaper and 3t shirts. we've gone through SO many clothes in the last two years! :)

If your son is running around and acting like a normal kid, then I would not be worried. If he is at the same activity and intellectual level as all the other kids in the daycare, then he is doing fine. My daughter is in the low percentiles too. I brought this up to her doctor and as I was talking to her about it, Briana was running in circles around each of us. Literally! The doctor laughed and said I see where all her calories go now! Briana is one of the smartest kids in her class and talks very well. If she was not keeping up with the other kids, then I would worry. My mom says to put her on vitamins, but I haven't done that yet. Some kids are just smaller than others. Don't rely on just science to tell you how your child is doing. Trust your own instincts. Good luck!

my son was the same way
wic suggested i feed him deserts instead of fruit
he appeared to be 'running it off' so he needed more calories not more food

I almost wish they would throw their percentiles out the window and stop worrying parents unnecesarily. If you are a petite person it stands to reason your child will be petite as well ( which is my case) if your child is reaching the normal milestones for his age, if you feed him healthy foods, I wouldn't worry. Kids develope at different rates, you never know when a growth spurt is right around the corner!
Good luck!
B.

if he seems healthy and happy I wouldn't worry too much about it. My oldest was hardly on the growth charts and when he did hit it occasionally he would be less than 5 percent. The doctors weren't too worried and figured it was genetics as my hubby is 5'6" and I am 5'2" so he was just short and I always had to write down what he ate and how much so when he went to his appointments they would look at his eating and determined that he was eating well, happy, and healthy so after a few months they didn't worry about his size anymore and they thought he wouldn't be taller than 5'4". He wore a size 2-3T to Kindergarten and was the smallest in his class until his sophmore year. He is now 16 yrs old, 5'6" and is still skinny but weighs around 120 and is still growing.

I am going through the same thing with my 14 month old. My only advice is dont worry too much. They are having me bring her in every month for a weight check...she is gaining, just not on the scale they want her to. My mom said I was the same way, the only difference was that when I was a baby, the doctor told my mom that "two chiuaua's cant make a great dane!" Kids go through phases. My daughter eats constantly, but is VERY active! She has been walking since she was 8 1/2 months old and hasnt stopped going since. Just make sure that your son is eating when he is hungry, you cant force him. And everything will turn out fine in the end. Hope this helps!

Those stupid charts are so wrong! They are an average that was taken a long time ago and it does not mean that your child is unhealthy. It could be that you just measured him right before a growth spurt so the numbers were off. My niece is actually fell off the charts at one point in time and she is a perfectly healthy, active, normal LITTLE girl. My SIL did as the drs said and started giving her food whenever she wanted it and now she regrets it. My niece now thinks she should get whatever she wants whenever she wants. So don't give in to the drs and don't change his eating habits. If you are worried that he is not getting enough calories, then try giving him pediasure or add chocolate to his milk or put butter on his veggies, things like that but don't force feed him. As long as he is active and growing then there is nothing to worry about. Use those mom instincts and don't worry about the drs.

B.,
I think there are a lot of things to consider. First are you and/or your husband small. When I say small I mean 5' - 5'5". OR around there. Second were either of you small as children. What about others in your family.

The reason I ask this is because both my husband and I were small as kids and are not that big now. I'm not quite 5'. My five year old weighs all of 26lbs, my four year old just got to 29lbs and my 2 year old is 21 lbs. It could be a genitics thing.
I don't know if this helps or not. Let me know what happens.

B.,
If he's healthy, I wouldn't worry. Some kids are just small for their age. One of my sons ate very little when he was young. The doctor was constantly pressuring me about his weight. I tried everything, and I just couldn't get him to eat more. He was always healthy though. That child is now 17. He still doesn't weigh a lot, but he really shot up heighth wise (but not until high school), and he has a six pack! He is very healthy, and eats like a pig! I can't keep enough food in the house for him! I can hardly believe he's the same child. These things have a way or working themselves out. Don't worry.

Good morning, B.! I have a 6 month old son and we have been battling the same "issues" since his birth. What I have been told is that as long as he is healthy otherwise and meeting development milestones, not to worry about what the percentiles are. Important thing is that he continues moving up the percintile chart. Like you say, offer him meals, snacks but you can't nor should you force him to eat!! It has been difficult for me because I feel like I should be doing something else, but I don't know what that could be. We have a 2 y/o daughter who has ALWAYS been in the 90-95 percentile and I haven't done a thing differently with the two of them?!?!

I'll be thinking about you!!

Hi,
Sounds like that he is a very happy and healthy child, as long as he is hitting all of the important milestones like talking, fine and large motor skills, I say no worries. I have a soon to be 3 year old who has been in the lowest percentile for weight, height and head since he was 1 1/2. I don't worry though, I am only 5'2 so he may just be a shorty like his mom!!!

I used to work with a woman that got a lecture from the nurse at every "well baby" visit complaining how tiny their daughter was...she worried herself to death about it.

I pointed out one day:

She was 4'10"
Her husband (dad) was 5'3"
Grandparents...all under 5'6"

We're not talking a gene pool of tallness now are we?

Truth is...if he is healthy, ACTIVE, and eats balanced meals why stress everyone out by force feeding him? You might take away all fruit juices, which dull their appetite and make sure to get him whole foods with plenty of good fats...

But you're right, you can't force a child to eat if they are not hungry.

Perhaps the doctor's office is trying to force your square peg into a round hole?

My son wasn't even ON those dumb charts until his 6-yr check-up, when he finally broke into the 5th percentile. I used to worry so much, but I've finally stopped; small boys run in my family, and in hubby's. He's fine, and I'm sure your son is fine, too. At least yours eats!
{{HUGS}}

If he is eating and receiving the vitamins and nutrients that he needs(check on mypyramid) then don't worry about it. He may just be a small person.

Good luck,
D.

My DD is in the low percentiles also. She is 3.5 and weighs 29lbs. My ped said not to worry. She's healthy happy active and growing, she's just small. It also depends on how large your family is. My Dh and I are both average to short and so is the rest of our family.

My girls were in the high percentiles when they were little (one still is) and my doctor told me that as long as they comparable then don't worry to much. Like mine would be in the 90% for height for 85% for wieght. But since they were both in the same range not to worry. If height had been in the 30% and weight in the 90% then there would be a problem. Just keep trying to get him to eat and encourage healthy stuff. And once he is in daycare he might start eating more and some diffrent stuff since he'll see the other kids eating it. Good luck!

Good morning B.,

I could never understand why pediatritans focus on those numbers. They represent only a few of our chidrens population. The numbers are used as an average as a comparison. Ease your mind. Your son's numbers maybe low, but how is he acting? If he is a happy healthy little guy, then you have nothing to worry about. You are right you can't force your child into eating more than he wants. Kids know when to stop eating. He is eating enough for his needs. Trust me if he needs more he will let you know. My little guy was small for the longest time, he is 18 months now and just as strong and solid as the next kid. Your son will catch up at some point it just may take a while. If your son is doing great like eating well, sleeping well, lots of activity and is happy, then he is healthy. I would be more concerned if he didn't seem like himself. Meaning that if he were ill with something needing serious medical attention, then I would be really worried. You know your son and follow your insticts. I hope this has been of some help to you. Good luck to you and your family.

A. H.

My 13 month old son is in the "very low percentage", but my pediatrician told me to not worry about it. Some kids are just smaller but tend to have a growth spurt. He eats all the time. He might not eat large amounts like some of the other kids in daycare but at least they are eating:)

All children come in different sizes so as long as he is healthy and the pediatrician is not concerned, I wouldn't worry. The charts are simply a comparison to the "average" child; as we all know there is no "average" child! Also, he may be small due to genetics. Were you or your husband really small children? Also, if the problem persists, or others develop, your doctor can look into growth issues. Take care and just love your little bundle of energy! Have a great day! K.

I would get something like Pediasure to help supplement. Its a sweet type drink that has all sorts of vitamins and nutrients in it. give it to him once or twice a day in lieu of milk. It should help some! Good luck!

Hi, B.! I know you already have alot of responses and I usually don't answer people. I like to read and learn. However, my son was full term (a little over a week late actually!) and weighed 5 lbs. 1 oz. The pediatrician sent us to an endocronologist when he was 2, to make sure everything was ok. He ran a lot of tests and then gave me a big, long name that he said meant my son was in direct proportion to his own self! My son ate little bits at a time. I made sure there was something for him to nibble on frequently like goldfish crackers and juice, cheese slices, meat sticks (like the Gerber kind) and things like that. My son would get up in the middle of the night to eat. I would wake him up in the morning and he would have his little fists full of fish crackers!
My daughter was in the 50 percentile, while my son never even made it onto the chart!
So, the end of my story is that my son is now 18 (will be 19 in November) and he is still fine. He is 5'7" and weighs about 120. Not a large guy, but he's doing ok. Still eats what he wants when he wants and is very healthy. He has never had a cavity in his life!
Don't sweat the small stuff!

C.

Try to give him snacks in between the bigger meals like an hour or so. Snacks should be like cheerios, veggies or fruits.I would not worry so much he will fill out eventually, but like ensure is a good supplement.

I wouldn't worry. Emme is 2.5 and weighs 25lbs...

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