Feeding advice needed

Quick background: My girls are almost 21 months old, adjusted to 18 months. They weigh 18.5lb each and are long and skinny things. We've never quite made it onto the growth charts but have been following the arc pretty well. I'm a petite girl from a short and thin family, my husband is tall and extremely thin from a family of the same.

I took the girls for their WB visit last week and was disappointed to learn that they are no longer following the growth curve- they've sort of plateaued. Only .5lb weight gain in a little over a month. Neither of them look unhealthy (they've got meat on 'em!) but the PA was concerned enough that we have a follow-up in a month. We went through the girls' diet and everything seemed normal, so we're hoping that they just aren't in a growth spurt and will pick up some pounds in the next month.

EXCEPT that they have just STOPPED EATING in this week since. It's a struggle! We do breakfast at 6:45 on weekdays, then a mid-morning snack, lunch at noon, a snack after naps, and a full dinner. We're pushing more milk, but it's caused them to flat-out refuse to eat a meal almost every day (which meal varies). Up until now I have not stressed over finicky eating once a day, I figured that they wouldn't starve themselves and knew when they are hungry, but now? Now I'm worrying!

What tips do you have? Any personal experience? We push cheeses, yogurts, veggies, and meats. They eat bread at one meal a day, minimum. I asked the PA if I needed to emphasize one food group more right now and she said no. I'm at a loss.

Alexis in particular is acting like she just doesn't like or want anything. We used to "top off" the girls with baby food if they seemed hungry, but that hasn't even been received well this last week.

Help!

 

I would not worry to much. I know when Sydney was about 2 she kind of plateaued on her growth chart. The pedi we saw that day said don't worry. You don't want to force foods on her or create bad eating habits later in life. This is also my girls who does no like to drink milk, so the pedi said let her drink chocolate milk. Now at age 6 she weighted 40.5 pounds on the scale dressed this morning.

 

I wish I had tips. My kids just don't eat (but they are big) so I can't imagine stressing over the fact that they don't eat on top of them being little things as well. I'm sorry you have to stress over this! I have to continue to say to myself, this is a game, this is a phase, they are using this as their only means of control or else I will go batty.

My eldest went through the exact same "I'm not eating" phase and thankfully it stopped, but it took a while to get there. Have you tried cutting out their milk in hopes that they will eat more? You are caught between a rock and hard spot. Obviously I have no tips, but just wanted to say that this too shall pass and I hope that they start eating and gaining for you soon!

 

How about peanut butter and avocados? I have some friends who use those when they are trying to get their kids to gain weight. Peanut butter toast or PB&J are good ways to get in peanut butter.

My boys are very big for their age (not quite 21 months and 30 and 28 lbs), but I have a friend whose 3 year old weighs less than both my boys. The pedi (we go to the same one) has been trying to get her to push more milk and protein sources, but also said that he appears healthy, just small for his age. And his dad was much the same when he was that age apparently.

My thinking is you can't force your kids to eat, nor should you, since that teaches bad eating habits (eating when not hungry, eating past fullness, etc.). But you can try to offer some more calorie and protein dense foods and hopefully they will eat them. As far as the milk, what about giving it to them in between meals rather than with meals? Or even before bed as an extra snack?

 

I'm thinking that this coincides with the cold that Samantha has? My two don't eat if they're sick. Maybe Alexis is catching it?

If you want a list of high calorie things, PM Tarin. Her Grandt and Grayson are on high calorie diets.

 

So whenever we switch Henry to high calorie foods, he consumes less to compensate. Just wanted to warn you about that.

 

When my twins don't eat, I give them a milkshake which they always drink. That way I don't worry about them starving.

 

I know exactly how you feel! Jess and Josh are still off the charts for weight. Do you give them pediasure or whole milk? Either way I would start adding a tablespoon of heavy cream in that. It adds a ton of calories without adding bulk. Also, there are calorie powders that you can add, such a duocal, that do not change texture or bulk. You can put it on anything.

I know someone suggested cutting milk to see if it helps, but unless the pedi wants you to try cutting milk, I wouldn't chance it. I'd keep them drinking the same amount of milk. There's plenty of time to try that approach when they are older and have more weight/fat. They need their fat right now. I didn't try cutting milk until they turned 4 and it worked for one boy. But they were around 28 lbs at the time. So they had a bit of reserve just in case they didn't eat enough.

If they stopped eating, they may be coming down with something. I know the more I stressed over eating the worse things got sometimes. But I completely know how you feel!!!

 

I think it's normal to not have much of an appetite at this age. Even my little piggy boy twin has lost interest in food. I make shakes for my skinny older son with milk, peanut butter, bannana and honey - wonder if your little ones would drink shakes?

 

One of my girls did this at 15 months. The phase lasted about 2 months. I basically did exactly what everyone else is recommending that you do, which is keep offering high-calorie, nutrient-dense foods, e.g., milkshakes, butter, avocado, nut butters, eggs, cheese. Unfortunately, there's not much else that you can do.

 

I was also going to suggest milkshakes, smoothies, and pediasure. One of my girls only gained 2 lbs between 6 and 12 months. To this day they're both tiny. We gave them pediasure for extra calories, as well as milkshakes and smoothies. Act like you're making it for yourself and put an extra straw in it.

 

When my oldest was this age we lived on pediasure. The one thing our ped hammers home is they are not going to starve themselves. If they are truely feeling hunger they will eat. and they will eat whatever you put infront of them. One thing my kido's LOVE is Quaker Healthy Harvest Banana Walnut oatmeal. They have that for breakfast nearly every morning. Good luck. My oldest dd has never been on the chart, she is almost 10 and was 49.5 lbs at her last appointment and the twins ds is in the 5th and dd is still below the 5th. But they are chubby and healthy.

 

I stress a LOT about my son. My girls are the same age as yours and now weigh the same their brother (all of them are about 30 lbs) and he just turned 4! At his last check-up it showed he had LOST weight. I think it was because his last check-up was in the winter and he had been wearing heavier clothes but at any rate, still not good.

I have actually been trying to cut out snacks. I find when my kids eat too often (they tend to like grazing) they don't have any really good meals. The afternoon snack I find really affects dinner so I really try to limit it (obviously if they are starving I feed them). If they haven't snacked they usually eat a really good meal. Another thing I've tried is smoothies. I have a really good book called Juices and Smoothies for Kids when he's not hungry or refusing to eat this can be a good way to get something nutritious into him. You can add nut butters or other high fat/calorie foods like avocado too.

I keep trying to tell myself it's just his genetics. I'm tall and thin, as is the rest of my family, and my husband is not a big guy so chances are he's just not going to be a 6'4" 250lb football player but it's hard not to stress especially when his baby sisters have caught up to him . As long as your girls are active and healthy (which they sound like they are) just try keep doing what you're doing, it's probably just who they are .

 

Thanks everybody for the suggestions. This has become incredibly frustrating and it's really worrying us. They ate virtually nothing today. Gaah!

I hadn't wanted to try shakes yet for fear of it becoming a substitute for regular meals, but we may be getting to that point. I'm going to give it through the end of the weekend (to see if it's related to the colds) and then I'm pulling out all the stops. I'll let you know which of these tips work.

The PA actually told us to push milk. I'm not going to lie, it is sorely temping to let them drink a night bottle again...

 

the one thing i was going to say is that they aren't supposed to gain a whole lot the 2nd year... like 5 or 6 pounds total... so... 1/2 pound in a month would be "average"... I wouldn't say that is "tanking"... and a pp mentioned maybe they have a cold?

at our 15 mo WB visit ours were both plateaued, like you said it was concerning. the pedi recommended pediasure, which I didn't do... I just started including a healthy snack instead.

I wouldn't necessarily think that the extra milk is what they need though, does it have the rounded nutrition like formula/breast milk? i know you want something in them, but not sure that a straight milk diet is the way... ugh for coming up with something good. at least with the pediasure they would be getting a more well rounded nutrition than with just straight milk. and maybe you can sneak in some yummy fruit to spice up the flavor and get them some fruits in.

 

You've gotten some great advice Stephanie and another alternative I wanted to offer (I had to do this with my skinny minnies) is adding Carnation Instant Breakfast to their milk for extra calories and vitamins. My BF suggested this to me because it was something she did with her oldest boy back when the pedi wanted him to put some weight on.
Keep us posted with how the girls are doing!

 

I really don't think there's much you can do other than what you're doing. I have a little guy (he is on the charts) and from time to time have worried about his consumption, but he's very clear at this age what he wants to eat and when he wants it. I'd keep offering cheeses, eggs, whole milk yogurt, and other things that are both nutrient- and calorie-dense (Pediasure is always a good supplement, although my son would never drink it). I'd be cautious about those powdered calorie supplements. I know a Mom who used them because her daughter would literally only eat Yo Baby yogurt and they can be very hard on the digestive system because they're so calorie-loaded. Her daughter struggled with them and stopped eating other food.

 

One totally different idea: I don't know what the weather is like where you are but when we had a phase of little appetite I found that my LOs ate better out of doors. We just took our normal snack into the garden and called it a picknick and I often needed to get more, way more than they usually eat. Something about the fresh air? Or something to do with more relaxed rules on table manners or grazing that make eating more fun (without enforcing habits I don't want in the house)?

I remember how worried I was when failure to gain weight happened to us and we were told to come in for an extra check-up although I felt they were healthy and active and doing well. GL, hopefully a growth and weight gain spurt will come soon!

 

Our oldest had a bottle MUCH longer than most babies. I won't say how old because I don't need to hear the critisisim but it was well past 2. She was getting dangerously close to the failure to thrive zone and the ped wanted her on pediasure and the only way she would drink it was in a bottle so thats what she got. Her doctor said he didn't care how she got the extra cals and nutrition from the pediasure as long as she got it and that a bottle would do less damange than not growing would. Do what you think is best. If bottles are the only way your little ones will take the milk or pediasure that you need them to then go for it. If you were breastfeeding alot of mom's wouldn't think twice so don't feel pressure to take that bottle away. Being underweight can and will cause more problems than bottles will. Braces can fix teeth

 

You know it probably sounds counter intuitive, but I would do what E's 3 said, and cut the snacks. I also would not up the milk intake. You find a lot of picky eating phases in the second year, and eating too much milk and offering food too often both make that worse. Also if they drink too much milk they run the risk of low iron. I'd offer them fewer meals with high calorie foods and add butter, full fat yogurt, and heavy starches.

 

My 1st ds was low on the growth curve then fell off it a little after 12 months. My doc didn't worry and just had him come in for a weight and measure once a month for the next 3 months. he slowly started back up on his own curve (not the growth chart curve), no problem.

I also have one that eats very little one daily meal, usually at dinner. I never worry about it. It sounds like you are offering up healthy choices and your girls are doing great. I would not change what you are doing. I would not want to make them feel too pressured to eat either. I agree with others about not pushing milk or really any other food. I would never go back to a bottle or baby food. (Baby food is just nasty mushy stuff)

Just keep offering the healthy foods and don't skimp on fat (which I'm sure you already know). THey need it to grow. Stick a little extra butter on veggies, and don't go low fat on your milk or yogurt or cheese etc.

 

Thanks, everybody! The girls are doing better this week. We're offering yogurt with every meal right now and sticking with the same menu items as before. We've dropped the morning snack and that actually seems to have helped a ton. They're eating peanut butter but, sadly, no avocado (bummer, it's one of my favorites!).

I've got my MIL and the nanny (daytime care givers) keeping feeding journals to add to ours and bring back to our appointment. It's tough because it seems as if their appetite has waned as their pickiness has increased. I think they're just trying to give me grey hair.

We're going to keep pushing!

 

Have you ever seen a nutritionist for FTT? I personally didn't think it helped us, but many other moms of FTT kids I know have had success with their nutritionists. It may be something to consider. Our family Dr recommend ours.

 

I think a nutritionist is the next step at the doctor's office if the weights haven't increased on the 10th.

 

Ah, that's good. The thing that reminded me of it, was that you said you had their daycare "workers" keeping food journals. Those really help the nutrionists! We had to be super exact so they could calculate daily caloric intake.

 

Glad that they are doing better. I'm not sure if you are giving milk at the same time as the food, but as a PP suggested, I would consider spacing it out a little. Maybe give them a cup of milk an hour or so before the meal, and then offer them a little bit more at the end of the meal. We do this at dinner time and it seems to work pretty well.

 

We have same prob here. My kids actually eat alot 4 times/day. But they eat only steam veggies, rice, noodles, eggs, sausage, fruit. I love veggies and fruit. My son eats less than my daughter. So I always offer whole milk yogurt at the end of lunch dinner1 dinner 2. They also drink 12-16oz of milk. They useful love cheese now don't care

Their Pedi said as log as they gain 1 lb/3 months, she is happy. So far their weight gain speed is at that pace. They are in between 10-25 percentiles. And I weigh them every 2 weeks to make sure they stay in the range. Very frustrating!

I add half and half in their whole milk and pancake. I use milk instea of water for pancake mix. I add butter in their veggies. I cook sticky rice with skinned green beans and coconut milk. And they love it. My kids are very active. So they always tall and skinny but healthy. I think yours are the same. Don't worry too much! Huggsss!

 

I don't know if your kids like mac and cheese, but here is a great recipe. I make it periodically and portion out and freeze it for easy meals for my boys. With trying to add weight, you could use full fat cheese and whole milk, which would ramp up the calories. I was making it this morning and thought I should share it. You don't even cook the macaroni first - very easy and my boys LOVE it. I will say, though, that it is very peppery - I suggest using at most 1/2 tsp of pepper, or even 1/4 would be enough if your kids don't like peppery things.

http://allrecipes.com/Recipe/ginnys-cheezy-macaroni/detail.aspx

 

That's an EASY recipe! Love it!

 

Have you tried not giving them their milk with there meals? My girls, if I give them their milk with their meals, they wont eat. So they get milk right when they wake up. THen eat breakfast 1/2 hour later. I do give it to them with lunch but sometimes they drink it and sometimes they eat and not drink, so if thats the case I put it in the frige and give it abck to them with snack. THen I dont give it to them with dinner, I give it to them about 1/2 hour b4 bed. SO i know they are driking it.

THat might help split it uop a little bit for some weight gain?! maybe. good luck!

 

We went in for our follow-up yesterday and left pretty happy. The PA agreed with our theory that the girls' growth declined when we took them off the thickened Enfacare. We went through our diet again and were told that we are doing everything right (despite them gaining only 4 and 1 ounces). The PA said she was going to confer with our doctor and would call if he had any concerns, but that she was going to sell us as happy, healthy, energetic, but small girls. Woo!

She called at 6:30 and said the doctor doesn't agree with us. We have to go back in four more weeks and may have to undergo testing at that point. I am just so drained with this!

 

Aww, Stephanie,I am sorry that the doctor doesn't agree with you. Do remember that it's only one doctor's opinion and any testing they do is probably a precaution. You are doing all the right things and you're a good momma for being so concerned. :hug: I hope the girls go through a big growth spurt this month and that you get good results in 4 weeks!

 

You know just looking at the picture of your girls. They have way more baby fat than Lena. Until about the last month, Lena has been very thin. She's 10th%, but I can tell you for a fact, she did not have as much girth as your girls do in that picture. I think 4oz. is a pretty reasonable weight gain in less than a month.

What's their height percentile? Do they have low iron or any vitamin deficiencies? If they were low on any vitamins or minerals I might be worried, but honestly, it sounds like your Dr. is being overly cautious.

Are they actually eating better or still being picky?

 

Testing isn't necessarily a bad thing. One of the first things they may do is an xray of their hand to see if they are growth delayed. If they are, it just means that they would grow for a longer time frame. Basic bloodwork might tell you if they have any vitamin deficiences. It is quite stressful though! Just keep doing what you are doing.

 

I don't think they would do a bone-age x ray with a hand, I don't think it's indicated in children under 2 for diagnostic purposes. They would be more likely to do a hemi-skeleton, however, under two they probably would choose to wait a year or a year and a half. I think malnourishment/vitamin deficiencies would be more of what they would check at this time.