Low weight toddler

Hi there,

Just wondering if anyone else has had a similar experience, and if so if you have any suggestions. I have b/g twins, 22 months old, my boy has always been on the smaller size but is still within 'normal' range on the growth chart. My girl however is tiny. She is on the chart for height, but is way, way off the chart for weight. She is currently only 16lbs 9 oz. We have had all sorts of tests done - to check for celiac, cystic fibrosis and malnutrition but all negative (thank goodness!) Yet, she is soooo skinny. Now our pediatrician is sending us to a 'Failure to Thrive' team at the local hospital. Seriously, could there possibly be a worse name than THAT? Anyway, we are consulting Dr's so that is a good thing - but I'm curious if anyone has experienced this first hand - at first I was feeling fine with her weight as she seems ok in every other way (knock on wood), but now I'm so worried. Thanks.

 

I'm sorry that this has got you worried! :hug: Has your DD fallen off her own growth curve (the ped should have been tracking this since she was born) or is she just low on the "standard" growth chart? I know my ped isn't concerned unless my guys fall off their curve; they've always been on the low end or even below the chart, and Nate did once fall off his curve. Does your DD eat well?

I know the "Failure to Thrive" name sounds really dire, but I've heard great things from other moms who have been referred to a FTT clinic. It's not about judging you as a parent, it's all about finding out why your DD isn't gaining well and figuring out strategies to help. You may find some great specialists, like nutritionists and feeding therapists who can really reassure you and help you get a better understanding about what's going on.

When do you go to your first visit with the FTT group? Please keep us posted! :hug:

 

I have not had experience, but wanted to say that I hope you find out some good news soon. Yes good news is that what you've had tested already is negative!

Is she falling off of a growth curve? Our twins are down at the 5% but have been on the same curve since about 10 months.

Are they suggesting to eat naturally fatty foods, like avocados and adding more nutrition? I hope that the new team will help and figure it out.

 

Jessy was always tiny and we found out her heart murmur was worse than they thought. I really don't know how you miss a hole that large in the septal wall. She is still small for her age (5 ys 36 lbs). We did pedisure and fatter foods(ex extra butter) for her but it didn't amount to much change

 

What about the genetics of your family? Are you and your DH small, average or large? Does your daughter resemble someone in the family, in terms of body?

We went through a similar issue when our guys turns 2. Our nurse practitioner was concerned about their enormous heads. He got us all freaked out about some genetic diseases where large craniums are a characteristic. He made us see another doctor to check it out. Through it all, no one bothered to measure DH or me. DH has a ginormous head, like he can never buy a hat that fits. And even at birth, our boys had large heads. We fretted and worried for weeks for nothing.

 

Sabrina is 5yo and weighs 28 lbs. She's so tiny. My 19 mo toddler weighs 27 lbs and she can fit her feet in his shoes, though she is 1 shoe size bigger. Sydney, her twin, is 18 lbs, 5 inches and 3 shoe sizes bigger. And is still only maybe 45%ile for height, so not very big. Sabrina has never been on the charts for anything, and got a failure to thrive diagnosis just last year, to put her on pediasure through WIC, which was good because we never could have afforded it, otherwise. But it hasn't really made much of a difference, and it's a catch-22 because if she fills up on that, she doesn't eat much of anything. I don't know what the answer is. We've had all kinds of tests done, and the only thing that's come back so far was a severe Vit. D deficiency. But then that's to be expected with her vision problems and severe photophobia. We've since gotten her much darker glasses so she can stand to be outside a little more, and she takes vit. D supplements. But her size hasn't improved. She does seem relatively healthy in other ways and luckily was the only one of 14 people (us and extended family visiting) who didn't get the stomach flu at Christmas... thankfully, because she can't afford to lose anything.

So no advice from me. Just commiserating.

 

I am just so happy that I found this board - you are all so wonderful taking the time to reply, and thank you for your well wishes for my daughter. I am really relieved to hear good things about the Failure to Thrive clinics. I'm hoping this will be helpful. We have been trying with the high fat/high calorie foods and the pediasure (and YES, it is expensive!) but I agree with the comments that it fills her up and then she doesn't eat much quantity and it doesn't seem to make any difference. I can really relate to the story of the 'ginormous' heads (my friend had the exact same thing happen!), i am nervous we will now put Addison through a dozen invasive/or whatever type medical tests all because she is just small. But on the flip side, I am nervous not to have it looked into just in case it is something. Sigh.

sorry, to answer the question - she was on the curve (3rd percentile) but we weren't worried as she stayed on the same curve. Then all of a sudden for the last 3 checkups she nosedived right off and is sinking. it is scary to see the curve.

It is really interesting to me about the heart murmer situation. My daughter was born with a hole in her heart, and a duct that wasn't closed. I asked the cardiologist specifically and he looked at me like I was an idiot and told me there is no relation to weight. ? I think I will follow up on that one.

thanks again for your replies!

 

oops - forgot to say - yes, I am quite thin myself and always have been so it could be genetics although I was never close to as tiny as she is. I am adopted and don't know what else is in my background....my hubby is stocky and it definitely doesn't come from his side of the family. LOL

 

:hug: I know both of mine are on the small side but when I look at DH and his sisters as kids, they were super skinny, so that's where my two get it from. We have been doing a high fat diet with them and just at their 3 year check up, DS is 20% for weight and DD is 10%...they had been at 5% or lower since age 1.
I am sorry your Addison has had to go through so much testing and I hope the FTT clinic will have answers for you :hug: Please keep us posted!

 

while I completely understand your concern (my DD at 4 1/2 is just barely 35 lbs) FTT is also about meeting milestones, and general health...I spoke to my pedi about this after one of my nephew's OT's (he's disabled) asked me if she was FTT when she was around 2 (was barely 23 lbs) - so of course I flipped my lid too (she's always been 5th %ile or less) - if she's meeting her milestones, generally healthy (doesn't get sick more than any other kid, is active, is learning) etc...then she just may be a small kid...is she lethargic? doesn't sleep well? that's also part of the bigger picture...

I'm glad the medical testing was all negative, and I hope the FTT clinic gives you some answers, but please also know that she may be normal!

 

I have found it best to give pedisure at night after dinner.

 

I'm sorry I didn't get a chance to post yesterday. Both of my twins (ID boys) are FTT and have been for a very long time. We've never made it to the charts. No one is small like this in either side of the family. We have done some testing, but still need to do a couple more. Reflux was an issue for both since birth. So we were being seen by a GI. Our GI left his group to go out on his own (he's the very best in the area), and we can't afford to see him anymore, as insurance won't cover. So we tried another at Children's who was AWFUL. So we haven't been back to anyone since. Insurance changed this year, so we may try to get back and see him again soon. I'm positive Joshua still has it.

Anyways, have you done the bone age xray yet? If so, did it show delayed growth? That's the one test we still need to do, and it's not invasive. We still need to do the bloodwork for growth hormone levels also. Everything you mentioned seemed to be tests that a pedi or a GI would do. Seeing a team would enable you to come at the diagnosis from a genetic and or endocrinology point of view also. If I'm not mistaken, they also have feeding therapist to at their disposal if needed. It may be just what you need to either get a diagnosis or rule everything out.

We've been doing pediasure for ages. But recently decided that we only saw a negative with the amount of sugar. So we opted to take them off. Jesse was supposed to get no milk and only pediasure for a long time. He's smaller than Joshua. We are now giving whole milk and adding chocolate syrup. If I can get them off sweetened milk, I'd be very happy!!!

FTT sounds awful, but the label is needed for insurance purposes to allow for further testing. It doesn't mean that they aren't "thriving", sometimes the Dr's will even use Failure to Grow or Slow to Grow instead, just because it doesn't sound so bad to the mom. If your anything like me, you've tried everything you know to do to get your child to gain weight. Our issue isn't necessarily that they don't weight enough (they don't), but that their height to weight ratio is off the chart. They are much closer to the chart in height than weight. And that is more problemsome than weight alone. The big red sign, so to speak, for you is the fall off of her own curve. It may just be that she needs a bit of help gaining. Has anyone ever mentioned an appetite enhancer? It works for some, some have to use it on and off to keep the benefits, and for some it doesn't work at all. We've never tried one. But, other FTT moms I know have tried it and have seen very good results.

Anyways, I've been there for a long time, if you ever want to vent. It's not fun. But hopefully you'll either get to the bottom of why she won't gain really soon. {{{{{{{HUGE HUGS}}}}}}}

 

I agree, I have up until the big dip off the chart been trying to look at the big picture and thank goodness she seems otherwise good so I haven't been too worried, just figured she was just small. I think sometimes all these charts and statistics can be misleading. But with the dip, and the extreme low weight I guess we need to rule out any other causes.....

Nini - thank you so much. I am very, very sorry that you have been going through this for so long with your boys. It must be stressful and worrisome. I know mealtimes around here are very stressful for me although I try very hard not to show it to the kids! I'm glad that you have resources available to you and hope you get back with your good specialist soon! I appreciate the info on what tests could be done, we haven't done any of them you mentioned so I'm guessing those will be the next step. I hear you on the sugar. I struggle with wanting to feel them healthy but then just having to do whatever helps with weight gain. I think a feeding therapist would be helpful....I never even knew there was such thing! I will let you know what they find out and am thankful for your offer to let me vent sometimes...and hope that if you ever want to vent you can come to me and we can vent together!

Funny story though - I took my kids to a play center and a Mom came up to me and was absolutely AMAZED at how incredibly ADVANCED by little girl is. She was raving about how she is already walking and then Addison came over and said something to me and the lady just about lost it. She said in complete disbelief "She talks too??? But that is so unbelievable!!" I didn't understand at all what was up with this lady and finally I clued in and asked her how old she thought my daughter was and she said 9 months!!!!!!!! Of course she was 20 months at the time and doing all the stuff a 20 month old does!!!! I thought on the way home that I should have kept up the pretense and pretended she was just a genius child. LOL!!!!!

 

Awww, funny, but not then also. I had those moments of people not understanding that the 18 month old in the infant car seat was not still an infant.

 

Nini, I never heard of an appetite enhancer. Can you tell me more about that? Getting Sabrina to eat is such a chore. She just gets full at the drop of a hat. Plus she gets tired from chewing it seems, and just doesn't want to hassle, I think. She's not on the chart for height or weight, and her weight to height ratio is only like 15th percentile (and that's when it's up). She's just plain scrawny. And like you, the incredibly tiny size doesn't seem to run in our family. Most of my kids are on the short side (except Spencer), but still between 20th-45th percentile. And my oldest son would definitely be considered thin. But again, not in any kind of worrisome way.

 

Dielle, the antihistamine Periactin has an appetite enhancer side effect that may work for some. Like I said, I've never used it myself as it has never been prescribed, but there are many FTT moms (from FTT boards I've found) that have used it with some success. I have been very tempted to ask for some for Jesse, as he's the one who has more difficulty eating and is smaller in both height and weight. It can have side effects like drowsiness or excitement. It can also loose it's benefits. A lot of time the Dr and parents have to play with the dosage and timing. Like having them on it for 2 weeks and off of it for 2 weeks.

Any weight gain in some FTT children is so important. It's worth a try if she needs to gain. My guys are getting closer to the chart and not falling away anymore. But like I said Jesse can loose at a moments notice.

I should also say, that while my older boys are not FTT and NEVER have been even close. They don't gain weight easily. But it's due to a very competitive hockey program they are in. My oldest skates 7 days a week during the main season. If he gains a pound during that 7 month period, I'd be happy and shocked. But he his height to weight ratio is like in the 40%. Good thing muscle outweighs fat. MY middle son just started the program this year and seems to be doing the same thing. Although his height to weight is more like the 15%. But still anything between 5% and 95% is considered normal.

 

I'm going to throw a bit of a wild theory out there.
We have a friend who's youngest daughter is a peanut. I remember that at 4.5, she was just growing in to size 2t clothes. She never age much and seemed to graze tiny bits when her mother could get her to eat. The little girl is also adopted from Guatemala, so it's very likely that she's just tiny, ie genetically from indigenous parents who themselves were under 5'.
When they moved to the US, the little girl got better dental care and started eating more. The dentist hypothesized that the little girl's teeth had hurt, which discouraged her from eating. She's still at peanut (about to turn 7), but she's put on alot of weight and grown a ton. She's still smaller than her classmates, but she looks like she's just small, not necessarily younger.

Maybe it's worth looking in to things that may discourage your daughter form eating. Teeth that hurt. Or throat/mouth pain. I know I'm grasping at straws here, but I thought it was worth mentioning.

 

There do seem to be other things. And she has horrid teeth. My older 3 kids have had from 0-2 cavities each, and got their first after 7 yo. Sabrina got her first huge cavity in a front tooth when she was 2. I don't know if it's related to being twins, but both the girls have considerably worse teeth than my other kids. She doesn't complain about them hurting, but I'll talk to her about it. She does have regular visits to the dentist and is due to have a cavity filled next week. And I actually take much better care of their teeth than I ever did with my older kids at young ages (I'm embarassed to say that it never occurred to me with them to floss for a toddler). But she has a hard time chewing stuff. It takes her so much longer to eat a bite of anything, than any child I've known. And if it's something that really takes some chewing like raw veggies or most meat (except well ground), it's almost impossible for her to chew it. I've mentioned that to the Dr. but I think I'll pursue it again, and see if it's something that some OT could help or something. But adding pediasure and other easy to swallow calories hasn't seemed to work, either. I don't know. ug!

 

Hi there -

I think it is great to think of different ideas of what might be happening. I'm definitely going to think about whether there is possibly anything (like teeth) that could be hurting. I know my little one has been teething a lot so maybe it is that!

Oh my goodness!!! I never, ever would have thought of flossing my toddlers teeth. I always feel proud if they get brushed once a day. I can't even imagine getting that done. Do you find it hard?

I'm not sure at what age the Dentist is able to do this, but last time I was there, they told me that if a child has 'weak' teeth (i.e.: lots of cavities, 'weak' (probably not the right word) enamel, they can paint on this liquid that will strengthen them and reduce the cavities. Might be worth asking your dentist anyway.

 

My kids have had the painted on stuff. And I use little dental flossers kind of like thisto do their teeth, which is sooooo much easier than trying to get my fingers in their mouth with regular floss. I only do it once/day right before bed, and honestly it's more like 5 times/week.

 

My daughter was 3 % and then dropped off the charts with a slow increase upward. SCary. I want to recommend the book "Child of mine: feeding with love and good sense" by Ellyn Satter. It really helped me so much. Other suggestions would be to check the internet for "high calorie toddler foods" and see some good stuff.

Pedisure was great, two cans a day can actually give them all that they need for a day.

I added cream to EVERYTHING !! I just had a container in the fridge and mixed it with veggies, oatmeal, everything !!
Butter to everything..
Frequent snacks -- some kids do better having small snacks every couple of hours.
Make sure YOU eat. Everytime I brought out food, then it made them hungry too.

As the previous posts (pp) mentioned... sometimes you need to look at your family too. My husband isn't a large person so it can easily be genetics as well. Just make every bite count yet try to find a way NOT to stress out at meal times because it makes it worse. I know a mom of a 8 year old who still repeatedly tells her daughter to EAT EAT EAT then ends up spoon feeding her -- it becomes a control issue for the child. NoT what you want.

TRust YOUR instincts not the doctors. If YOU feel it is ok, then likely it is.

Heather