My Friends Son Is Really Small and She Is in Denial

Some children are just on the small side and still healthy, however, his diet sounds pretty bad to me. It sounds like he needs more fat and protein and fiber and just about everything! I would suggest that his mother see a registered dietian. I have read that giving soy products (esspecially as much as you are mentionsing) is bad for little boys because of all the phyto estrogens (plant estrogens) that it contains, it can acctually start to "feminize" boys and mens bodies which is really bad for them. Be really careful about talking to his mom though, moms tend to get defensive about what they feed their children or how they are rasing them or whatever, no one likes to think that they might be wrong.

as long as her doctor isn't worried it shouldn't be a problem- maybe you could suggest just getting a second opinion?? My son is healthy healthy (30 months) and he kinda did the same thing growth wise- grew like a champ until he was one- then just stopped growing. He's really low on all the hight and weight- but very healthy. I do know that maybe this is something she may already be stressing about- obiously about his diet, I can't imagine that kind of stress, so I would suggest trying to approach it like a shoulder to lean on vs. "you're doing it wrong" ya know? hope this makes sense. good luck :)

My children are both vegan by our own choice and my children have always been in the 80% and higher group for both weight and height. It sounds to me like both of you need to do some research into diet without dairy. It is totally possible to live a healthy life with no diary. I am not sure if he will eat meat but you can try some of the veggie burgers and tofu as subtitutes. It is hard to adjust to the new diet and there are plenty of days when I wish I could just make a box of macoroni and cheese but my kids eat a great varitey of different healthy foods that most kids won't even touch! Here are a few suggestions for some new things to try:

This is typically what my kids eat -

For breakfast:
Fruit (Berries)
Quaker instant oatmeal (my kids like the maple brown sugar)
Rice Milk

Lunch
Natural Peanut Butter and Jelly Wheat Bread (always easy and good)
or try adding tofu to his rice (cut into cubes cook with a little bit of olive oil and soy sauce or trying using different sauces- tofu absorbes flavor) add some peas (packed with protien) and carrots.
Fresh fruit
Soy yogurt - look in the health food section of your grocery store and try different stores some have better selection than others.

Dinner
Veggie Burritos
Black or Pinto beans
Guacomole
Green Peppers
Carrots
Squash
Zuccini - I use any veggies I have on hand

I would just get some cookbook or look online - it can be hard to adjust to but he needs more varitey and more colorful foods in his diet.

Hope that helps!

Your friend is fortunate to have you! I suggest you let her know your concerns, and that you care for her and her son very much. You might encourage her to get a second opinion from another pediatrician. This way you aren't telling her to drop her existing pediatrician. If you have a good one, maybe you can recommend them. We have been very pleased with Dr. Michael Kurtz in Aurora (he has more than one office).

there's only a concern if he's falling off his growth chart. mine have always been on the small side - my almost 6 year old weighs only 36 pounds, but she's been at the 10th percentile for weight since she was 2. the real concern is that it seems as if his pediatrician is not tracking his growth chart - I would try to broach this subject very tactfully.
the other concern is lack of fat in his diet. although americans eat way too much fat in general so this is usually not an issue. anyway - the minimum needed for an adult is about 10% of calories - young kids (aka toddlers) need quite a bit more than this, not only for growth, but also brain development (the brain is mostly fat). again, this is something to broach very tactfully. I'd also be concerned about what seems to be the rut of his diet - its very hard to feed kids without a diet restriction but this little guy needs to be exposed to lots of veggies and other sources of protein. although I'm vegetarian, I would never feed my kids this much soy...over 80% of the soy in this country is genetically modified (crossed w/an unrelated species via the lab) and the estrogenic properties both make it not the first choice for kids' protein source.
so, what to do. I'd broach it w/a "do you mind if I expose him to other veggies? I'm having bean tacos today - can I give him one w/out cheese?, etc."
good luck!

Just because her son has a milk allergy, I'm not sure why he doesn't get much fat in his diet. The first thing I would try is goat's milk. A lot of kids who have a milk allergy are fine with goat milk, and it's actually healthier than cow's milk. If that's not an option, Fleishman's makes a dairy- free butter (just read the package- it's made from corn oil- but you can find it anywhere) or there's oils you can put in things- like Flaxseed oil in the applesauce to add fat, or cooking with coconut oil. Adding these things in (like buttering toast or rice with Fleishman's, giving him a tablespoon a day of the Flaxseed oil) will make a big difference. My son had a milk and soy allergy, so he had to have rice milk. He got really skinny so we took him to a nutritionist and that was her suggestion! Good luck!

P.S. I also agree with a lot of the responses- the thing of concern is that he was normal and is now at the bottom of the chart. From my understanding, a doctor doesn't get concerned if a child was always small but whose growth follows that good curve that you know. A big change like that is not good and its unbelievable that her doc was not even aware.......

I would encourage her to talk with her pediatrician. It is important to make sure he is getting enough protein, etc. However, he might also just be on the small side. Both of my kids are in the 5th percentile but are perfectly healthy. My daughter was in the 25th percentile but by 12 months old she had dropped down to the 5th. There was some concern at first, but then that is where she has stayed since and is growing well. Our doctor told me that she has probably adjusted to her "natural" weight, where she is supposed to be vs. extra baby weight.

Best wishes,
J.

His diet is very concerning. The fat content of soy milk versus the whole that is recommended is quite different. Is it cow's milk that he is allergic to? Does this rule out cheese, yogurt, butter, etc. (sometimes it does, sometimes it doesn't)? What about goat milk? There are goat milk cheeses too.
This seems like SUCH a limited diet, and could really make him a picky eater in the future. Avocados are a great source of fat, and could be used in place of applesauce by blending it with bananas - my son LOVES this. You may also try looking into some lentil recipes (this is NOT my area of knowledge, but have been looking into it lately). They are a great protein source. You just said that he doesn't have meat. Are they raising him vegetarian, or it just isn't offered? Turkey on whole grain bread? Plain white rice doesn't offer too much and soy sauce just adds salt.
I would ask your friend if she is willing to let you try to expand his diet (if necessary say that you are expanding your own childrens' tastes and ask if he can have some). Ask for foods to stay away from (milk, cheese, meat?) and try to do something within those parameters. Then let her know when he really seems to like something. Give her the recipe if she wants.
I don't know if the weight/percentile is truly a worry as I don't know the family, but I would keep charting him, and let her know where he is, and suggest that the doctor should really be doing this. If he starts getting a more balanced diet, that may take care of this too, but at least your charting will show if it is working.
Fat is so important to infants and toddlers. He doesn't need to be chunky, but he does need a balanced diet. Good luck.

That sounds really tough. It's so hard when our friends do things that aren't great for their kids....I don't know about his actual growth (my son is small too and had a huge drop down to the 5th percentile....he is still only 28 pounds at almost 3 and a half....and I work really hard to give him nutritionaly dense foods too)....but he surely needs a more balanced diet with more fat and more protein.

One possible indirect tactic, as someone else suggested, is to start cooking things for yourself and your family and sharing with her son. She might actually appreciate your effort and help since it really is hard to come up with ideas for allergy-safe snacks. I have found 5 or 6 good dairy-free (and egg free) cookbooks online. You could possibly order one and just start baking things to have around your house and sharing (with her permission)....you can actually make some pretty delicious muffins and quickbreads.....spread with a little peanut butter (or "sun butter" - made with sunflower seeds, if he can't have nuts), soy cream cheese or Smart Balance Lite (the "lite" version is vegan and safe for his allergies) it could make a great high fat snack.

Also, my daughter is allergic to both eggs and dairy and I was very worried about what to wean her to after breastfeeding.....soy milk is not a good substitute for whole milk as it is so much lower in calories and fat. I took her to a nutritionist at the children's hospital and they had me put her on a soy based "next step" formula for toddlers (available at all grocery stores) -- it has the fat, protein, and calories of whole milk but is safe for her to drink. I wasn't crazy about giving her so much soy but being allergic, she didn't have many options anyway. Maybe that would be a better choice for your little friend since he is so tiny. That said, I don't know how you suggest that tactfully....just thought I'd throw it out there.

Oh, again, not sure how to do this tactfully but you could suggest he take a kid's DHA or fish oil supplement....especially important for brain growth and considering this little guy is short on fat intake anyway it would probably be a really good idea. Maybe you could start your youngest on it and offer to get some for her son too???

Good luck getting your message across in a loving way....

S.,

you are helping to care for her son and have his best interest in mind, and you aren't demeaning her in any way. Include those words and have her rush him to a different doctor. A pediatrician for sure from there maybe a dietitian. Now that he is older, he may be able to tolerate milk better than when he was younger. Just a thought.

V.

I would be concerned. My son is small for his age also but always has been. His doctor told me that she's not concerned cause he is still growing on a small curve. She said that if he were to stop growing or have any dramatic changes like loosing wieght then we would need to re-evaluate what was going on. It sounds like his diet needs some adjustsments. If he is allergic to dairy then maybe finding out the specifics of that. I have a friend who's son is allergic to milk and they put him on Soy. By doing that he seemed to have really yucky poop that really stunk. It was suggested that she put him on Lactaid and they tried it. Her son is much happier now and his stool is much more normal.
One thing I don't understand is why you don't give him meat. I understand the dairy part but if meat and dairy are being cut out then he really should go see his doc or another doc that will be more thorough with his diet and more proactive.
Good luck to you and your friend.

my daughter sounds identical to this little boy except with no allergies! she just stopped gaining weight at about 9 months. she weighed 18 lbs from 9 months until she hit 2. Lots of tests and more food didn't fix anything. she was just tiny. she is 6 now and weighs 34lbs and can still 4T pants. As long as your friends little boy is active and looks healthy he may just be small. If she has never even seen a growth chart she may seriously want to try another pediatrician! You sound like a great friend by the way! Good luck!

Is he growing at all?

I personally don't see a thing wrong with his weight because I and 3 of my 4 kids that have passed that age were weighing the same as your friends son. I, personally, did not pass 24 lbs until I was almost 4 years old! Growth charts are based on the average child. NOT ALL CHILDREN ARE THE SAME. I have very small children and everyone always think s they are younger than they really are.

If he goes to the doctor on a regular basis and the doctor has said nothing about his growth, there shouldn't be anything to worry about.

Make it a GREAT day!

S.

I served an LDS mission in Taiwan and assisted some of the welfare service missionaries over there. One of their contacts had a baby about the same age and size as your friend's baby - with nearly blonde hair. (Really light hair is a very bad sign for Chinese babies because it suggests that the baby is malnourished and is not getting enough protein.) As soon as the welfare services missionaries found this woman and her baby, they recognized the signs of malnutrition and began teaching her the fundamentals of nutrition, which she did not know. All she had been feeding the baby was rice and water - no protein. The missionaries, several of whom were nurses, figured that the baby was within weeks of death at that time. The woman responded positively to the teaching and incorporated protein foods, fruits, and vegetables into the baby's diet. The baby began to grow, her hair began to get dark, and she began to thrive after nearly dying due to the dietary change.

It sounds like your friend's son is on a similar deadly diet to the one that this Chinese baby was on. Your friend needs to incorporate protein foods, vegetables, and fruit into her son's diet as soon as possible or risk losing him.

This sounds like a very serious problem.

My son is almost exactly the same size as your friend's son and he is 28 months old. He is a bit taller at about 33.5 inches and 26 plus pounds. I have worried and stressed over him his whole life because of the weight issue. He even was in the 50% until about 8 months like your friend's son! Our doctor has done every test under the sun. He is fine, this is just his body type. I would try to get more calories into your friend's son which is hard without dairy. Can he eat peanut butter? Eggs? I'm assuming yougurt is out. Look online for high calorie food ideas for toddlers. What a great friend you are! Gently suggest to your friend to try to get more calories into him.

I had the same issue with my son, except my dr. did show me weight charts. He had me putting veg. oil in his food, just stirring it in. You could do this at your house and find other ways to increase his calorie intake. I also stopped washing the syrup off the mandarin oranges I gave him and giving him chocolate soy milk (I think I mixed in carnation instant breakfast). I know there are message boards about milk allergies and how to get extra calories in them because soy milk and products are so much lower in calories. This is the first thing my dr. talked to me about when we had to make the switch since my kids where low on the charts anyway.
I think the decision about if you mention this to her really depends on what kind of relationship you have. Good luck.

Hi S.,
I think it's good you are noticing this about his diet. I see a definite lack of vegetables and fish. Even if he won't eat fish, he should take a dose of cod liver oil once a week. He needs some variety. I also agree with giving him goats milk.
Good luck,
Dee

There's an online allergy recipe site that might be helpful for both her and you:
http://www.foodallergykitchen.com/

Something she may not have even thought of, is that a "milk allergy" is more properly a "cow milk allergy". Her little guy may be able to have goat milk and goat milk products like goatmilk yogurt.

Also, there are soy-based protein supplement powders on the market (I've no idea about brands or anything, not something I've ever used), which could be mixed into soy shakes or banana muffins etc. Of course, since I've never used them I haven't read the labels, and they might have casein or other milk product derivatives. THAT is the problem with milk allergy. The byproducts are in practically everything. Things people wouldn't even suspect. (Corn, wheat and soy are like that too.) It's really stressful and upsetting to try to find any convenient food when you're dealing with that.

Avocados are calorie dense and have fat, he might like mashed or sliced avocado.

The thing that worries me is that he's falling behind on his growth chart. It doesn't sound like he grew a bit, hit a plateau, grew some more, and so on. And that her doctor hasn't ever shown her one is so odd! I thought they ALL did that these days! I am usually pretty protective of not alarming moms with small kids (I have a shrimpy little fellow myself), but this would worry me too. I don't think you're being over-protective.

At least have the chat with her, and just let her know you don't want to upset her, but you love her little boy too and want to be on board with them in helping him eat a well-rounded diet. And that maybe if he's "picky" (like all 2 year olds, hah), that a safe food for him that he wouldn't try at home he might eat for you.

I would talk to her about this before doing anything with his food, though. His diet does seem out of balance, and low in necessary fat and protein. Dealing with food/allergy/oral sensory issues is challenging and stressful.

Hi S. - I think it's okay to tell her that you're concerned about his shrinking frame and as his caregiver, would like to know how you can help to support his nutrition during the day.

If he can have soy sauce, he is probably not gluten intolerant so that opens up a lot of options for varying his diet. You also didnt mention anything about nuts. It sounds like she feeds him a meat-free diet?

It doesnt appear from your post that he is getting adequate protein and fats in his diet. They are incredibly important for brain development and metabolic functions. He may need a B12 supplement. He also needs to be in the sun for 15-20 minutes a day for adequate Vit. D.

Perhaps help her find some resources on diet and nutrition for kids with dairy allergies to help her increase the variety of his diet. You might also look for ones that have good protein alternatives to soy since too many phytoestrogens are not great for developing boys.

He should be able to have a good varied diet even with a milk allergy - every meal should have protein, complex carbohydrate, fiber and a healthy fat.

There are plenty of preschooler-friendly meals that are easy and well-balanced and contain plenty of protein. PB&J sandwiches, bean burritos, avocado chunks, soy hotdogs are all great sources of healthy fats and proteins.

Here is a good article for vegetarian diets for kids:

http://www.pcrm.org/health/veginfo/veg_diets_for_children...

She is a first time mom trying to do things by the book, but your concern is valid. Can you suggest that maybe she could visit your pediatrician with you? My Dr ALWAYS shows us the charts and with a kiddo with such severe allergies I can't believe the Dr is not watching him way closer!

I don't see much protein in his diet from what you described. At 26 months, unless someone in the family had a serious nut allergy (or he does which you didn't mention) he could receive extra fats and protein from nut butters, beans, tofu, TVP, flax, hemp, etc. There are many many people with milk allergies and even more who chose not to eat meat or dairy and live healthy lives at normal weight/sizes. If the meals that you have described are provided by mom or you, regardless, seeing a dietition would be a very good idea. Also, there are numerous resources that you might look into yourself or point his mom to that provide excellent information on how to keep a meat-free, dairy-free diet well-rounded and healthy both online and in bookstores, many of which are very kid-friendly.

Hi S.. I think its great that you are concerned and are being an advocate for your friends' child. I think whenever there is a concern over whether a baby is thriving or not, it can be a gray area. I'm amazed his doc isn't showing his mom growth charts- I thought those were a mainstay. I don't however really think they are the best thing. Used as a tool they are great, but I think they can lead doctors to give bad advice. It sounds like this little boy has quite a limited diet and that does not need to be the case even though he can't have dairy. My daughter can't have dairy and she has a ton of food options. A great resource I would suggest is a book called "Super Baby Food". It has a ton of information about how much fat, calories, protein, etc. little ones should get based on their age. There are also great recipes in there too. One thing I've always done with my daughter is add fat to everything. I love coconut oil (get Garden of Life Extra Virgin Coconut oil- its the only one that isn't horribly processed and actually tastes like coconuts), olive oil, avocado oil (very handy because its tasteless) and Earth Balance non-dairy spread. You can add these healthy fats to his vegies, grains, and cereal. I think adding some variety to his diet is key and as long as he seems healthy and happy, you are on the right track. Maybe you could explore some recipes together and help her get more creative with his diet. Hope this helps!