HELP- 18 Month Old Measuring Small

Updated on May 28, 2010
A.H. asks from Flower Mound, TX
15 answers

My daughter is almost 19 months but we had her 18 month checkup today. She weighed 21 lbs 8 oz and measured in the 9th percentile. I have not been worried about her weight (even though I knew she was small) because she ate a blanced diet (fruits, veggies, beans, cheese, etc.) and is meeting her milestones. She even has a little bit of a "belly." The only thing she really doesn't want to eat is meat. She has been known to out-eat my 4 year old son from time to time.

The doctor, however, is concerned as her percentile has dropped. She recommended doing the high-fat diet and really emphasized the need for her to eat meat. (She didn't seem to think that the beans provided enough protein.) I have a hand-out of all sorts of things to give her.

So.. I would love some help mamas:
1) Opinions on whether I really should be worried about this or not.
2) Anyone who has been there... done that and has advice
3) Any ideas for things that I can make to help her gain weight without sending the rest of us to the obese side. (I don't have time to cook separate meals for her 3 times a day).
4) Sample menu items to try

Thanks a bunch!

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answers from Detroit on

my daughter fell off the growth chart at 15 months.. she was 19 pounds at 18 months.. but tall.. so she looked super skinny.

the dr was a bit concerned then I had my son who was built exactly the same.. two tall skinny kids..

feel her whatever she will eat.. offer ice cream cheese,, other proteins.. toddlers are often fussy eateres.. just feed her what she will eat.

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answers from Fort Wayne on

Been there before and am again! :) A couple of things...has she started walking recently? Are you outside more, running, playing etc? My first daughter was about the same size as your daughter at 18 mos. She had started walking and it was summer, so we were outside ALL the time. My 10 month old doesn't eve weight 14 lbs yet. So, yeah...I've gotten all the lectures from doctors about kids gaining weight. We were told to give my oldest Carnation Instant Breakfast once a day. Other things like whole fat yogurt, 4% milkfat cottage cheese, avocados, peanut butter, natural cheese, are also options. My girls are both carnivores and always have been, so I 'm not much help on the meat. Will she eat peanutbutter and eggs? those both have protein in them.

But...I wouldn't worry too much. If she eats a balanced diet then she's probably fine. I don't know why so many doctor's are SO focused on the chart. They don't seem to ever take into account the size or stature of mom and dad. I switched pediatricians because our old one wanted to run all kinds of tests on my oldest because she was low on the chart. He never once took into account the fact that I'm small and my husband is really skinny. I'm sure she's just fine :)


answers from Fresno on

Like the other mamas said, being in a lower percentile is not always something to worry about. You could feed her higher-fat and higher-protein snacks (separate from the meals you make your family) and see if that changes anything. But some kids are just LITTLE! Does she have rosy cheeks? Is she active and alert? If so then I wouldn't worry so much.

As a point of reference, I am 6' tall and my husband is a burly 6' tall, and our older daughter is 4'8" and is 7 years old. Then there's our younger daughter! She has always been tiny! She was born big but fell to the 15% in height by 2 years old and has stayed there ever since. She's 5 years old, and that's just the growth curve she's on. Now, since we are a family of giants, my little one has been through a battery of tests (since sometimes slow growth is attributed to some worrisome conditions). Well, after a gazillion blood tests, x-rays and everything else... she's fine. Absolutely fine. NOTHING wrong with her at all. She's just short. She even makes jokes about it ("Hey! Isn't this shirt I'm wearing the one that Kiki wore when she was 2?" "Mommy, can we watch Little People Big World so I can see my people?") Sometimes people are just short. It is what it is! I love it, actually, because I can still pick her up and carry her around. It's nice to have my "baby" stay little a while longer. =)



answers from Dallas on

Been there, done it and going through it again. :) My son fell off the chart and was officially labeled "failure to thrive". He was at the 95th percentile for weight at birth and by 10 months he was at the 4th percentile. It was really hard to hear as a mom. My husband thought it was hog wash all along and attributed a lot of it our children being early walkers and how active they are. He was, and still is, a very active boy. With my son we went through all sorts of testing. The day they threatened to catheter him because he wasn't peeing fast enough for the tech, I refused any more tests. My daughter is also not gaining. With my daughter the pedi has said that now it's a proven pattern and that although it needs to be watched, we aren't overly concerned. But we do have scheduled weight checks. My pedi isn't too concerned with her end number as long as it is going up. At her 18 month check up she was 22lbs and I was thrilled with that number.

I was also concerned about starting bad habits with my kids. And I refuse to make separate meals for the kids, so we sometimes modify things.We try to be careful. Some things that we do is a morning snack an afternoon snack and a before bedtime snack. My kids would rather eat fruits and veggies too, so we try to push the protein. We cube up deli meats, turkey is their fave. Both of my kids love Edemame (soy beans), which is high in protein. I buy it frozen at Costco. Avocados have good healthy fats, so we eat a lot of those. It was suggested to put real butter on all their veggies (I was assured kids process fats differently) so we do that occasionally. I worry about them getting used to buttery veggies, so we don't do it every time and we mix up which veggies get butter. Pasta with little olive oil, tomatoes and cheese. Dried fruits. My son is older and he snacks on a lot of nuts. Sweet potatoes are higher in calories than many kids will eat them mashed, roasted or fried. Eggs are high in fat and protein. Cheese is a popular snack for us too. We also add cream cheese to a lot of things (sometimes smearing it on lunch meat and rolling it up, they love it). We don't do dessert every night, but when we do we usually add whipped cream where we can. They both still drink whole milk....even my 4yo. We have fruit washed and on hand all the time. If they are still hungry after a meal or snack they can have fruit.

It's something I monitor and try to watch, but I no longer loose sleep over it. My kids are just meant to be a little smaller. One mom on this site once mentioned that the percentiles were an average...which means someone has to be below average at times. :) HTH! GL!



answers from Dallas on

She sounds very much like my sons. My older son also started falling off the charts (despite starting out above the midrange) at about that age. By age 2, the pediatrician said that he was just going to be petite. Well, the pedi was totally wrong and there was something wrong with my sons. The fact that your daughter is consuming lots of food but not gaining and has a belly are all signs of celiac/gluten intolerance. My sons weren't diagnosed until they were 7 and 10 when they stopped growing altogether. After we started the GF diet, my oldest son grew 4 inches a year and gained 20 lbs a year for over 4 years. At age 14, he was 6' tall and now the child the pedi said would be petite is 6'4" tall and weighs almost 200 lbs at age 17. My younger son lost inches in his waist after starting the GF diet - that was because his gut wasn't fat - it was the fact that his intestines were inflamed from the gluten.

The fact that the doctor is encouraging a high fat diet is yet another sign as kids that have undiagnosed celiac have fat malabsorption due to the damage to the intestines from the gluten. One easy way to see if this is a problem for your child (and for all the other mamas with small kids) is to see if your child's stools float in the toilet. I didn't know that wasn't normal until I was 42 and started a GF diet.

The meat is probably very hard for your daughter to digest which is why she has an aversion. Folks with celiac often have lower than normal levels of the enzymes and bile necessary to properly digest proteins. I too had a strong aversion to meat and ate almost vegetarian until after I went on the GF diet.

This is a genetic disease and is very common in folks of Northern European descent, although anyone can develop this. This is partly due to the fact that the wheat has been so hybridized that it's not the same wheat our ancestors ate. The amount of gluten is significantly higher and our bodies cannot properly digest it, thus the amount of proteins that can end up in the blood stream often lead to this autoimmune reaction. The good news is that it is very treatable by dietary changes alone. This is really why most doctors are clueless about it - there is no Rx they can give, so based on their business model, there's no motivation to test for it. You can do the testing on your own through enterolab:

If your doctor is willing to test, then that's great. You might also ask that they measure vitamin D, vitamin B12, ferritin (iron storage) and folate. Low levels of any of those are also signs of undiagnosed celiac. If your kids (under age 6) have low ferritin, then that means mama likely does as well since kids get an iron store at birth that should last until they are around 6 or 7 (another symptom I had was that I was anemic at age 6).

I learned all of this the hard way and I would hate to see others children suffer like mine did. It's hard for kids this age to tell you they don't feel well or that BMs hurt. But, my sons were amazed at what it felt like to feel well after they went on the diet. They were both used to severe intestinal cramps (as was I) along with every BM. I never would have guessed that I could feel so well. I felt better at 47 than I had ever felt in my entire life.



answers from Columbus on

I don't think you have anything to worry about!! I have two boys and both are very tiny. My 2.5 yr old is only 21 lbs and very active and healthy. My 4.5 yr old, almost 5 in July is only 29lbs and very active and healthy as well. Genetics is a huge factor in human growth; and both my husband and I are small. The pred. was concerned about my 2.5 yr old for sometime, but after normal testings, he has come to the conclusion that genetically he is going to be small. It was just recommended to feed them healthy foods and lots of protein. Best of luck with your baby girl!!



answers from Dallas on

Different doctors always say different things. My daughter was always relatively small and slowly went down the weight chart has she started getting more active. She finally hit the 5th to 10th percentile at around 15 months or 18 months (can't remember). I was more concerned with her weight than her doctor. So, to appease me he gave me some suggestions. Put lots of butter on everything and give her one or two pediasures a day. The next checkup she had risen to the 50% with is where she stayed for a while.

That being said, I took her in for her 4 yr checkup and the doctor (different one because we have moved) came in and said she was a little worried about her weight because she is lower in weight than height. She is in the 30th percentile for weight and 66th percentile for height. She doesn't look skinny at all and eats like a trucker sometimes but eats healthy stuff. The doctor said to give her whole milk and just make sure all of her calories and nutrients are coming from healthy foods.

So, you never know! But I sure would love to eat like she does and be in the 30th percentile :-)



answers from Sherman on

Well my 2 year old is 20 lbs 3 oz and is not even CLOSE to being on the chart! She is healthy, hitting her milestones and eats a great variety of foods at every meal. Unless she is showing signs of illness or regression of milestones then I would not worry about her weight. Are you or your husband small? If so...duh! (my 4 year old is 28 lbs and my 5 year old is 33 lbs...we are just raising "midgets" haha)



answers from Gainesville on

Honestly, I don't put a ton of stock in the charts. I remember reading something about the charts and they are based solely on formula fed infants and they tend to run heavier on average than breastfed babies. Don't know if that applies to you guys but I found it interesting.

My preemie son was never on the charts till he was over 2. He stayed rear facing in his seat till he was almost 2 because he was small weight wise. Our doc was never particularly worried because he was a good eater and I provided him with a balanced diet. He is now a perfectly healthy 5 year old. My son was never much of a meat eater either until he was well over 2. He just didn't care for the texture at all. I gave him full-fat cheese, beans, cottage cheese, yogurt, etc. You can also try tofu, whole wheat pasta ( it has a great amount of protein), add wheat germ to cereal or yogurt. You should still be providing whole milk and you can also add things like avocado. It's a great choice for little ones!



answers from Washington DC on

I do think that doctors jump in sometimes and worry people , my middle daughter was 20lb at 18 months , very tall and no fat on her at all , she was and still is very lean , at 4 1/2 yrs old now , she still only weighs 35lb. I would suggest taking a look at your build and her dad's , plus your immdediate family , is anyone of slim build? She will after all follow after someone in the family , also I don't think you need to pump meat into her , there are plenty of vegetarian children that are perfectly healthy. She is 19 months old and I imagine very active , so yes they do slow down with the weight gain ,and sometimes lose a little , if you feel her diet is healthy and varied then I say trust your mothers instinct and carry on as you are , she's made it to 19 months so you must be doing something right!.


answers from Detroit on

in all honesty i'm not saying that your doc is wrong but me, my son and my younger sister were all "small children" and babies. I carried my son exactly 40 weeks and he came out 6lbs 5oz. i was overdue and came out 6lbs 7 oz can't remeber how much my sister weighed but it was around those sizes also.the doctor wanted run all kinds of test on me because i didn't grow much but was on target for my age in every other category they were just getting ready to start testing and it was like i had a HUGE growth spurt over night! (my mother says it was the popeye's chicken lol) now this was in the early 80's so small back then was wayyy smaller then it is now. my sister was born in the early 90's they wanted to test her also my mom said no! she's 18 now and perfect in height and weight. now my son is still in the low percentile for his age in height and weight( he just turned four and wieghed in at 35lbs barely) and he's really short,but his father and I aren't that tall. they wanted to test him and i said no because some people are just small. if your daughter is eating good and she's on track milestone wise i won't worry. and you have to realize children are much bigger then what they used to be. so is she just right and these other kids TOO BIG! i wouldn't worry but it's up to you. sometimes geneerations of genes makes someone big, average or small. good luck and i wish you well.



answers from Los Angeles on


I am so sorry that you are going through this. My daughter is 18 months and weighs 16lbs (0 percentile) and measures in the 16th percentile. They have ran so many tests, so far nothing invasive. They are concerned they are missing something. She is fine in every other way. We have trouble with meat as well, she likes turkey slices and Italian sausage. That is about the only meat she is even remotely interested. We give her peanut butter sandwiches for protein. She is supposed to eat ice cream every day for additional calories, and butter in anything we cook..

I totally understand how you are feeling, but I try not to feel overly concerned. You can only do what you can do, and don't let the doctors run over you..

Good luck!



answers from Chicago on

my grand-daughter was always so small...never being on the charts and ate very healthy...if we would go out to dinner she would just want broccoli...the doctors got very concerned as she was not even on the they did a checkup on her for cystic fibrosis and thank goodness that was negative..she just turned 5 and is now weighing a whopping 37 lbs...she is still very tiny but she is on the charts...she can fit in size 18 months pants except for the length...she is tiny and that is fine...she is healthy. beans are a great source of protein...another one of brianna's favorite food too. she was never a big meat eater either. have they done any blood tests to see if she was anemic? at one point my daughter had her drinking something like ensure but it was for children...i think meijer carries it...if you would like the name i can ask my daughter...i just don't think introducing a high fat diet is the best thing because then we are encouraging that kind of eating and then when she gets older she will have high choestrol etc..even children can have anyone in your family or your husband's family tiny? see brianna's grandma, great grandmas were very thoughts and prayers are with you because i can remember what we went through when they were so concern with brianna's weight!!! Good luck to you and GOD bless!!! sometimes i think they should throw those charts away!!!



answers from Wausau on

My daughter was in the 10th percentile for height and the 5th for weight all through infancy and toddlerhood. I didn't worry about it since she also met milestones and ate fairly well...although was much pickyer than her older brother. She did eat meat though. She just turned 6 and is now average for her age. She is 48 pounds. I can't remember how tall at the moment but she is average when looking at her kindergarten class. She is now in a size 6 shirt and bounces between a 5 and 6 in pants.
Is there a nutritionist/registered dietician (sp) on staff at the doctors office? Or maybe they are affiliated with a hospital or university where they can refer you to one. They would be able to help you plan meals and give you ideas on a high protein diet even if she won't eat meat.
Good luck to you.


answers from Chicago on

I could have written your post word for word regarding my son. He didn't grow AT ALL between his 15 month and 18th month apts. In fact, he actually LOST 4oz. He eats everything and a frequently, so that's not an issue for us. He's just small. All the kids in our family are. He weighed exactly the same as your daughter, and measured in the 5th percentile. The pediatrician all but accused me of not feeding him!

In short, don't worry about it. Kids at this age have serious growth spurts and delays. In the 5 months since that visit, he's gained 4lbs and grown 5 inches. I haven't changed a thing. It's normal! Keep doing what you're doing, make sure her dairy is "whole" instead of 2%, etc... and just enjoy her. She'll catch up!

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