Underweight/Not Eating Cont'd

So some of you may know that my girls are underweight. Last month they weighed 19lbs. Isabelle was very close to 20, but Aurielle was only 19lbs and some ounces. Well, we had to take Auri into the doctors because she was acting very strange. She was tugging at her right ear quite a bit and digging in it. She also was taking about 4 hours to go to sleep at night. Turns out she had a mild double ear infection and she had a lot of wax buildup in her right ear (the one she was digging in). The wax buildup happened when she was 9 months old as well, so I knew that's what it was this time. Well, I took her in and she got weighed and she lost about 5 ounces! That's a lot in a month and I'm extremely worried. She was prescribed antibiotics, but I didn't give them to her because the infection wasn't bad at all and it's actually gone now. If she drinks pediasure she won't eat food. If she drinks too much milk she won't eat food. I'm really at my wits end and seriously cried in my laundry room (where they can't see me) because I'm so worried. I'm pretty sure Isabelle is gaining weight just based on her looks, but I never really know until I get to the doctor. Plus, she still eats really well. Not sure what to do here...I'm at a loss.

 

Did she lose weight or not gain as fast? My Henry is only 19lbs and just recently have I figured out how to get him to eat. He now uses a fork and yes, meals take forever. I basically put whatever food he will eat (he loves canned apples right now) on the fork and give it to him one piece at a time. while he is "feeding himself" I also spoon yogurt into his mouth. He now gets yogurt with every single meal because it is a protein he will eat. It is very hard when they seem to subsist on air. I would let her eat until she gets bored then give her the pediasure to fill her up.

 

No, she lost weight. Also, they've been using spoons and forks since they were about 11 months old. They also know how to use big people utensils. If she's eaten any of her meal she won't touch the pediasure. I'm in a very tough place with her right now.

 

I always give jessy Pediasure at night after all other meals had been eaten that way it didn't affect eating. You might try fattening up her meal options with some higher calorie foods. Didn't help here I think i have the only kids who wont eat breaded food

 

Thanks, but we already do fatten up their foods with butter, cream, sour cream, whole milk. I can't get her to eat most of her meals. She only ate lunch today...no snacks or anything else. I always feed them their favorites and never pressure them into eating.

 

Jessy didn't eat supper either and it was something she liked

 

I guess my first thought is that having dual ear infections can totally affect weight gain, or weight loss. I wouldn't try not to get too upset about the weight loss, because the ear infections probably are the cause more than anything. Those sore ears make them not want to suck/swallow. Are you sure that the ears have completely resolved?

The only other piece of advice I wanted to share.... I'm totally guilty of this. I pigeon-hole my kids sometimes. I say things like, he'll never eat that, or he hates this or, whatever... I guess one thing I've learned from meeting with the nutritionist here, is to just keep setting regular in the high chair/booster seat snack and meal times, fatten up the food, and try to be as unstressed about it as possible. I know after saying that my kids won't even drink milk shake/smoothies, after making them over and over and over... and pouring them down the drain for MONTHS, within the past couple weeks suddenly he'll drain it! I know, easier said than done. Right?

Anyway, I know finding out about the weight loss breaks your heart, but try not to let it get to you too much, because at this point I would totally blame the ear infections more than anything. Hopefully if they are all cleared up she can start eating better and gaining again.

 

When I took her in her ear infections were at the tail end. The doctor let me look at her ears and honestly, they weren't that bad even the doctor said the same thing...she gave me the antibiotics anyway. I'm really conscious about not stressing around them. If I get upset, I leave the room and come back when I'm calm. I always put them in their seats at the table for meals. They don't really snack...maybe here and there, but today it was nothing and it hasn't been like this. The past few weeks she would at least snack, drink some milk or eat at least two meals, but today was horrible. She ran away from me crying, kicking when I went to put her in her seat - she was really upset and clearly did not want to eat. I offered some pediasure and she threw it. She was very angry that I was even offering her anything as if I should know that she doesn't want to eat. I've noticed over the past month that her personality is different. She was my quiet, calm baby, but now she is more aggressive especially with her sister. Not sure if this personality change is just part of her growing up or if it's the lack of food. Otherwise, she doesn't look or act sick. She doesn't have any symptoms of the ear infection anymore. She's not tugging, digging in her ears or chewing on her fingers.

I do feed them their favorites a lot, but I also introduce new foods. Tonight I made them au gratin potatoes and she didn't want them. I paired them with her favorite buttered broccoli and she didn't even eat that. I'm not sure what's going on, but they go back for a weight check on the 23rd and I'm almost certain she will have lost even more weight. She really can't afford to lose any. She's 36 inches tall and 19 lbs. Sigh.

I just want to add that this has never happened. They have always been really good eaters. I seriously never had a problem with them scarfing down their meals or milk. So this new behavior is quite concerning.

 

I know you mentioned you got an antibiotic, but didn't give it to her b/c it was cleared up, but I think I would go ahead and give her the antibiotic just to be on the safe side and to be sure the infection doesn't take any longer to heal. Does she like muffins (chocolate our my kids favorite or banana with chocolate chips)- I have seen a lot of muffin recipes that add calorie and protein boosters, and it's also something you can make a good batch and freeze. I don't really have much to add, but try not to stress out about it, just keep doing the great job you are doing and offer something new, never know what they may eat.

Just another thought for a smoothie is to add coconut milk in some concoction for high calorie and fat.

Good Luck and keep us posted.

 

I have a 3rd percentile twin who has been like that since birth. She was actually BELOW the 3rd at one time. (she could be there now too) I read your post and I hear myself. I breaks your heart you want just a little extra just incase they get sick. You see other kids eat and your jaw drops open. My daughter will be 3 yrs old in November and she weighs 12.5 kg or 27 pounds. the BEST advice was from a fellow twin mom on here to suggested to read the book "child of mine: feeding with love and good sense". I was able to get it from the library here and wow the BEST.

Next, look at you, look at your family. My dh is a bit taller than me and while I maybe average he is a smaller frame for a guy. My best friend also had a child with low weight growth and she is a smaller petite person. Maybe in your family there is smaller framed people. You might not have bigger kids.

I have had roller coaster rides of emotions with dealing with her weight and now I'm good. She is petite and likely always will be. She is growing in height and head circumference. Even her size 4-5 feet have grown. I am at a point now where I feed her and I don't look. Sometimes feeding her while they watch T.v. has had some better results. (sadly) I'm aware of which yogurt I buy and I add all the extras but many times i can still get frustrated when all my extra work pays off with barely a bite.

Please read the book, it seems to help every parent in one way or another. Next, learn everything you can and know the high calorie foods. Then, feed her and close you eyes they will grow up beautifully.



also google :high calorie foods toddler

coconut milk is very high calorie -- I made a rice pudding with it before and it was a hit (only once though -- next time nobody wanted it).
avocados, bananas, sausages, greek yogurt with honey...


Heather
pm me anytime.

 

Heather makes a very good point. She may be genetically petite. My DS has never been on the growth chart. At 12 months he was 18 lbs (< 3rd) and 30 inches (50th). He just has a tiny frame, but his daddy was 6'5" and 160 lbs in hs.

That being said, 5 oz is really not that much. She is probably stalled out more than losing, and 5 oz could be the difference between weighing before a poop/pee and after one! Toddlers go through a stair step pattern of growth with stalling and then spurts. If you are offering the high calorie food then it is all you can do. No child will starve themselves.

My advice would be to offer the pediasure at a snacktime or bedtime and preserve the meals for food. If she is fighting eating then don't force it but keep offering. There are people who cannot sit and eat a full meal but could graze all day and maybe that is what she needs to do. Also, could she be teething? Lately DS started refusing all his favorites again and I went back to babyfood and yogurt because it felt better on his mouth.

As pediatricians, we only worry about underweight kids if 1. It is impacting their height or development or 2. It is a sign of a bigger medical problem. If she is growing, developing and healthy I wouldn't stress yourself about it. She may just grow up to be the next runway model and we'll all be jealous

 

I made my coconut rice pudding tonight so I thought I'd share the recipe (great for low weight kids who have allergies)

1/4 cup of rice
565 ml of coconut CREAM (this is the higher fat stuff)
Later on I added about 1 cup of milk

raisins are great but I had none today.
cinnamon to taste.

Mix ingredients with a bit of sugar and cook in a pot until cooked. I only had a large and very small jar so that is why i used 565ml but the recipe is forgiving. Milk, cream, whatever. It was a bit hot so I cooled it down with icecream. It worked today but might not work tomorrow. hehe



Plus, here is a website I've seen before and liked it. We did the peanut butter things didn't work for us, but my other daughter liked it.

http://www.framinghampediatrics.com/High%20Calorie%20Foods%20for%20Toddlers.pdf


Heather

 

Thanks all for your suggestions. I'm really not trying to push anyone's advice aside, but my girls will not eat anything overly sweet. They can eat fruit fine, but will not eat puddings, cakes, cookies nothing like that especially coconut milk. I've tried that one as well and it was a big battle. She just drank a huge cup of milk, so that's a start for today. Also, I will try to pick up that book, but we don't have a library that's close to us and I currently share a car with DH who takes it to work every morning because he has an hour commute. When we have extra money I will purchase it on Amazon. I just want to stress that I don't pressure them into eating. I set it down and just read to them while they eat. If they don't eat I clean them up and take them out of their chairs and wait until next meal time.

I've googled high calorie foods a a couple of weeks ago when this problem started to arise. When I found out she had ear infections I thought for sure that was the problem, but right now she is not longer exhibiting signs of an ear infection. I make most of those foods and Isabelle will eat them no problem, but Auri won't have anything to do with them. Right now the only thing she will eat are strawberries. Let's see how today goes. I shall keep you all updated since I might need to vent again. Thanks again!

 

Maybe you could not let her have milk till after she eats. Sounds like she maybe filling up on it

 

Thanks, but then she won't drink it because she's full on food. The doctor prefaced how important that milk fat is so we give them their milk first thing in the morning then feed them about an hour to an hour and a half later.

 

Maybe it would help if you ate with them. Sometimes mine won't eat what's on their tray but they want it off my plate! Also, you could try a non-messy snack in their playroom to add in extra calories in between meals. Mine aren't big on sweets either; we use a lot of cheese to add calories, protein and fat. In fact, if she eats cheese and yogurt then you can worry a little less about the milk. We nurse in the AM, then change and go downstairs for breakfast, so that is similar with what you do with milk then food an hour later.

Again, I wouldn't get upset about it because as long as you are offering her the food you are doing everything you can. You can't force a child to eat and letting them dictate when they are not hungry will help them manage their appetites in adulthood. If it is just how she is built she will grow at her own pace consistently. The reason she has a weight check is to make sure she isn't losing more and if that is the case the doctor will probably order tests. These would be to rule out any medical reason for her not gaining, and if that is the case then fixing the problem would help her gain again. If there is no medical problem, then you are reassured and go on doing what you are doing.

I personally think a lot of pediatricians focus on charts and percentiles a little too much when the most important thing is the trend of the curve over time. Try not to get caught up on one point on that graph and instead look at the big picture over time. I've accepted that my son is going to be small and laugh about the fact that at 14 months he can still wear 3-6 shorts!

 

I guess I'm doing all I can because I do eat with them everyday for every meal. We'll see how their weight check goes in a few weeks. I doubt they will want to do tests because she simply is not sick. She is still a very active, happy baby. Thanks for all the support and advice all! I really do appreciate it.

She ate much, much better today. It wasn't a lot of food, but at least it's better than nothing. I just gave them their pediasure for a snack, so hopefully that won't mess things up considering we eat dinner around 6. Sigh...it's been a rough few weeks here and I'm all along. Again, I appreciate the support and advice.

 

Hi Orangeyaglad,
Just read through all the posts and I see why you are so concerned. Telling you not to worry is useless, you will still worry! It's a primal instinct
to make sure your children are eating well and thriving.
This is what I think, in summarizing what I've read:
1. The ear infection, albeit mild, was probably bothering her, and may have been at the end of or during a little virus, so that may be why she wasn't eating well. Something children can carry a bug but will still go on with their day as if it's nothing, but you will see it in the intake or loose stools or something.
2. It may be the toddler control thing too, my DD went through this three weeks ago where she barely ate anything all week and I was having major anxiety, then she decided not eating was no fun so now she's back to normal. She is also the more petite twin, and is between the 10th and 25th percentile.
3. If she takes Pediasure, can you give it to her before bed so she's got those calories working in her tummy while she sleeps?
4. Would you feel better giving her a multivitamin during this time until she picks up again? At least she would get a good amount of the daily requirements, and you might feel better know knowing she is?
5. And if this should persist, which I have a feeling it won't, might she be slightly anemic? Common at this age, and can make kids' appetites not so good.

Please let us know how she does in the next week

 

I'm so sorry you're still dealing with this! :hug: The PPs have given you some great suggestions, and I just wanted to tell you to *try* and not worry. Kids really pick up on stress and meals can become a battle, which makes things even worse. I know how hard it is (Nate developed a bottle aversion at 8 months and fell off his growth chart), but the Ellyn Satter book recommended *really* helped me. She has a website with tidbits about feeding issues: http://www.ellynsatter.com/ If you can't find the book at the library, PM me and I will send you my copy.

ETA: I just found it online for $3.42 (used) with no tax or shipping (HERE). I don't know how reputable the site is (Textbooksrus.com), but it looks ok. Hope this helps!

 

Thank you. I will look into both books, but right now we literally have $1 in our bank account. Today it's not better. They both didn't eat anything or drink any milk. Not sure what's going on because I've never had to deal with it.

 

I would ask the ped for a referral to a nutritionist or feeding specialist. If they're both literally not eating anything, then you need some professional guidance to come up with some strategies to help!! :hug:

 

we spoke with a nutritionist briefly while we were at their last appointment and she said I was doing all the things she would have told me to do anyway. they never had feeding issues before.

 

I don't have any other advice to offer other than what PP have said, but just offering big hugs for you!! My boys are small too, 20lbs @ 18mos, although they have been consistently small. I have one big eater, although he seems to like to poop it all out rather than gain weight and one super picky non-eater. Its very frustrating when Rhys won't eat but developmentally he's right on track so I am trying to go with the flow. My biggest issue is with MIL who feels the need to remind me how much bigger younger babies are than the boys but thats a whole other topic :spiteful:

 

I have 2 very petite toddlers too... but like all pp's said you have to just trust that they will not starve themselves. If they were acting extra fussy or feverish or just 'off' then I would talk to your PED some more but otherwise you have to just do your best to ignore it. I do monitor their weights on our home scale (not super accurate but trends over time tell alot). It is really weird how toddler weight works, seems to me they can go a long time gaining nothing or even losing several ounces. Then they hit a huge spurt, eat like crazy and gain about a 1/2 lb in a week. Then they slide back and lose a few ounces and then get back to the original gain amount. In other words, it is a real roller coaster!... and you can obviously tell i've obsessed about this some myself . The lack of eating is probably just due to several factors like others have mentioned (ears, teething, etc). My son went about 2 weeks eating almost nothing except a few containers of yogurt per day (and not the high fat type, he wouldn't eat that). He lost a lot of weight but since has been eating like i have NEVER seen and has gained 1 lb. in a month which is twice as much as ever! So, I think you need to look at it long term, you never know what's just around the corner and TRY as best you can to look at how well they eat over a week or even two week period rather than day by day. Good Luck I know it's super hard :good: and if you feel there really is a problem, there very well may be so just monitor the situation and talk to your PED if it doesn't improve.

 

I don't know how much this will help, but here goes.... Parker has had health issues since he's been born along with being failure to thrive from around 9 months until the age of 2-2 1/2. He was with a Pediatric GI specialist for a couple years that was a godsend and originally he went to him because he had issues with reflux (not painful or anything he'd just spit up every hour from birth?!?!) One of the first things that doctor did was cut parker's milk down to 16 ozs a day at 12 months because he said at this age he should start to get a good chunk of his calories from food and not fill up on milk... very important. I hemmed and hawed, but did what he said because i thought the same thing as you he needed the milk calories.... but in the same instance i was filling him up with milk so he developed no appetite for food. So we cut him to 2- 8 ozs cups of milk along with getting in 1 pediasure a day... Also, always offer the food first then the milk. Yes, i know you are worried about the calories, but honesly in the long run it's better to give them an appetite for food then just plain liquid. The more you offer them the food, eventually they might give in and try it especially if they start to get hungry. When it comes to the acutal food...offer fatty stuff in the healthiest way you can. I know you said you already tried, but just keep up with it. Have you tried Advocado maybe with a splash of salt? Just an idea... have you tried burritos? Rice with butter? Peanut butter and honey sandwiches? I noticed parker like somethings cut in certain ways, but not others even though the food was absolutely the same thing each time... so maybe serving it differntly or even if you have to try to feed them the food yourself to see if they will take it then. Another key thing he said to me was that at this age 1-2.... you are good if you get 3-5 decent meals in for a week. Your girls are in a rough age so they are going to have their moments where they are going to give you a run for your money. Just Keep your head up and make eating a fun activity if you can and eventually they might come around. i remember the struggles we had with parker were extremely overwhelming and i would stress about every little ounce with him especially because the major health issue was hypogammaglobulinanemia of infancy (an immune deficiency that children grow out of) which made him prone to becoming sick very often... every time he was sick he would drop weight. It broke my heart in two. He was so tiny at 1.. 16 lbs 14 ozs i believe because of sickness... he looked like death to me and so frail... i just worked on it and worked on it constantly offering food to him and getting his body on a schedule of eating and eventually after a good year it did start getting better. He was under the charts ... not even 3 percent and now i can say he is a small thriving 15 percent at the age of almost 4 years... he's been consistently 15 percent for at least a good year and a half now. Keep with it and the girls will come around.... and know that others have been there and there's light at the end of the tunnel.

one more thing.. do you think they could be cutting teeth? Just another thought as to why they might not want food right now

 

Yesterday, we made some changes. I didn't give their milk to them right when they woke up. I waited until breakfast, fed them soon after they woke up and they ate pretty well. Aurielle is teething. She has been for quite sometime. We're still waiting on those second molars to come in and they are taking forever. But she feels better from her ears as we decided a few days ago to give her her medicine. They've never been big snackers and if they did snack they would only eat a cracker or two. So I eliminated the snacks and they both ate a lot better. Aurielle isn't back to eating like she was a few weeks ago, but she is ate at least half of each of her meals which is good in my book. Isabelle has always been my good eater and she'll almost always clean her plate even if she's teething. They eat a wide variety of food as I'm always adding different things to my recipe book, so that's not an issue.

We'll see how today goes. Thanks for all the advice/help. It's good to know I'm not alone.

 

I just skimmed the responses, but has anyone looked into Celiac's? My friend's toddler was losing weight/not gaining and that was the issue. Her body was just unable to break down the food they were giving her. After making a few changes to her diet, she is like a different little girl. Good luck to you!

 

Hi orangeyaglad, happy to see your last post. Hopefully it was a strange phase and nothing else. You are doing a great job staying on top of it and making sure you don't miss anything, I give you a lot of credit!!!

 

Thank you! I really appreciate that. A big part of it seems to be them teething. I don't they've ever teethed for this long! I would rather lower their intake of milk than their food. It makes more sense to me.

 

I had to respond even those this is a few days old. My DD is also very petite. She was 18 lbs at 18 months and now is 25 lbs at 3 years (38 months). Since she started walking, she has been below or just at the 3rd percentile. I have wavered between being very concerned to not concerned. The pediatrician is not concerned at all. He said she is very consistent on her growth curve, healthy and thriving. She is just petite. Just finally, after her 3 year old check up, have I finally completely come to terms with her small size. She is fine. She is just small. She eats like a bird, but she is healthy.

She also has bounced up and down a lb every few months. If she gets a cold or an ear infection, she will lose a little weight. But in a month or so, she'll put it back on. If she gets really constipated (which she does), she will easily gain a lb and then lose it when she finally poops. As adults, our weight fluctuates. So I think the same is true for kids. (Obviously theirs will fluctuate within ounces or maybe a lb whereas adults can bounce around 3-5 lbs easily over a few days.)

Over the last 18 months, I have tried to "fatten her up" with different high calorie foods and I have also just thrown my hands up in the air and let her eat what she wanted when she wanted. And to be honest, nothing I have done has made a difference. I think when I fed her the high calorie stuff, she just ate less overall because she knew what her body needed. I think you just have to offer her healthy food at regular times, and not stress about it. See what the weight check at the end of the month shows.

If you are finding pediasure expensive, which I bet you are, you can also mix Carnation Instant Breakfast with whole milk for a similar effect. We did that. Actually, we used the generic Kroger-brand stuff because it was even cheaper. DD also eats a lot of cheese and peanut butter. She will eat pb off a spoon!

 

Thank you for your response. We actually decided to stop the pediasure as it was seriously screwing up their eating habits no matter when we gave it to them. They eat well, but not a lot like some toddlers. The past week she is finally back to herself and she is finished with her antibiotics. Both are STILL teething, but they are back to eating. Also, we stopped giving them the soy milk and now give them regular cow's milk with a tiny bit of chocolate in it. They are now drinking two full cups of milk per day as well as their three meals and some snacking in between. They never were big snackers...they would rather eat a meal.

I can visibly see and feel that Isabelle has gained some weight. I see some chubby on her legs, but Aurielle is still skinny. If they weren't my kids I wouldn't be able to tell at all. Aurielle was my main concern because she just stopped eating all together, but I'm thinking it was a combination of the ear infection and teething.

Thanks all for the wonderful suggestions and advice. I really appreciate it!

 

Glad to hear the kids are doing better with eating. One of my twins lost 3lbs at 18 mos old. It was in a matter of 2 mos. I was terrified. We put him on an appetite stimulant which helped a little but he still took forever to gain.
One thing about the pediasure, it does work wonders if they aren't going to eat anything anyway. If they go through the teething/ear infections or anything like that again. The pediasure (or even the generic brands which offer more fat & calories) are MUCH better for them than something they "might" nibble on anyway. They also have new ones that are called sidekicks and aren't as "filling". They are the only thing that put weight on my son till he finally decided he enjoyed eating. He is now a great eater. We got off the appetite stimulant about a year ago. He is now 5.5yrs old and weighs 35lbs! Considering he wasn't even on the charts for over a year and now is in the 10%, I am hoping he passed that phase of his life. He is still skinny but I think thats just how he is gonna be.
I hope yours start to eat for you again soon!!!

 

Both my boys were in that >3rd percentile for the first 2 years (plus a few months for Jake). My mom was my saving grace through my feeding battles when she told me that I used to skip meals as a kid. It was like, I ate one day, then didn't eat much for 2 days. I turned out fine! (and wish I could stop eating). If it's not causing her medical problems, just keep offering food and go with it. The year the boys were 2 we added Carnation Instant Breakfast to every cup of whole milk. We did milk 3x's a day. By keeping it routine, they knew they would get it and when. We did a cup at wake up. Ate "breakfast" (usually cheerios and yogurt) two hours later. Did lunch around noon. Milk at 1/2 (before nap) and whatever they didn't finish of that after naptime. Dinner around 6. Milk before bed. We too did a lot of yogurt (even bought the kind in tubes and froze it for something different). I wish you the best of luck and hope you are able to let go of the worry sometime soon. I have to admit that it took me almost 2 years to do it, but it did happen. They still usually only eat one meal a day, but obviously it's enough for them. Hang in there!