4-Year Old Daughter with Low Weight...

Updated on February 04, 2012
T.M. asks from Tampa, FL
15 answers

This seems to be my day for questions. I took my daughter in for her 4-year well check up with her pediatrician. Her ped is absolutely wonderful and I trust her opinion completely. The doctor is a bit concerned that my daughter is not gaining weight fast enough. She has always been on the smaller side since birth. She is normal for height, but she is only 29 pounds. She has only gained 1 pound since her 3 year well check up. She has always been a picky eater. Seriously, this child would eat chicken nuggets and french fries every day if I let her. If she eats really well for lunch, then it is almost certain that she will barely pick at her dinner.

The ped wants me to start giving her a nutritional drink twice a day to help add calories. She has also given me a referral for a nutritionist, which is fine. However, you all might remember from previous posts that my DH has recently been diagnosed with some health issues. I am having to cook and serve low sodium, low cholesteral meals to address his health issues. So essentially, everything that I am doing for us diet wise to address my husband's issues, I will have to do the complete opposite for my daughter. For her, I am supposed to add butter and cheese to things, add lots of potatoes etc... And BTW, the ped tells me that I shouldn't be a short order cook and everyone should eat the same meal...hence the referal to the nutritionist.

If this wasn't such a ridiculous situation, I might laugh. How in the hell am I supposed to feed my family welll enough to address their needs and keep them healthy? So if I start trying to bulk up my daughter, then my son is going to want the same things. So I might end up causing the opposite problem with him.... I am SO confused as to how to handle this....

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M.C.

answers from Washington DC on

My 5y weights 38 lbs.

I wouldn't freak out until you speak to the nutritionist. There are ways to increase the protien and nutirents of meals without adding butter.

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K.B.

answers from Milwaukee on

I would keep the meals you are doing but add snacks for your daughter like the nutritional drinks, milk and other healthy items that might help her gain weight. If she is eating healthy foods, taking a multi-vitamin, and other healthy items talked about to adde to her diet it might just be the way she processes food. A family friend has a daughter who is stick think & loves to run, she is in 5th grade and has had many tests done and she just processes the food differently.

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✿.3.

answers from Reading on

Hi!
My daughter is 4 1/2 and only weighs 30 pounds. At every well visit, she is only in the 5% range for weight and I always ask the pediatrician if I should be concerned. I always get the same answer - no! She's healthy and she is growing and that's all that matters. He said that I could tell you to go home and give her potatoes and add calories to everything but that's not healthy. He said that as long as she is growing (height wise), she's fine.

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K.M.

answers from Kansas City on

My son will be 4 in March. I had him at the doctor today and he is 28.8lbs. We've been trying to bulk him up, but he's just small. Are you small? I am 5'2" and 100lbs. My 6 year old only weighs 36lbs. I just don't think my kids are going to be very big. Maybe your kids are the same way. I would not worry too much!

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K.M.

answers from Denver on

My son is small too. He is 4 1/2 now and weighs about 34 pounds. But my husband and I are not real big people. I am 5'8" and about 125-130 and my husband is about 6'3" and 160. My ped used to be worried about our son too because he fell off the weight charts for awhile and did all this testing and then was like well, maybe its the genetics. Yeah, you think? Anyways she seems okay to me, but the nutritional shake is not a bad idea. We used to have my son on those too.

J.M.

answers from Philadelphia on

I would cook the same meal and J. add cheese and breads to hers. Shes not going to eat super unhealthy J. to be bulked up so your son could get the same extras if needed. Maybe add sour cream and cheese to her mashed potatos inside? Do grilled chicken and for hers melt cheese on top and leave your husbands J. seasoned or unseasoned? if you do meats sauteed with a tiny bit of veg oil you can change each persons in the pan easily...the same for if you bake things, do one pan for everyone and a little one for your daughter that has a little extra calories

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J.L.

answers from St. Cloud on

I think the nutritionist is going to be able to answer a lot of your questions. Start a running list of questions so you're well prepared for the appointment. Never has a child starved themselves!

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S.B.

answers from Dallas on

I am not sure how to address the picky eater part of this equation. But both of my kids are on the low side for weight. My son dropped off the weight chart around one years old. We ran a million tests until I told the doctor no more. We were never sent to a nutritionist, but it might have been helpful. The pedi finally stopped harping on my son's weight at his five year check up. I simply made a few changes to our regular meals to help our kids add weight. First off, I didn't do this every night. I did not want my kids to think peas slathered in butter were the only way to eat them. I also didn't change their food in front of them. Again, I didn't want to hear, "You forgot the butter." So yes, we added butter to their portion. I used unsalted. And I added to the veggies. Sometimes their meat too. If we were having salmon, I might slather theirs in butter before serving. Sometimes I'd substitute the meat for sausage. Those are really easy to heat up with whatever you are cooking. So if we had shrimp (one of the few things my kids won't eat), they'd get sausage. I also added cream cheese when I could. A little to eggs. A little on their sandwich. And it's easy to sprinkle cheese on things. And there is a difference between fat and cholesterol. Things like avocados are high in good fats. Chickpeas have no saturated fat or cholesterol, so humus is another snacking option. The thing that turned the corner for us, was turning those "nutritional supplements" into milk shakes. I would make pedialite milkshakes for snacks and that really helped my kiddo pack on some weight. His weight was still a topic for discussion, but we were finally told we no longer had to come in once a month for weight checks.

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L.O.

answers from Detroit on

my daughter weighed 30 pounds at 4 - 33 pounds at 5 adn 37 pounds at 6.. she is growing .. .slowly.. she is super super skinny..

she is average to a bit taller than average so she looks even skinnier.. but she is not sickly.. she gets a cold every now and again.. but we are not at the dr other than for yearly checkups.

So.. go to the nutritionist if you want.. but you have to balance the needs of all family members.. and cooking 3 meals is crazy..

Your daughter is fine.. people come in differnt sizes.. she will probably be smallish as an adult..

my daughter eats 2 meals a day most days.. picks at her dinner.. unless it is spaghetti which she will eat tons of..

C.P.

answers from Columbia on

I was very underweight until after I had kids. I'm still thin. My sons are both following the same trend. They're very active and because they're so underweight, I allow them lots of snacks between meals. We also eat rather late in the evening.

See the nutritionist...but don't worry too much. She's not going to starve herself. Eventually, she'll catch up.

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A.B.

answers from Pittsburgh on

Honestly as long as she is healthy and eating she will be fine. My soon to be 5yo daughter has always been at the very bottom of the charts. She finely hit 30lbs in December. You should of seen the happy dance I did. She of course looked at me like I was a nut.

She has been part of WIC since she was born and they were on me a good bit. The doctors on the other hand said as long as she is not losing weight, shes eating and active, they told me not to worry. Let her eat what she is eating as long as you feel that she is doing fine.

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S.V.

answers from Los Angeles on

My son is 4 1/2 and is about 32 lbs. He has been on pediasure for a few years now also, and the doctor has been telling me as long as he is on the charts he is fine, he is on the short side too. My husband and I are not big people so I dont worry about it anymore. And he is a pick eater as well! It sucks, but I'm not going to worry about it anymore because it would drive me insane!!! :0) Good luck!

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D.S.

answers from Kansas City on

I'm not a doctor, nutritionist or an expert, but I am a mother of a 4 year old son that is right around the 30/31 lbs. mark. To me, I'm surprised your ped is concerned and recommended these steps. But again, I don't know the history of your child, her habits, your family heritage, her growth curves since birth or her natural build. I would never tell you to not listen to your doctor and certainly won't start now.

But this is why I'm surprised:

1. Why add calories or bulk up at all? 29 doesn't seem terribly underweight or really underweight at all unless there has been a health issue in the past or in your family. I believe my son also gained only a pound or two between years 3 and 4. In fact, this visit was one of the only times he's ever even been on the charts. (He came home from the hospital at 4 lbs. 14 oz. (with no nicu stay or anything other than delivery at 39 1/2 weeks, checkup and home) and remains on the smaller side. He's gained height for a respectable percentile so we have the dilemma of size 2 or 3 fit his waist but size 4 fits his length. Love those adjustable waist pants.) My peds have always checked to see that he is healthy, meeting milestones/developing "normally" and active. There is no concern that anything is being affected by a weight that is under some of his peers.

2. The whole chart/ percentile thing is a bit of crock anyway. When I first stressed about my little guy being little, my ped was quick to point out that the charts get updated all the time! That is, our chart is based on percentiles of average American children. So as our averages go up, the charts skew towards bigger children as well. And our chart would not necessarily be the same as one from another country. It's your own child's growth curve and history that matter. If there is a significant change in either direction from one set time period to another, there is cause for concern. Mine has shown consistency throughout, even though his numbers are low.

3. Have you read what is in those so-called nutritional drinks?! Yikes. Chemicals and sugar out the wazzoo. My first ped was old-school, as I happen to be, but he was that way because he was old! Sadly he retired last year. But coming from a generation before we valued individual nutrients over food (vitamin C added to breakfast bar is not the same as vitamin C eaten in a whole orange) and without these convenience items created to solve a problem that may not really exist, he took the viewpoint I do that adding calories and nutrients through artificial means was not the same as eating food that was good for you. He also warned about drinking the majority of calories instead of eating them. He was a staunch advocate for childhood obesity issues and was quick to point out failure to thrive is much different than weighing less than someone else.

4. However, even though I agreed with him, we did see a nutritionist at the children's hospital! My son simply wouldn't - and still won't - eat more than a bite or two per meal. And sure we heard, he's growing (even if not in big strides), he's "normal," he's developing on track - but you know it's frustrating to see them living on air! She said we were doing the right things by feeding him healthy foods at the right times and if he didn't eat, we should listen to him because he's listening to his body. Forcing him to eat or changing his diet to include bad foods for the sake of calories (loading up on cheese and cream, piling on empty carbs and empty calories) simply would teach him bad eating habits. His taste-buds are still forming and his body is still balancing its natural hunger cues, together forming his future palette and preferences. I have nothing against butter, whole milk, real sugar, etc. because they are more natural foods than the substitutes and are the only things I use, but in moderation; I can't allow his body to gorge on them as the only method of calorie or nutrient intake or he may crave them his entire life. There is no substitute for healthy foods and they come in many different forms, to be consumed at many different times. She also repeated the "don't drink your calories" mantra.

Sorry for what seems like a rant. Food vs. foodlike stuff and children's eating habits are big issues of mine! You will do what's right for your family and I'm sure be able to keep all of them healthy. Good luck!

And for the record, it's easier to know and say all this than do it 100% of the time. Peek in my cabinets and you'll find junk. Still I do my best to do what's right. But who doesn't love a treat of Swedish Fish or processed pudding with chocolate flavor once in a while?! Sigh.

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R.C.

answers from Sarasota on

It amazes me that, in a country struggling with massive obesity, the doctors end up stressing mothers out about how LITTLE their children weigh! I really agree with Debi S.

I have one child who (I've added it up) eats roughly half the calories an active child her age "should" eat. She's always been that way and her pediatrician is fine with it since she's growing, happy, energetic, etc.

My other child (who is four) eats huge breakfasts, average lunches and a bite or two of dinner. We make family meals, and sometimes he will try a bite of everything and not like it, so he gets whole wheat bread and his milk. He's fine (remember--he eats huge breakfasts).

If it matters, both their BMI's are around 15, which puts them somewhere in the 30-40th percentile. But they eat totally differently!

I can't see adding a lot of junk to your menu, using artificial food, or cooking separately for everyone. But it seems like it wouldn't be too hard to let your daughter sprinkle cheese or put butter on her food. Kids do need fat to grow. Or she could snack on nuts--I bet you can think of other things.

I KNOW it's really hard, but if you're daughter's happy, healthy and energetic, what is the doctor trying to fix?

Hang in there!

L.B.

answers from Biloxi on

My son is 15 and has always been on the slim side of the height/weight charts. In fact, he didn't break 100 pounds until last year. He and I were ecstatic. He is now proudly 107 pounds but stands almost 5'4"

When he was a toddler I added Carnation Instant Breakfast to his milk with every meal to help him pick up some weight. It was easy to do, I didn't have to cook separate meals for him and me, and it really did help.

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