6 Year Old - TOO SKINNY

As his parents I would be concerned. They have already done the first step by going to his pediatrician. All children are different and being 30% is not great, but it is on the chart. Most concerning to my pediatirician is growth pattern and has that gone down. Is his weight gain at a consistent rate or has there been a big dip? Perhaps he has maybe an allergy to wheat or gluten. I had a friend who was skinny growing up and didn't find out until her 20s that she has intolerance to wheat which is in everything and why she was always feeling bad. Another possible doctor to see if they're not having any luck is a nutritionist.

It's good he's seeing a doctor.
My grandmother had a congenital fold in her stomach. What people pay for for lap band surgery she had naturally years before it was invented. She could only eat tiny meals but very frequently and she was a tiny thing most of her life.
If he can't eat in volume, it's important what he does eat is as nutritionally complete as possible. Can he chew a Flintstones chewable once a day?
An egg, a slice of avocado, peanut butter on a few crackers, a protein drink, etc.
As for the anti social behavior - if the child is starving for what ever reason, he might not feel well enough to play with others and he just self entertains with the Legos. Also if he's painfully thin looking, I'm sure he's already tired of others commenting about it.
I hope they find out what ever is going on and that it's easily fixable.

it sounds very much like celiac disease to me. I went through it with my daughter. She was much younger though. Shortly after she turned 1 she lost a lot of weight, started to look very sick, pale, hollow looking and started throwing up and having an upset stomach all the time. We tried so many things with her, but nothing seemed to help. When she was about 2.5 we had some blood drawn and found she was anemic. she went on iron supplements and 3 months later we went to have her blood redrawn. The lab messed up, they did the wrong test, and she came back positive for celiacs disease. We did a biopsy to confirm it. Once we started the gluten free diet she gained 7 lbs and grew 2 inches in a MONTH! it was insane! She is now in the 95th for height and the 75th for weight and is a beautiful, healthy, happy, well colored little girl. I would definitely have them check for it!

Put butter on everything. My eldest daughter is a total stringbean, and kids don't worry about cholesterol like we do. Bread, veggies, rice, whatever... put butter on it!! I thought my kids doc was nuts when they first told me to do that, but it worked like a charm for my skinny minnie ;) She didn't notice at all when I stopped once she reached a healthy weight.

**Update... everyone is so quick to want to diagnose something like this, and yes, while there could be some underlying issue, it could be that the kids honest to god a picky, bird-like eater, and too busy to want to eat enough. Really. It could quite possibly be something as simple as that, and he'll grow out of it. Just my 2 cents :)

I'd be more concerned about the behaviors than the weight. 30th percentile alone might not be an issue, but some of the behaviors he has around food and socializing definitely would concern me. Because of the mention of his "tummy hurting", I'm glad he's seeing a doctor. The behaviors alone make me think of someone with an eating disorder, but 6 is pretty young for that to show up, but it's not impossible. Anorexia is all about control, and if he gets positive reinforcement for this behavior...

Wow, tough to say- it could be some sort of physical problem like celiac disease or something (glad they're pursuing that)- or the picky eating could be a symptom of a sensory processing disorder. Some children have tactile oversensitivity in the mouth, and certain food textures are intolerable to them. Sometimes it's the smell of the food that causes problems for them.
Sometimes because of this, they are not getting the nutrition they need, and that can affect their behavior, stamina, and development.
Here's some information about that:

http://www.sensory-processing-disorder.com/picky-eaters.html

BTW- I'm not a doctor or anything, but it doesn't sound like lactose intolerance to me. If they are eliminating dairy from his diet because of this, he's missing out on fat and protein he needs.

My 7 year old is skinny. He is such a picky eater and does not eat alot either. He says he is full even after a few bites. He does not have regular bowel movements and can hold it for 2 weeks (this is something that scares me to the point where I am looking for a pediatric gastroenterologist). So in essence, he really is full. My son tires easily too because of this. Did you nephew walk the museum without complaining he was tired? The parents are on the right track to see if it is a medical issue. Some of it may be for the attention but rule out any medical disorders beforehand.

You're right to be worried - I hope his parent follow through with the medical evaluations. I can't say I have an idea what it might be, but as his aunt I would be plying him with high-calorie food every chance I got. Hope it is something resolvable.

Michelle - your son may have a nerve deficiency in the stretch receptors of the colon...I read about this once...aganglionic megacolon. Read up on megacolon. Best of luck.

While you're waiting for the test results there are 2 things you can do:

First, he comes and sits down with everyone else when food is served, everytime! Whether it's a party, eating out or ordinary family meals & snacks, everytime. It's not a choice, he is at the table and he isn't dismissed until everyone else gets up, so that he gets into the habit of mealtimes. The expectation is that he eats when the other children eat.

Second, go get him some nutritional drink to boost his caloric intake, such as Ensure. Target and Walmart make a generic one that is reasonable in price and there is also one tailored especially for kids (very expensive). He has that instead of ice water and is expected to finish his serving before he gets up.

Good Luck!

Poor baby - SO glad his parents are getting this checked out and that he has such a loving aunt to watch out for him too. I hope it's nothing serious - could just be that he doesn't feel good with an intolerance to certain foods.

Also poor diet is one contributor to a low WBC, so gaining an understanding of whether he should have any certain diet restrictions and increasing his caloric intake, along with some sort of supplement (Pediasure or other multivitamin) should make him start feeling much better, provided he doesn't have something more serious medically interfering. Keep us posted, please.

The main thing is: the parents took him to the Doctor. And that the parents DO tell the Doctor about his eating/behavior. Openly. So that the Doctor can properly help and diagnose the child.

Some parents, do not say to the Doctor, what is going on with their child. I babysat a child like that who's parents were like that. For example.

How are the parents, per parenting? Are they 'normal' parents with common sense?
How do they act toward him or treat him, per his poor eating? For example.
Well at least they have taken him to the Doctor.

This is also an interesting article, in picky eating kids:
http://abcnews.go.com/Nightline/Recipes/extremely-picky-e...

The size itself is not concerning - my six year old is the same weight, and rather tall. But he eats, a LOT, and is active and social. There is definitely something not right with your nephew, I would just encourage the parents to keep pushing the doctor (and get second and third opinions), until there is an answer and his behavior starts to improve drastically!

Pray and hope the bloodwork comes out ok.