19 Month Son Not Eating Enough to Gain Weight

Updated on February 02, 2008
H.D. asks from Rancho Cordova, CA
26 answers

My 19 month old son weighs 17.5 pounds, and has been back and forth to the doctor for over six months now regarding his weight/size. After blood, urine and stool tests the pediatrician said he was not sure why Corey is not gaining weight. He said that Corey weighs less than his fraternal twin (who has always weighed about 2 pounds more), and that's part of the concern. The dr sent us to a GI dr, and she has us giving him carnation instant breakfast three times day, plus try to give him breakfast, lunch and dinner plus two snacks. We have food available all day, and he will nibble, but rarely eats a lot. At his appointment the other day, the GI dr suggested we try an allergy medicine that is supposed to make him hungry. In one month, we have to get him weighed, and if he hasn't gained enough weight in 2 months(she didn't give me a #), she wants him to have a feeding tube (through the nose to his tummy). We do not agree with the feeding tube suggestion, mostly because he's not "sick", and he does eat, he's just little. Has anybody had their child on an allergy pill to gain weight? Was it successful? Do you have any food ideas to help chunk him up?

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L.F.

answers from Los Angeles on

My daugher had not gained weight between 9 and 12 months and was around 16 pounds. We were seeing a GI specialist b/c she had reflux. The GI put her on the medicine you were asking about b/c she determined her problem was just her appetite. The medicine seemed to help a little, but not dramatically. Now at 14 months she is almost 19 pounds and her pediatrician took her of the medicine b/c we both felt uneasy about giving it any longer.

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C.S.

answers from Fresno on

Have they tested for silliac's (I think I spelled it wrong) it's basically a allergy to wheat, and it doesn't let the body absorb any other nutrients... we have a friend who's son was just diagnosed. He wasn't gaining any weight either and as soon as they took him off all wheat, he chubbed up nicely!! Did they test for any other food allergies?? I would imagine they have, but that's all I can suggest. I hope they find out soon!

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J.H.

answers from Sacramento on

Hi H.,

If you feel that Corey is doing okay I would not go with a feeding tube. I would first ask to switch to a supplement with more calories and fat before moving right to a feeding tube. Aske him about Nutren Jr or Peptamin or even pediasure. Carnation Instant Breakfast may not have the right nutrients that a child needs. I work at a home infusion pharmacy. We deal with children and adults who need enteral products (formula's). IF you are seeing a GI specialist you should have him send a prescription to a home infusion pharmacy with documention as to why Corey need the supplements and you insurance may cover the formula at no cost to you, like any other prescription. Almost all Home infusion pharmacies deliver to your home at no charge as well. I would also tell your GI doctor that you would like an appointment with a Registered Dietician first. Some kids are just smaller. I agree with you to not go straight to an NG tube.

I hope that helps and if you have more questions let me know.

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H.A.

answers from San Francisco on

You should consult a Registered Dietition. Check with the American Dietetic Association (ADA) to find one in your area who specializes in kids. Have your ruled out lactose intolerance. Good Luck!!

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S.H.

answers from Honolulu on

**Everyone, Sorry about the double entry below.... there was some technical glitch as I did this. For some reason my entry got entered twice.**

I really feel for you, it seems you are a terrific Mom doing a great job at finding out about her baby boy. I have not heard about that "allergy" medicine... but maybe you should "research" it online... find out whatever you can. There are so many reasons for lack of weight gain... at least your doctor is investigating it through various tests. I am not a doctor, so I cannot say what is best to do. But about your question about "chunking up" a child... well, I have heard of Pediasure and that a lot of Moms use it per their doctors. It is full of nutrients and is like a meal replacement drink. I have had some friends who have had children who were in the "failure to thrive" percentiles and did not gain weight well or grow/develop for what is "typical." One of them never found out, another had "swallowing" coordination
problems and something to do with the opening of the esophagus sphincter muscle not functioning properly. Again, I'm not sure of exact medical term, but that is the way my friend described it to me.
In any case, please take care, and use your gut instinct. Hopefully the doctors can add closure to this.
~Susan
www.cafepress.com/littlegoogoo

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E.B.

answers from San Francisco on

Hi H.,
I know this can be so stressful. As a mom and a nutritionist, I have a few things that might be helpful. First, your son is not alone in being small. My son didn't hit 20 pounds until he was 2. That's just who he is. If he has always been smaller than his fraternal twin, perhaps that is just how he is supposed to be. Doctors can be very hung up about whether kids fit on their charts. Sometimes they are correct to be concerned and sometimes they are not. We want so badly to see our children grow and be healthy, so it's hard to know what the right thing is.

Professionally, when I see a child who is not eating well or gaining weight, I always look at whether child has food sensitivities. Gluten intolerance is a classic cause of "failure to thrive." An intestine damaged by gluten or other foods can cause digestive distress, which might make a child hesitant to eat. it also makes it hard for them to digest and absorb nutrients that they are eating. Many children are very intuitive about their bodies. They may not be able to say "when I eat this food I feel bad," but they may say they don't like it or simply refuse to eat. Sometimes if we can just tune in to those messages, we can get a lot of information about what our children really need.

You could go ahead and try a gluten-free diet and see how it goes. I am not a fan of carnation instant breakfast--it is a highly processed food and not very nourishing in the long run--or of the allergy medicine idea. I would certainly look elsewhere first. Please feel free to contact me if you would like to talk about this further. You can find my information at www.nutritionforthewholefamily.com.

I wish you and your family the best. I think in all likelihood, your son is just fine the way he is!

E.

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K.L.

answers from San Francisco on

Well, the feeding tube suggestion is a little suspect to me -- I am a special education teacher and, even in children with some very chronic illnesses, a feeding tube of any type is the last resort. Is your child lethargic, and did the doctor mention any of his blood work being abnormal? If his blood work did not show any defficiency in things like iron, potassium etc then he is obviously giving his body plenty if nutrition to function properly.
So, now that you know he needs to gain weight, its your job to buff up his meals. For breakfast, give him toast with butter - I know it may sound unhealthy, but in a child that is failing to thrive and been suggested the option of a feeding tube - you need to bulk up his fat intake a little. Give him cheese, whole milk yogurt, use butter where it is called for, avocados, beans - things high in protein and fat. This does NOT mean giving him extra sugar or sweets. You can also hide veggies in his favorite foods if he doesnt like to eat them such as putting pureed carrots in the spaghetti sauce.
Dont just let snacks be available. ASK him if he wants a snack, or a cup of milk - you can also have him drink those powdered vitamin drinks made for children - they taste GREAT and one serving has all the nutrition of a balanced meal.
Be creative with his food and find ways to get some more protein into him

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L.M.

answers from San Francisco on

I would hope they've check this, but my daughter had a heart murmur that was slowing down her growth as blood wasn't circulating correctly. It went away by itself, but we had a cardiologist checking her periodically to make sure it was closing. She's now quite happy, healthy, at nearly 5 yrs.

I definitely wouldn't go with the feeding tube or the medication. If kids are hungry they'll eat. Forcing food on them only causes problems later on. I'd try a different doctor or better yet a nutritionist to try and figure out what might help, or if any help is needed.

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L.K.

answers from San Francisco on

Dear H.,

I sympathize with you because our 19 month old son has also had weight issues since the very beginning, always well below the 5% and dropping off his own weight curve, etc. The doctors want to start all the tests on him at the next visit if he hasn't gained weight by then. Luckily we have found something that seems to be working, and I wonder if it might help your son too?

Someone suggested that we give him probiotics in order to help replenish the beneficial bacteria in his gut, because without these bacteria it is possible the food that he does eat is just not being properly absorbed. I used bifidobacterium infantis, because I already had it on hand, but I think you can use others as well, like those including the lactobacilli acidophilus and bifidus, etc. (I don't know where you live, but you can probably get them at stores like Whole Foods, Pharmacia, Elephant Pharmacy, etc.)

Anyway, just a few days after I started mixing the probiotics in his morning oatmeal, he already seemed to get rounder and rosier and more robust, and we also noticed that he has been pooping less often.

I hope this might help your son as well. Best of luck to you!

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A.M.

answers from Honolulu on

I have a very healthy and active 18 month at 18 pounds....she nibbles all day. I started doing yogurt and fruit shakes with milk and that has really started to get her appetite going and she is starting to get a little chunkier. I use half of a yo-on the go strawberry smoothie with one or two jars of gerber banana mixed berry or others. she can't get enough of them. be patient and they will work there way up to eating more. i always put a wide variety, in which very little is eaten and then she likes one thing one day, nothing the next. don't be afraid to try "strong flavored" foods, my daughter prefers them and tends to eat more. i also load up my whole wheat pancakes with smashed bananas or other fruit, dose it with a little pure maple syrup or strawberry jam lightly and you get those lips smackin'. good luck!

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T.G.

answers from Los Angeles on

I have a 4 1/2 year old son that had a feeding tube placed at 7 weeks for failure to thrive. We have since learned that he has all kinds of other issues and eventually had to be placed on growth hormone. When he was 7 months old, he developed adhesions in his bowel and had to have a bowel resection. At the time, he was 14 pounds and got all the way down to under 10 pounds at 10 months. He has had a problem gaining weight ever since. We had lots of advice and suggestions from doctors about weight gainers, medications,etc. My husband and I didn't want to put him through any more so I did my research. Getting your child to "gain weight" isn't about giving them tons of food, it's giving them the right fats and enough calories to sustain their little bodies. We did put my son on 3 cans of Pediasure a day (I don't know what kind of insurance you have, but because it was a medical necessity for "failure to thrive," my son's Dr. was able to write a prescription and we only have a small co-pay for 90 cans a month.) This was for extra supplementation to ensure he was receiving enough vitamins, protein, and minerals. I also looked into healthy, yet fattening foods. Here are some ideas: cottage cheese with cut up avocado,peanut butter and jelly on mini bagels, pasta and sauce (loaded with carbs!) adding butter and sour cream to mashed potatoes, adding protein powder to yogurt, milk or juice (I like Biochem Labs Whey Powder, Natural Flavor.. nothing artificial) If your son has allergies to gluten, whey, lactose, soy, dairy, nuts, etc. some of these things won't be options for you but you can still use a Brown Rice Protein powder. They have it at Whole Foods and if not, can order it for you (The brand is MLO) Try "sneaking" healthy things into his meals like sweet potatoes in a grilled cheese sandwich or stirred into macaroni and cheese. Another good source of healthy fat is flaxseed oil. Don't buy him reduced fat or fat free things... they need the calories. I would caution against anything with the words "hydrogenated or partially hydrogenated, or high fructose corn syrup" in the ingredient list. I would also caution against empty calories like fruit juices, or unhealthy calories like fast food. I tell you this from years of experience and my son is now finally on the growth charts, wearing age appropriate clothing and is thriving well. He's grown into having quite a hearty appetite!
I know how frustrating it can be to feel like you are doing your best and the Dr.s are suggesting something you aren't comfortable with. Bottom line is: YOU know your child, and the decision is up to you. I hope you find whatever the cause is and that it is easily treatable.
Good luck and if even one of the suggestions helps your son, I am so happy for you!

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T.M.

answers from Los Angeles on

All kids eat different amounts and thus weigh different amounts. The only difference it seems like is that you have his twin to compare him to. Don't the specialists say NOT to compare our kids to their siblings?!

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C.B.

answers from Los Angeles on

Hi H.,

Is your son's weight proportionate to his height? My 20 month old is 20 pounds, but he is in the 0 percentile for both weight & height & otherwise very healthy & active. He was born with reflux, which he has since outgrown & that is most likely what contributed to his small size. When he was unable to keep food down & having breathing problems, we had him on antacid medication & tried to give him more fattening foods, but he has been feeling fine since around his first birthday & his doctors (a family practitioner & a GI specialist from UCLA) are not at all worried about his small size since he has no other health issues. They say, some kids are just small & as long as he's healthy otherwise, that's fine with me!

C. : )

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M.E.

answers from San Francisco on

I can relate to your problem, because I have a similar situation. I have 11 month old boy/girl twins. Aiden has been the smaller one since birth, and doesn't seem to have much of an appetite. He currently weighs 15 1/2 pounds, and his twin sister weighs almost 18 pounds.
We put him on proactin-(also called Cyproheptadine), when he was 6 months old and it has made a big difference. I would love to talk with you further about this if you are interested.
Marisa Ecker
[email protected]____.com

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F.D.

answers from Honolulu on

At 19 months 17.5 this may be small in weight but really besides the weight is there anything else wrong with him. Always listen to your doctors but also consider this. Most of us as we get older struggle with our weight if we give children medication to get them hungry is there a 100% guarentee that the medication won't mess up any of his glands and metabolism and or other functions in his body. Also if nothing else is wrong think of a few things is he really active, is he the kid that doesn't want to sit still and eat, is he the kid that doesn't want to miss out on anything.

My son is almost three (He is described as above) and for the past year stayed at 28-30lbs my doctor is concerned but I offer him breakfast, lunch, dinner and snacks in between. He lets me know when he is hungry and he eats it. It seems like that is what he does all day (Sometimes) and he eats a lot for each meal. Even though my doctors are worried I don't because I know he is totally active and he isn't sick. I am just guessing but I think he has a really fast Metabolism. I wish I had that.

Children will let us know when they are hungry and when they are done I feel that we shouldn't make them eat more. I struggle with my weight and I would get a second opinion before giving him something that makes him hungry make sure to read all the side effects and think of long term consequences not just a quick fix. (Sorry but when it comes to giving children medicines I sometimes don't trust the doctors even with their background. (After how many years did they finally recall all cold medications for kids) Make them identify the problem first and then give you solutions other than medication which may harm them later)

Other solution is hook up with an herbologist we have a few here in Hawaii. He may just need to keep up with his vitamins and get some probiotics to help make sure his body is functioning correctly. I would def. do this first or get a second opinion from a westerized doctor. But don't take one doctor's word when it comes to medicating your child especially for something other than normal medication. (Antibiotics, fever reducer and things we mostly use when they get sick)

I hope this helps
F.

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A.W.

answers from San Francisco on

I think that it is difficult to say if a child is under or overweight for that matter in the first few years. I have know children who are off the top of the charts for the first 3 years and then 5 years later are in the average category. I just think you need to trust your self and your sense of your child. Both my children were deamed under weight the first one I put butter on everything and he gained a pound in no time. He also ended up not liking food unless it has butter or salt, so for my second son I am taking the perspective that as long as he is happy and seems to be altert and active I am not going to worry. I also wonder about those charts that decided what weight everyone should be, I am sure I didn't fit on them when I was a child either.

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L.B.

answers from San Luis Obispo on

I might suggest that you research a second opinion and ask other moms that you trust for pediatrician referrals. If you are not comfortable with the doctor's suggestions for the future you should look at finding an alternative. You could also contact your insurance company for a referral. I am a mother of 2 boys and have gone to more holistic approaches over the years. Many health food stores have someone to give you some suggestions for remedies and answer questions. Perhaps it is not what he is eating but how his body is absorbing the nutrients. I wish the best.

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C.D.

answers from Los Angeles on

My twins are also small. At 24 months they were 21 and 22 lbs. We did all the same tests and when my doc couldnt find anything wrong he shruged his shoulders and said my kids are just small. I would get a second opinion before you get a feeding tube. I thought my doc took it a little to lightly. Also, my kids are in the 0% height, weight and head size.. all proprotioned. I hope this helps I know how stessful it can be. I stress more over my kids getting on a scale then I do seeing my own weight.

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R.C.

answers from San Francisco on

Your son may be underweight, but I totally disagree with the drs. approach. If your child is otherwise healthy, just let him be. My son barely ate all summer long (17-19 months). Then, he got his molars. Now (22 months), he's back in the 50th percentile. He doesn't eat all that much, but he does maintain his weight at this point. Babies can't really chew, so serve soft foods, broken up. Bread, chopped up fruit, chopped up canned fruit in juice, even jarred baby food. My son wouldn't eat meat until about a month ago, because he couldn't chew it. Don't medicate if you don't have to. If your son drinks a lot of milk, limit him to 18-24 oz. per day. Milk fills a child up, but it doesn't provide all of the nutrition that a child needs. Give water or 100% fruit juice (no sugar) instead.
I hope this helps!

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B.H.

answers from Los Angeles on

No, he's not sick, just according to doctors (who go by charts), he needs something. They just don't know want. You can't fault them really. They are trained at medical school by the pharmaceutical companies not by nutrtionial advisros. When we go to them with challenges, they seek a pharmaceutical answer. But please don't give Corey medication to make him hungry and double please stay away from any medical procedure that isn't ABSOLUETLY necessary.

What nutritional options (and please, Carnation breakfast is NOT A NUTRITIONAL OPTION!) did your doctor suggest for you?

Vitamins? Minerals? Nutrients? Essential Fatty Acids? Iron? Foic Acid? B vitamins? Vitamin D? ANYTHING??

Did she tell you what to nutrients he is deficient in if any at all? You said his blood work and urine denote nothing, then guess what, usually nothing is there. Doctors need to find "something" to make them feel like they are doing their jobs, and to make parents feel better.

BOTH my daughters were less than the 25th percentile of their weight category until they were about 6. My husband and I created small babies, and guess what? They are both healthy thriving little girls (12 and 8 today!).

I BEG YOU, Please look at a high grade nutritional program that will give Corey all the vitamins, minerals and nutrients he needs. Stay away from health produts you can purchase in department and grocery stores...God love them but there you get what you pay for.

I work with families to get their kids (and parents too!) on the right track to health and wellness through nutritonal options. If you are interested, I can introduce you to a nutritonal option that is 100% natural, organic and made for kids. It will give Corey more than the required daily doasage of what his little body needs. My children (12 and 8) have been on this program for almost 2 years, and are doing amazingly well! They have not been sick, they are very healthy and they are now a very healthy weight...now if the 12 year old would just stop growing, she is almost taller than me! LOL!!

Please give us 30 days (the cost is about $130). What have you got to lose?

B.
www.HeyYouGetReal.com

Please may I help you?

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M.S.

answers from Los Angeles on

I suggest you visit NAET.com, and consult with a practitioner in the area. I use Dr. David Karaba in Fullerton (East West Medical Group). You may also want to read Say Good-by to Children's Allergies by Dr. Devi Nambudripad (you can order the book through the NAET website. Since your son's difficulties may be allergy related it would certainly be worth your time to at least consult with an NAET trained doctor. Especially as NAET is non-invasive and infants may be treated through a surrogate (parent).

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L.C.

answers from Los Angeles on

I know 19 month old babies are picky eaters. I have 3 kids and all have been picky eaters at this age. I currently have a 19 month old as well and she weighs 23 pounds but is now entering the "pickiness" She loves yogurts, oatmeal, and bread. That's about it. Well, your son doesn't sound ill or really that underweight. I have never heard of inserting a feeding tube to a child just because he doesn't eat enough. I would encourage different foods, try those gogurts, they have good amount of calories and ensure. But I'm sure your son is fine and will eat gradually and eventually.

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A.A.

answers from Los Angeles on

Try N.A.E.T. testing or speak to an acupuncutrist first. Try not to give him a drug to make him eat more. Use this as your last resort. And where you or the father very small at this age!!! It sounds like he may have an alergy of some kind the NAET testing will test him against EVERYTHING!!!

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A.C.

answers from San Francisco on

HI,
My daughter had and has trouble gaining weight. She is ten now.
The GI Doctor put her on pediasure 2-3 times per day but it had so much sugar that she was like a zombie. so we stopped very quickly....
Then somehow I found Enterex Diabetic with Fiber vanilla flavor for adults with diabetes. 8 oz of liquid drink has 11 g of protein. It has <1g of sugar. My daughter was getting that for a long time just 1 can a day. I did not refregirated it only used room temperature. Note this is for adults and GI DR. said it was OK for kids... It has milk in it. we did monthly weight checks at the doctor's office.... Then it was recommended to review my daughters diet with a nutritionist and that helped a lot.
She was very sensitive to the child's needs and likes.

So, I was adding coconut oil, using almond butter, adding butter and some olive oil to veggies and rice..
using eggplant, avocado, beans and chicken and white fish, salmon, yogurt. drinks water only.
My daughter eats 5 times a day, breakfast, am snack, lunch, dinner and supper.

Because of not wanting to use the milk in Enterex we stopped it and recently I started her on Ultracare for Kids vanilla flavor by Metagenics. It is a powder, which I mix with water. She drinks this two times a day using one scoop of the powder. One scoop has 8 g of protein from rice... plus kids type vitamins. We are very happy with this. I buy this from our family DC (Doctor of Chiropractic and Clinical Nutritionist).

I hope this helps.

We also ruled out allergies to milk and wheat and other foods. Since she get no milk she takes supplements for calcium...

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L.C.

answers from Chico on

My son has Spina Bifida and has gone through times where he will throw up almost everything he eats for sometimes 3-5 months at a time! I have had to try drastic measures in order to keep him from losing weight. A nutritionist told me to mix butter into his mashed vegetables and other foods. I feed him a lot of peanut butter, cheese, butter, and other high calorie foods. I suggest not letting your son get full on low calorie foods, like water, melons, pears, and so on. Focus on giving him whole milk, cheese, peanut butter, avocados, and 100% juice that has not been diluted, until he has gained weight and is back on the chart! Carnation Instant Cereal is FULL of calories, and I also have some Pediasure if you want it. Feel free to contact me privately if you need to discuss this further, or if you need anything else. -L.

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W.W.

answers from Sacramento on

Have you tried giving him high fat healthy foods? Things like avocadoes, whole milk, cheese, whole fat yogurt, etc. Dr. Sears has a great book (The Baby Book) about picky nibbler eaters that worked great for my oldest son. Basically you take a muffin tin, line it, fill it with fresh food (and high fat in your case) and leave it for your child to nibble on all day. If you do dairy products or things that spoil quickly, just put them in a separate container and replace every so often. You'd be surprised at how much more they eat when they aren't thinking about it. If you still nurse, maybe you could nurse more. Or supplement with formula? I don't know much about formula so babies may not need formula at 19 months... Good luck!

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