Failure to Thrive Diagnosis for 1 Year Old

Hello R.,

I am glad to hear things are going better. I wanted to add to previous responder. I agree that likely, you are doing just fine with your little one, who sounds healthy and happy. First, make sure baby is not taking more than 4 oz of juice a day, which can blunt the appetite. Second, ensure that her lab electrolytes are normal (this can signal a rare kidney condition called RTA which may present with FTT) as well as her metabolic screen from birth. Third, I have a few Indian friends (and lived in NYC for a while) and know that the typical Indian vegetarian diet is actually very healthy and beautifully balanced. I am pretty sure that is not the problem, but I guess it is worth investigating with a nutritionist. And finally, if you are still breastfeeding, that may be reason why she plots small on the growth charts. A healthy breastfeeding baby is often much larger or much smaller than formula fed or supplemented babies. Also, as your baby ages, your milk gets less fatty to accomodate her nutritional changes. very likely, your baby is little and that is completely normal for her. Consider yourself blessed; your healthy diet and breastfeeding are greatly reducing her chances for becoming obese in the future. Congratulations to you! And I would not worry at all, she is likely OK.

Hi R..
Hearing Failure to thrive must be so scary. I'm sorry to hear that you're having this issue at all.
I am not a doctor and have NO experience in this. Both my boys were like 20lbs by 6 months. HA. BUT...
I just wanted to tell you that at one point my mom was caring for a baby for a friend who has MS...she was totally underweight because the mother wasn't feeding her properly, so my mom had her for like 5 months. Someone even called the authorities on my mom because she was so small and my mom was asked by them to double her birth weight by her first birthday. Anyway, long story short...she was feeding her (well one of the things) was Avacado and Banana, fresh, homemade! I even fed it to my kids and they LOVED IT and it's very fattening. If you have a blender, you can get a good ripe Avacado and a couple of bananas. It makes a lot and really this isn't a good one to freeze. But this little girl LOVED it and so did my boys. It has such healthy fats to it.
Sorry I'm not directly answering your question, but I really don't have much advice or experience in this area and I don't know your little girl. I hope everything is okay. Just thought since you are a vegetarian, you need somehthing that's adding fat and this will def. help.

God bless. I hope it all works out okay.

Hi

I'm in a similar situation. My 9 month old daughter is below 5% in weight (she's currently a bit below 15 lbs) but is at 50% in head circumference and height. She is hitting all her other milestones and eats a normal amount of food (27+ oz of milk base lactose-free formular, about 2-4 table spoons of rice porridge with meats and vegies, and baby puffs and snacks per day). Our pediatrician advised that we can take her to see an endocrinologist if we are worry. Since she is eating well, have normal bowel movement (once/day), and is hitting all the milestone, our pediatrician asked if my husband and I were small as a baby. It turns out that both of us were small (we don't know our percentile because we were raised in other countries and there were no population data at the time). Since all else were normal, we and our pediatrician did not see a reason to worry. (I have to say that I am still keeping a close eye on her food intake).

I do agree with the other moms that your daughter may need animal proteins and fats. Is she eating normal amount of food and milk (of any kind)? Were you and your husband small when you were young? Do both or any of you have high metabolism? If you are very worried, do try and get a second opinion then seek help from a specialist. I hope you'll find a way to help your little girl and get some peace of mind.

A little about me:
First time mom of a 9 month old little girl.

R.,
I am so sorry to hear about this diagnosis, you sound like such a caring and concerned mom. The bright side is that this isn't a disease, it is a stage.
You know that being a vegetarian, especially one who can't eat dairy products, has a special set of nutritional challenges. Does your doctor have a pediatric nutritionist he can recommend? If that is not a specialist he has contact with, I think you can contact your nearest Children's Hospital to find a pediatric nutritionist.
I wish you good fortune and good health!

Dear R.,
I know you've already sorted things out with your doctor and I'm really happy you're on the right track.
I just wanted to drop a quick note to you and tell you not to worry. I'm sure your daughter is perfectly fine.

I'm the mother of a 13 month old boy and he has always been quite underweight according to the American charts. However, he was born in India and we lived there until he was almost 6 months old. According to the Indian charts, he's right on average. The charts the doctors use here are based upon the general build of babies here and don't take into account other ethnicities, as someone else did mention in one of your responses. I grew up in the United States and was considered underweight from the day I was born until I was about 15. I had a perfectly healthy and normal childhood and my doctor told my mom that it was healthier to be underweight, even as a baby.

The second thing I wanted to say is that you shouldn't worry about raising your daughter a vegetarian. There are many parts of the world where children are regularly raised as vegetarians and lead extremely health lives. I get really annoyed when self-righteous mothers try and make it seem like their way is the only right way and accuse you of hurting your child by not feeding her meat. Moms who think like this--don't make judgements on the way people of other cultures raise their children. Your way is only one in a million healthy and effective ways of doing things.

A baby can be underweight whether she eats meat or not. You seem like a really caring, dedicated mother, and instinctively, you'll know what's right for your baby. Keep doing what you think is right and don't let self-righteous moms scare you off of it.

Take care and I hope all goes well!

I would have your doctor check you child for a gluten or wheat allergy. When I read this the normal height and development other than being really thin seems to follow what I have with my son. He was 2 when he fell off the charts blamed on him being overly active. He also had dairy and egg issues. He is now almost 15 and just got diagnosed this year. Unfortunately kids at her age eat a lot of items with wheat products but it is much better to know.

Hi R.,
How was she doing for her other checkups? this is new?

FAts to add: avocado, organic meats (with fat left in), we exclude sweets and juices (they're not necessary).

Is she allergic to all milks? Would goat milk/cheese work? My son prefers those over cow (he was sensitive to cow and I think still is, though he only gets cheese).

You can add olive oil to her vegetables (like you would a pat of butter).

You don't have to worry about making things taste good for her either, she's at an age when she'll either accept or not accept it plain - and usually the 2nd or 3rd time around will accept what she wouldn't before.

I'm coming up blank on the other things we did for my son's weight gain (still hasn't gained much but then we were at 19 at a year).

Be careful they don't run too many tests at the same time - make sure you know what is going on, and YOU are keeping track of what they are doing. THEY are the ones seeing other kids and THEY get busy and caught up and might not notice something that gets doubled or re done.

Good luck,
M.

PS: after reading what you ahd to say I don't know why the allergist is asking you to wean to soy. Your milk is SO much more healthy for her. I have found that doctors will try to get you to wean because they DON'T know much about milk - and don't find out about it either. I just had a doc tell me to wean my son for 24 - 48 hours just to be on the safe side - and it was TOTALLY unnecessary! Contact la leche league to be more confident in your decision. They will give you the FACTS!. My son's ped is all for me dropping nursing altogether - and that is what is keeping him healthy in all this garbage going on! (It's like they WANT kids to get sick at this age! gah!)

R.

As you have read, each person may or may have not had good experiences with thier child not gaining weight. I know you said you were a vegetarian, and your daughter is allerfic to dairy. If being a vegetarian is for religious reasons then I have to respect that, if it is not than you may need to introduce meat which is high in fats and protiens to your baby. She is not getting any protien because she is allerfic to milk, butter, cheese and yogurt and she is not eating red meats. Sometimes we have to put how we feel about foods (such as meats) aside in the interest of our children. The best suggestion is lots of meats, and GREEN vegetables. I would also try to give her pedialite as often as possible. Whatever suggestion you may go with I hope the best for your child.

I am very allergic to cows milk but totally fine with goat mild products such as milk, cheese and yogurt. It is much healthier and easier to digest than milk. There is a test that gets more specific if you can't find where to get it so you can test her. I put coconut butter (good raw organic version in health food stores) which is really high in amino acids and quality calories in my son's smoothies and yogurt. Good luck!

My son was diagnosed with cystic fibrosis at age 4. they say the biggist flag is the failure to thrive. He was having about 10 bowel movements a day that were very greasy and was eating massive amounts of food prior to being diagnosed. just something they may want to check out. it is a simple sweat test that is used for diagnosis. good luck

Does your pediatrician know you are raising your 1 year old a vegetarian and if so, what does he say? If not, why haven't you told him? While I completely respect your husband and you being vegetarians, I have to agree that it probably isn't the healthiest thing for a 1 year old...especially when she is in the "failure to thrive" category. You say she eats plenty so you don't understand why she is in this category. That should tell you she isn't getting enough of what she needs. If she were and is eating so well, she should be thriving. You don't have to introduce nuggets or hot dogs if you really have a problem with them but some turkey and chicken would probably make a difference.

I do hope you update us.

Failure to thrive is a non diagnosis. Doesn't tell you a single thing other than your child isn't growing as the charts say she should. My kids were always at the low end of the charts for height and weight (probably because my hubby and I are both shorter and slight build) so I use to joke that if one of them was tall and heavy my hubby would be wondering who the father was.

If she's eatting a variety of things, has plenty of energy to run around, and seems to be doing well then just talk with the nutritionist for some tips and don't worry.

Hi,
I would not worry so much if your daughter seems fine in every other way.
No way I agree with anyone telling you to giver her animal protein...the worse protein for you!!! I would rather her be small and healthy then get any diseases later in life because you are feeding her animal protein(i.e. heart disease, cancer, diabetes...). If anyone did there homework and googled the health comparison of aminal protein verses plant protein, they would be shocked.
You may indeed fatten her up a bit, but too many other health risks to worry about.
I wish you luck, and I believe your daughter will be just fine. Too many doctors like to label kids and scare the parents. You will know if something is wrong with her!!

My daughter was always (still is) on the smaller side. She is 3 1/2 and weights 25 pounds! I never really paid much attention to what "percentile" she was in - I think she was only 5% for weight and 10% for height at 2 1/2 years old. She never even made it on the charts until about 2 years old. She has a well visit in December, so we'll see how she's progressed. She has always been slow to gain weight. Her 1st pediatrician was always having me get her weight checked and running tests, nothing was ever found. We switched peds and the new one is not concerned with her weight. She is making all developmental milestones as well and appears to be a normal, healthy, little girl. As a mom, I still worry about her, especially now that she is more and more picky with eating! I have to be very creative with what I feed her and it gets very frustrating at times! If you truly feel your daughter is ok, I would get a 2nd opinion for a peace of mind. Best of luck to you. Feel free to contact me if you want to talk more.

Best,
Annie

It is one thing for a pediatrician to be concerned about slow growth, but usually when put in the catagory of "Failure to Thrive", there are developmental issues as well as just a concern with size. As long as she is meeting all of her developmental milestones on time and is otherwise a happy, healthy, active child, I wouldn't worry too much. My daughter who is now almost 4 has always been tiny...not even on the charts after 2 mos. She weighed only 14 lbs. 6 oz. at her 1 year apt. and was only 20 lbs. at age 2. She is going to be 4 next month and weighs 29 lbs. now. Our pediatrician said as long as she is eating a well balanced diet (she always ate a variety of foods, loves green veggies, and went through typical stages of eating more of one food group than another), was healthy and hitting her developmental milestones, we should not worry. The one difference is that my daughter is proportionatly small. It sounds like your daughter is having trouble gaining/maintaining weight, which could be a result of lack of protein in her diet due to not eating any dairy or meat. I am sure your doctor has addressed her diet though... I would definately get her tested to rule out medical problems, but don't worry until you get to the route of the problem. She may just have a high metabolism! My daughters doctor always said, "somebody has to be at the 1st percentile!"

Oh, for pete's sakes! Please don't listen to all these people who are telling you that it's a probelm to be vegetarian. I know plenty of perfectly healthy, plump, vegan children - no eggs, dairy, fish or milk. And it sounds like your diet is less restrictive than that because you are giving her eggs and even ghee.

Go to your nutritionist and try out some of the new foods that people are suggesting and make sure YOU are eating all these healthy fat, healthy protein foods so you will give it to her in your breast milk. If she continues in the same percentiles but is hitting all her milestones and is acting alert and happy - get another opinion.

Americans can be so narrow minded sometimes - What do they think the billions of vegetarian children throughout the world are doing? Starving? Visual evidence would tell us otherwise.

Definitely see a nutritionist like the other moms said. You have to make sure, as a vegetarian, that she is getting enough protein. Plant protein is considered low-quality protein and meat protein is high quality. You have to know which foods to combine to make sure she is getting all 9 essential amino acids. Look it up if this is news to you. It's important.

I think the nutrionist will make a big difference. Breastfed babies are usually slimmer than the formula fed ones and that is usually a good thing but babies need fat for their brains to develop normally so I don't think this is something to ignore as some moms have suggested. My son is slender as well but I monitor his food carefully to keep him at the 50 percent level. Why is your daughter lactose intolerant? It is milk or cheese as well? Lots of people can handle yogurt and cheese but not milk. I give my son french fries (in canola oil) all the time. This is after he eats his protein, and lots of fruits and veggies. He doesn't like cookies, cakes, candies, pasta or rice. I find that the french fries always work. Keep piling on the ghee.

Hi R.,

My daughter was even less than that at 1 year old. She was a really petite baby, though. She weighed 4 lbs 12 oz when she was born, and she was full term. Because she was hitting all her milestones our pediatrician said not to worry, she did have the routine blood tests done but everything was normal. My daughter's father was a petite baby too, maybe it's genetic?

if your daughter appears normal otherwise, and she's hitting her milestones, etc...I wouldn't worry too much. My daugter is now 6yrs old and weighs 37 pounds...still light for her age, but she's active and healthy otherwise. She also has a really high metabolism.

If the blood tests for your daughter come back normal, try not to worry, some kids are just petite...and as for height, my daughter is right there with her other classmates, she just happens to weigh less than them, but otherwise, intellectually, socially and emotionally she's on par with them.

Hope this helps to reassure you atleast a little.

Hi R. S
God bless you and I am so sorry for your situation.
First hang in there!!
Yes, other people have been in your situation, and perhaps now that they have made the diagnosis which is just words don't assume that the words are the reality.
Just as we could not assume that non-conclusive, which is what we got for a diagnosis, means there is no conclusion: you cannot assume that she is going to fail to thrive. Right now she is not growing properly and the MD's want to know why.
Does that make sense?
Our non-conclusive son who they put in the hospital for about 10 days, and found the formula he could have is now a college volleyball coach. At one point his records read
"will not survive the night", he too ate like a horse, but did not gain. Daughter does too and perhaps now that she is in college and they are watching her closely, they may have the answer.
Please email me --- Lots of questions which I may be able to help you with, at least help you think through.
I also have friend who had twins that are finally off feeding tube, after a "failure to thrive diagnosis"
I will pray for you and your "precious adorable" little one
God bless you with wisdom, and God give the MD's Your wisdom: as they study the tests may they find the answer to her problem & allow her to grow.
K. -- probably old enough to be your mom -- SAHM married 39 years --- adult children 38,coach; 33,lawyer; and twins 19 both are dean's list students at college

Hi R.,

I'm a vegetarian too. Babies need fat. Have you tried giving your daughter full fat coconut milk or avacodo. My daughter liked both as a baby. I poured just extra virgin olive oil on pasta too. I also let her eat fish (fish oil is very good for them) like sardines. She liked them, still does.

I can't remember when I started giving my daughter this

http://www.google.com/search?hl=en&q=delicious+kids+8...

It's just full of good stuff but I'd check with your nutritionist.

Also, sometimes when children are alergic to cow's milk they can tolorate goat's milk or raw cow's milk. Usually you can find these in a health food store.

God bless,
G.

She could be just a small kid like my son. He has a small head circumference and was in the 10% at that age. Now he's in the 5%. No problems. He hardly gets sick, and he's gifted to boot. The only thing you need to do is to make sure she eat well, and stimulate her mind with various physical and mental activities. She'll be fine.

You may bave to put some of your vegitarian habits aside and get her on a good protein source...MEAT!!

You should take her to a Registered Dietician also and get some good suggestions for food choices because she is getting into her toddler stage and she IS NOT going to eat well then. Her appetite is going to taper off as this is natural to happen as she gets older. So her caloric intake is going to get even less.
I understand your desire to refrain from meat sources, but when it comes to your daughter's nutrition and her survival, you will need to make choices you otherwise would not make. You can teach her to be a vegitarian again when all of this is behind her.
If she is allergic to dairy, that would not make her allergic to eggs, and they are one of the most perfect food sources.
Get some councelling from a dietician!
You need to do what is best for her, not what your beliefs are...that needs to be put on the back burner for a while.

What did you give her as a formula source?
Did you nurse her?? Did you give her a soy formula?
Put her back on it as there are formula's in Stage 2 for 9-24 months. slam packed with good nutirtion and will help her get her needed nutrients. Even if you have her off the bottle, put her back on it if that is the only way you can get her to drink it. Who cares about if she is on a bottle at a year or even 2 years...if that is how she will get added nutrician, then give it to her!!
Nestle Good Start has a Level 2 formula that is soy!
Go out and buy some for her!

Hope she is better soon!

I don't like to tell anyone how to live their life, or what choices to make...but perhaps for the interest of trying...I know you're vegetarian...and while I don't know the reasons bebehind it I would think perhaps you should introduce some meat products just to see if they help. Most are higher in fat and protien then many vegetables, and it might be the jumpstart she needs to bridge the gap. If it's out of the question, forget I mentioned it, it's just that I have nothing better to offer and it seems a large enough change that it could turn things aroudn.

All I have to offer is that my youngest daughter was not much bigger than yours at one year (she was 16 lbs 2 oz - and has always been around the fifth percentile. She just had a nice growth spurt and, finally, at 19 months she is 6 ounces away from 20 lbs- at last! I never heard the words, "Failure to Thrive," and that must be so, so hard. I agree with the last person, given your
dietary restrictions, you need the advice of a nutritionist on the most appropriate high calorie food you can feed her . Take comfort in the fact she is happy and hitting her milestones - that is huge! Kids can grow differently and there will always be some on the small end despite our cultural need to try and make everyone "above average." I really hope things go well for you.

Perhaps with her allergies, she is just not getting adequate nutrition.

Are you using a multivitamin? How about a soy protien drink to up her calories and give her adequate protein to build healty cells. Since she is hitting all her milestones - perhaps her body is just missing something.

I will send you a private message with a link to the products I am referring to.

To Your Health,
L.
www.nosickvisits.com

Is she still on formula or are you still breastfeeding? Just like kids who are not allergic to dairy go from formula/breastmilk to whole milk (or stay on breastmilk)until they are 2, she needs an adequate source of fat in her diet. Most milk substitutes (soy, rice, etc) do not have enough fat or protein. She should be on a hypoallergenic formula for at least the next year. My daughter is allergic to dairy and on a prescription formula. We were told by our allergist, GI and ped that she would stay on it until she was at least 2 and maybe longer. The nutritionist is a great idea. They can help you get more fat and protein in her diet, which can be an extra challenge when you are veg. With a FTT and allergy diagnosis, you may be able to get your insurance to cover the formula.

R.,

You have gotten some great advice so far (and some not so good, but just ignore those). If your baby is happy and healthy and hitting milestones, I would try not to worry about her size. If you are really worried, get a 2nd opinion.

Make sure your daughter is eating a healthy well balanced diet, which does not need to include meat. Lots of beans, lentils, veggies and I would suggest trying avocado. Its a good source of healthy fats.

Good luck,
R.

Do you use any of the attachment parenting practices? (See the links below.) For instance, physical touch (carrying/wearing the baby, massage, breastfeeding, cosleeping) are very important for children to thrive. You might want to increase physical closeness as one step towards helping your precious daughter gain weight and otherwise thrive. If the problem is some kind of clinical disorder, attachment parenting principles can still be beneficial. Best of luck!

Dr. Sears "What is Attachment Parenting"
http://www.askdrsears.com/html/10/T130300.asp

Attachment Parenting International
http://www.attachmentparenting.org/

I have a recommendation for you. It's a probiotic superfood. One example of weight gain is an anorexic who was only 80 pounds. In one year she gained 30 pounds and was healthy. This is a miracle if you know anything about anorexia.

I can't post a direct link here so email me: ____@____.com's vegan and packed with amino acids that will build healthy protein cells and also fix any potential gut problems so that nutrient absorption is increased. Amino acids are what she needs, not meat so don't get swayed on that. It could just be that something is missing from her diet. Ideally she would be exclusively breast fed for many months and then started off with fruits. There are healthy and very unhealthy ways to eat vegetarian! The amino acids form protein. Eating meat simply overburdens the body (never mind the ethical reasons, let's just talk health here) and it needs to be broken down in order for the protein to be utilized. Meat is a very ineffective way to get protein and it acidifies the body and leaves a person more prone to illness.

Feed her lots of fruits in their raw state but rinse her mouth after. That will contribute to health, vitamins, minerals, etc with no empty calories. There are lots of junk foods that will pack on weight but that is not healthy weight. The goal should be health, not numbers on a scale.

Let us know how her levels turns out after testing as that will be a big clue for other options. Toxicity could be an issue and if it's lead that would prevent calcium absorption in the bones possibly contributing to this issue as well.

I just saw your response and completely disagree with the allergist about soy. Soy is not really meant to be a human food product. I'm pretty sure they just banned soy formula in the UK. Here's an interesting link I found about breast milk increasing in fat the longer you breastfeed: http://www.medicineonline.com/news/10/6108/Fat-Content-of...

Meat has an extremely high risk factor for many health conditions. Many diseases have been completely reversed simply by going vegan--cancer, diabetes, heart disease, etc. On that note, some vegans will give their children raw goat's milk when they are finished breast feeding.

Interesting comment about attachment parenting. That was actually a direct steal from Jean Liedloff who wrote the book, The Continuum Concept. Awesome book and I highly recommend it to all parents.

Most Indians are very slim so I wouldn't necessarily take the "failure to thrive" that seriously but of course the nutritionist can be helpful. Hopefully she understands a vegetarian diet. Many nutritionists and dietitians are trained by the entities that profit from sales of unhealthy foods like dairy and wheat so keep that in mind if something doesn't seem to make sense. Shop around for someone who is on the same page as you.

From your description she sounds like she's doing just fine, she's just a bit on the slim side. These days with the majority of people being obese being slim looks out of place. Many babies are born obese and unhealthy. Those charts don't allow for much leeway. Children sometimes take after another relative, not just the parents. It could be a grandparent or aunt or uncle on either side whom they physically take after.

I like the idea of talking to a nutritionist. i feel for you. I am assuming at some point the pediatrician will recommend start giving her pediasure, i think she needs to be old enough to drink it. i don't know what age it's ok. pediasure it loaded with calories, and sugar too (the downside) unless she's allergic to it.
a few questions: will you raise her as vegetarian? if yes, will you be able to offer her foods high in calorie as it sounds like she needs it.
i also have to tell you, even though my girls were never as small as yours, i was constantly pushed for pediasure. my kids were within 25-50 percentile with weight, if mine were diagnosed as yours then i would probably do everything to get her back on track. which means, i would have said yes to pediasure,
is your daughter drinking and eating plenty? is she active? are your husband and you built small?
i also advise to go talk to an gastroentologist. get your answer as to what the problem is. you may end up not getting a real cause, but try. nutritionist should be able to tell you exactly what to feed her. if you end up being asked to give her foods that are non-vegetarian if i were you i would do it. right now, the main goal is to get her back on track
hope all works out for you and your daughter

My daughter was a failure to thrive when she was only a few days old. She didn't nurse well in the hospital and got jaundice and had to be put under the lights. She lost close to a full pound in the hospital. And it took her almost 2 weeks for her to gain it back. Failure to thrive is just a term they use when they aren't gaining weight fast enough. Let them do the blood work to rule everything out. She may just be a very petite little girl. My daughter didn't even weigh 20 lbs at 1 and at almost 2 1/2 she isn't even 30 lbs yet. She's about as big as a minute. I would introduce more regular foods that you eat. Stir away from the baby food. Also, get her to snack between meals.

Too many doctors and parents put stock on these non-nationality weight/height charts. These are based on "American" kids throughout the decades and has little to do with "global" measurements. My daughter being chinese has always been on the small side with normal 75% until 1 when she dropped to 25% weight and 10% height. She then dropped to 5% on weight and never got above 15%. Her pediatrician has never labeled her and never put her on supplements since she was happy and made other milestones. She's now 10 and well adjusted to being petite and rather happy about it. Bottom line, as long as she's happy and otherwise healthy, don't worry.

My son is also dairy restricted (on soy formula and rice milk) and we were told to give him high fat foods as this is what he is missing without the whole milk and other dairy products.

I know eating vegetarian is a lifestyle choice but maybe for a child-especially your, it is not the optimum choice at this time. Where is she getting her protein and fat from? You may want to at least for the time being introduce her to chicken/turkey-come with whatever else you are eating for some kind of comprimise between your lifestyle and her needs. What also comes to mind is avocado as a great food for her.

Eventually when she gets a little older and bigger, you can phase out the chicken/turkey and gear her more towards a vegetarian lifestyle.

In addition to that-how big are you and her father? My boss's grandchild is also a "failure to thrive" child, and after all tests nothing was found. The pediatrician failed to notice that both her parents are under 5'5" and very petite people! If you are both small, I would mention that and ask if maybe it is possible that it is genetic and she is just going to be that way too. But for now, don't ignore the nutrition side please.

"Failure to Thrive" is an alarming category, but it tells you that something isn't right with your daughter's development. Hitting her milestones within normal limits is only one aspect of her development. If she isn't growing at the expected rate, then something is wrong.

You say that "we" are vegetarians. Is this a choice you have made for your child as well? How is she getting "good fats" and protein? Is she on a vitamin?

I would suggest that you add meat products to her diet. I understand that you have made a decision not to do so yourself, but if it will help her gain weight I would think you would be willing to make some adjustments.

Little kids at this age LOVE to snack- try some veggie cheese, chicken nuggets, cut-up hot dogs, spaghetti with meat sauce. Little ones need a balanced diet with high levels of protein to thrive. I'm sure she's either breast feeding or drinking soy milk/formula, so I would suggest cutting-back on juices and really pushing the calories in the breastmilk and soy milk.

Please see a nutritionist. If you have insurance, get a referral from your pediatrician and it should be covered.