How to put weight on a kiddo....

DD (6 yr 2 months) went to the Dr for a check up on one of her medical conditions (gastrointestional) with a new Dr. She weighed a whopping 37 lbs even fully clothed.


He was not too concerned, but wanted to keep an eye on it. Especially since she has not changed shoe size in over a year, grew 1/2 an inch since summer-- but lost a lb or so. BUT different office, differnt scales. So best case--- she has not lost/gained/grew since June or so.

She is not a picky eater- but is on a high fiber, low acid, low dairy diet due to medical conditions. She eats a normal to low amount for her age.

Any ideas?


She wont drink buttermilk and we put butter on everything. She cant take nuts to school, but at home we do A LOT of peanut butter/Nutella.
She has a shocking amount of energy (though not hyper at all) and is alert, aware, and active.



FWIW: her fraternal twin is about an inch taller and 44lbs.

 

Avocado? Whole milk or 2% when she does do dairy? :huh:

 

My mom always encourages malts/shakes. That is what she did for my brother. Some kids are just naturally small. They get on the bus with a girl who is in a grade higher than them, but she has to be a good 10 lbs lighter than they are. She is just tiny. Good luck!

 

I was going to suggest avocado too - if she won't eat it like it is, you could make it into guacamole, or put slices on sandwiches (it's delicious with turkey, for example). Also, what about the protein drinks, like Ensure?

 

Pediasure is how we got jessy to weight the only issue is that it's hard to get a balance where they are still eating enough real food and still drinking the pediasure. We did it at bed because she was still drinking a cup before bed (and never had an accident). They have recipes for things like milkshakes and other desserts using it. I use a lot of butter on her food too

 

My neighbor's daughter across the street is 8 and 45lbs. She is small boned and it is the right size for her frame. The doctors do tons of tests and there is nothing wrong other than she is tiny. I'd relax and offer your DD full fat foods but let her make choices about what she wants to eat. One thing to note, many kids (the girl across the street and my son henry who is 24lbs at 2.5) will eat the same amount of calories which means when higher calorie food is offered, less is eaten. You say your doctor isn't worried. I would not stress about (easier said than done) and just try to offer her the food she needs.

Olives are high fat, avocados, and you could try to find high fiber bread that has a higher calorie count. Good luck.

 

Yes one of the twins friends is 8 and and is jessy's size

 

I was going to suggest avocado, nuts and something like a Pediasure as well. Can you make her smoothies or shakes with a yogurt or icecream she can eat and add in some higher cal stuff (maybe some oils, peanut butter, etc.). What about gravies? I did want to add that Abby just recently put on about 4 lbs. She stood still at 37.5 lbs. for her whole 5th year. Her shoe size remained the same as well. But, all of a sudden over the summer, she put on about an inch and 4 lbs and grew a shoe size. Her Dr. was never really worried, but I was kind of glad to see that growth spurt. At 6 yrs. 2 mo., she is 41.5 lbs and 44 1/4 inches tall.

 

Avocados, full fat dairy, shakes, butter, cheese...that's all I can think of at the moment.

My 5 and a half year old is a whopping 32lbs fully clothed. I doubt she'll get to 37 in a year. I used to worry but don't anymore. She's healthy, active, smart, and eats well. I never refuse her food if she asks, but don't push stuff either. She would never drink the pediasure. Hopefully your DD will go through a growth spurt soon and all will be well. I know how hard it is not to worry.

 

oh wow Lou - I know she and Abby were neck and neck for a while - Abby is FINALLY 40 lbs at 5 and a half...

 

She just might be a thin, tiny girl.

My Sarah will be 8 in a month and is about 48lbs. Timothy is about 48lbs also. He's just a bit taller. Sarah's just under 50" and Timothy's a little over 50". I'm not sure exactly where they are since they are having a growth spurt at the moment. Their swimming teacher has commented that Sarah's just built like a ballerina. Timothy looks to me like a little spider. He has these thin, stick-like arms and legs.

Sarah spent 3 years wearing the same shirts in the summer. Some of her winter shirts are still the ones she wore in kindergarten also. (She's in 2nd now). She spent 2 years in the same jeans. Some of her shoes are on their second year also. I know some of her shorts will probably get a 3rd year. She seems to grow more in sudden spurts. Timothy seems to grow more gradually and constantly. At one point, there was at least 3 inches between them. Now it's back to an inch difference.

Both the kids eat fairly healthy. Sarah especially is a healthy eater. She loves her fruits and veggies. Both are active. I actually don't try and add calories. As someone who had an eating disorder at one point, I'm afraid of setting up habits that they kids will struggle to break as grown-ups. I also think our definition of normal is skewed with the rise of obesity in kids. My kids are the about the lightest in their classes (I help the nurse and I've seen the lists of the kids' weights by class). Multiple kids weight double what mine do.

If your dr. isn't worried, I wouldn't worry about it. Sarah grows in fits and spurts. She's growing right now, but it's definitely been about 2 years since the last big growth spurt. In fact, Sarah's been complaining about Timothy getting new clothes and she doesn't get any. Now's she's been getting some and she's thrilled.

Marissa

 

Coconut oil is good, too!! I like it on pancakes and things like that. Sweet potatoes, too! It could be a good butter replacer if you want to use that "dairy allotment" elsewhere (we love 2% greek yogurt here). Avocados as others have suggested. Bananas are fatty as far as fruit goes, too. Chickpeas? Good for fiber and fat - you can even "spice/season" them and then bake them in the oven for a pretty tasty crunchy treat. Dried fruits are dense in calories too (dates, figs, etc), but might sort of train her palate the wrong way, ya know?

 

My girls are 7 and at 39 lbs. They are also 4 ft tall. Our ped hasn't been concerned with it, but all of our kids have followed pretty much the same pattern.

Since she's low dairy, I would concentrate on carbs, fruits, etc. You want to get extra calories in her but not accustom her to eating junk. Maybe protein powder mixed in some of her foods.

Good luck!

 

We have struggled with mitchells weight since he was 18 mos old. He was diagnosed failure to thrive. The biggest helper for us was periactin. Its an antihistamine but side effect is weight gain/hunger. We used that combined with 4-5 pediasures/day plus normal eating and gained slowly. He is now 6.5 and weighs 38/39 lbs depending on what scale we use. Oddly enough his twin weighs 39 lbs and nobody has ever been concerned about her weight. I try not to stress about it but we do try to let him eat when hes hungry. But he usually chooses the healthy stuff. Its so hard with low dairy since that's where so much fat can come from! The pediasure website does have great recipes but pediasure is pretty gross. If Dr isn't worried I would try hard not to stress. Sounds like you are really on top of things and doing a great job. All my kids are on the small side. We thought my oldest was never going to grow...but finally at almost 12 she is not super tiny for her age anymore.

 

We still do whole milk for both DDs actually!! The Dr said since they are small the fat is good. I wish she would eat avocado.....

We've tried Pediasure....but the more she drinks, the less she eats.....so I would rather get the calories from food rather than drink. Plus the pediasure created a while new element to her gastro problems!!! No fiber in it at.all.

That is good to know. My DD is 44.5 " and 37 lbs. It is not the weight (5th %tile) so much as her BMI is at or below 2%. Her curve has slowly gone down. She is gaining, but not at the rate they would like to see.

The Dr is new and he made a note of it and plotted from her records past weight. He wanted to watch it (which we have done before) since even though she is slowly gaining over a year, her height growth is faster (20th %tile) and her BMI is dropping.

If she was shorter, it woudl not be a big deal.

We will have to see a nurtritionist if it continues.

I wish she would eat gravy. She does not like condiments at all , which is fine since ketchup and mustard are both too acidic for her to eat every day.

We do a lot of carbs, in fact she LOVES carbs. But 80-90% of her carbs have to be high fiber & whole grain. We do a lot of fruit....but the high calorie ones (bananas!) are not so good for preventing constipation!


I think if we could do more dairy, we would have better luck keeping her weight up (she is limited to about 1/2 the normal dairy input of a kiddo her age). But it is hard with the dietary limitations she has!

She will eat protein, but does not ask.



So far we keep it low-key. I do not push food nor do I allow her a lot of junk foods (we do eat out occasionally and she does eat dessert a few times a week). We dont eat all organic, but not take-out either. Kind of in the middle. I do not want to fuss about her weight too much and make her too aware of it.


It is hard since she was a the bigger twin at birth and until they switched to solid food. Since about 18 months she has has fallen further and further behind her twin-- who is now 7 lbs heavier (and they are both slender!). It would not bother me so much if she did not already have gastrointestional issues that I worry are impacting her growth.

Thanks ladies!

 

Is she on any medications that could be causing slow growth? My ODS is on a particular med that is slowing his growth velocity. Meaning, they think he'll grow, but it will be delayed from the med. The twins are tiny and their BMI is off the chart, so I know how you feel. They haven't gained in a year either. Pediasure used to be ok, but now makes Josh's reflux rear it ugly head. So we do chocolate milk instead. You could probably add protein powder to a fruit juice smoothy. BUT, if she already stops eating as much with pediasure, she'll probably do the same with any shake or smoothy. I've learned that one with my guys.

I wish I could change things and just make our kids grow...

 

I'd try to make a smoothie out of protein powder and ice cream (if she can eat ice cream). My cousin has a daughter who has always been very skinny. Her dr told her to have her eat ice cream, because she NEEDED to gain weight. Ice cream did the trick. She was able to gain 6 lbs in 2/3 months.

 

I was going to suggest peanut butter and nutella sandwiches before I got to the end of your post. My girls can take those to school, and since they've started their recent addiction to them, I swear they have gained noticeable weight!

I also am in the camp that if your doc is not worried, I would not worry. Gracie is small like this. She is maybe 35 pounds, and will be 6 in March. Lily is only 2-3 pounds heavier than she is. Gracie was the bigger twin at birth too, but Lily quickly overtook her. The women in DH's family are quite petite - small feet, short stature, can eat whatever they want and stay skinny...so jealous. I am pretty sure that's what Gracie will be like too. She has the tiniest feet and they grow very slowly.

Maybe always serve a full fat dip with their veggies?

 

I'm leery of trying to put weight on a child for the sake of weight. I worry that it could lead to eating disorders later in life. She has energy, eats well and is otherwise thriving, right? Then the number on the scale is just a number. Our boys just turned 8. J is about 50" and maybe 50 lbs. He just burns energy. I joke with DH that our guys will be in high school before they hit the 80 lb mark to graduate from their booster seats. As long as she is thriving, I wouldn't pay attention to the scale.

 

That is what my girls pedi said at Sydney's well check visit last year , or maybe 2 year ago. She said the best thing to do was to teach the girls healthy eating habits. I think Sydney is 40 pounds and close over 48 inches.

 

My oldest has always been at the very bottom (or off the chart) for weight and 50% or higher for height. They weren't using BMI when she was little but in the last few years we keep getting info that her BMI is too low. She is healthy, active, smart with no issues at all. She just has NO body fat, even going through puberty! I agree with the others that as long as she isn't sickly, she's right where her body wants her right now. I've continued to offer higher calorie healthy foods (and sometimes treats) but she chooses what to eat and we go from there. We could add things like chips and soda every day that some of her friends eat but why? It would put weight on her but not in a good way. Try not to worry (although with other health issues, I know it's hard).

 

Before I read down to see your later post, I was going to say she's almost the same as Sarah (who just turned 6 and only hits 38 lbs fully clothed). But Sarah's also barely 40" tall (if that), so that is different. However, FWIW, Sarah's barely grown in the past year and eats almost nothing.

Sarah was the bigger one at birth and until about 12 months, but now Amy is almost 3" taller than Sarah and at least 3 lbs more (haven't weighed her recently, but I know she's over 40).

However -- given that she has known GI issues (which it sounds like is the primary reason for concern), I would see a nutritionist. Actually, I would have seen one already if I were you, just because given her dietary restrictions, I would have needed some help with figuring out what to feed her! (We may be headed that way ourselves -- no one has ever seemed concerned about Sarah's growth, but her picky eating and frequent "tummy aches" are an increasing problem in our family.)

Anyway, good luck!

 

She is thriving, yes. But the Dr. is watching it-- he is concerned enough to have mentioned it at her first visit after plotting weights and taking her history.

I would not put weight just for weights sake. The concern is her BMI is very very low and given her health problems (GI issues and severe relux) it is an issue. If she was just slender and could eat a regular diet, no worries. I have a slight build- she looks to follow my genetics. But given her history and the fact that she is falling off her own growth curve is worrisome.

The Dr did mention she was doing well and seemed healthy other than specific concerns, so he would check it out again in a few months. He did NOT tell me no big deal, she is tiny. He said we will have to watch it and he will recheck her in a few months (which I was hoping to add some weight between now and then!)

Yes, I do not make a big deal about food as much as we can. Yes, she does need to be aware of what she can and can not eat to keep her medical concerns in check. But do we make her eat- no. Offer or beg her to eat seconds- no. Offer her junk food- not really very often. Stress within her earshot that she is too slender- no.

She is totally incontinent (related to her digestive issues) and she is aware of it. Between that and making sure she is eating 'right' , DH and I are very aware of of trying to make sure she thinks of it as a 'fact of life' not a problem or something SHE needs to worry about.

We have good habits, thank goodness. She knows to avoid citrus foods and always asks if she can have more dairy toward the end of the day. She is aware that too much dairy will make it hard to poop.

For example: today she had a small holiday brownie as a snack (little does she know it was a high fiber, flaxseed stuffed brownie!) and then asked " May I have a healthy snack now too? I still want something to eat." And had 6 whole wheat Ritz and a glass of water. She knew she would not be able to have more brownie (sweets), but still wanted something to eat.

Both girls know healthy from unhealthy foods.

Thanks!

She is 45" +/- a bit tall, so she really is too thin for her weight of 37 lbs even (clothing and all). If we were to cut her long long hair she would probably be even lighter. LOL. Plus, due to her digestive woes--- 90% of the time she is full of constipation, which though it adds weight, it is not the kind I am looking for!

We have worked with a nutritionist in the past, it was helpful. But I dont think at this point they would have any new info for me and insurance does NOT cover it! Luckily, we have had great OT & Drs in the past that have helped fill in food ideas.

A very real concern is that with decent eating habit and appetite she just is not absorbing the nutrients she needs due to her gastro issues (reflux and digestive/lower intestine).

She is not a picky eater and actually eats a decent amount, more carbs and less protein than her twin- but about the same volume.

Actually, it is not too hard- just restrictive in some areas (mostly the limiting dairy). We just buy A LOT of high fiber foods, dont eat oranges/lemon-based stuff. And yes, occasionally we will eat McDonalds and then just try to make sure that the rest of the day she eats extra fiber!


* have you seen a peds GI specialist? We have had a great experience with several (we have moved a few times) and that has been much more helpful than the nutritionist we talked to (though she was nice, it was not a lot I did not know already from previous Dr and nursing staff discussions). We were able to rule out lactose/wheat intolerance. The DD mentioned in this post does NOT get frequent stomach aches, but her twin does....turns out her twin is lactose intolerant. It was an easy fix, no dairy with lactose or give her a Lactaid supplement before dairy foods-- no stomach aches!! Fabulous solution and easy. Lactose intolerance runs in my family though, so it is something we considered very quickly. She did soy-formula as an infant and then seemed to outgrow it when a toddler and then had trouble again from age 2-5...surprisingly it has improved a bit in the past year. Mostly liquid dairy (ice cream, milk, shakes, whipped cream, etc) is the most troublesome, plain cheeses bother her a little and yogurt seems to be OK.**







She does take meds for asthma and digestive issues, but none of them hurt growth.


It is not a matter of just a tiny , thin kiddo- it is more a medically related concern that she is dropping down the curve and how to help heft her back up on a low-acid, low dairy, high fiber diet!

Yes, she has a Pediatrician and a Peds Gastroenterologist following her.

 

Thanks for the info about the ped GI specialist. I've thought of it, but have been reluctant to go there because our diet is SO dairy-heavy, it would be a major change in how I shop, cook, etc. (And she is so picky -- mac & cheese and cheese pizza are about the only foods she eats enthusiastically.) I'm sure once we got used to it, it would be worth it if she wasn't having stomach aches all the time! But it would be a very painful adjustment. However, of course I also don't want her to grow up in pain, finally get diagnosed with something, and then say "My parents never believed me when I said my stomach hurt!" :unsure:

 

This was me as a kid. Probiotics have completely changed my digestion as an adult. I had some success with Dairy Ease growing up but by far the probiotics have helped the most.

 

Yes, Probiotics are AWESOME!!

Both DDs eat an Activia yogurt daily, as well as a few times a week a probiotic kefir (lactose free) drink. Great stuff. Also, since upping probiotics- we have had a lot less sickness. Both of these count toward DDs 16 oz or less of dairy a day....so I try to make sure what she eats counts.


DD that is lactose intolerant uses Lactaid milk and ice cream. Good stuff. She does not like soy/rice milk and there is little to no fat in them. We also do coconut milk!

 

I wonder if she would do well on periactin to increase her appetite? After we got the twins constipations issues more under control, they were considering an appetite enhancer. We ended up having to change pedi GI's, so everything changed at that point. The next step would have been to find out if they had slow gastric emptying.

 

Your child sounds like mine !! Not even on the charts. the constipation issues ... so constipated. As a child we'd feed her prunes, prunes, prunes...

We saw a Pedi who recommended "Lax-a day" (Polyethylene Glycol 3350) takes it with in every glass of milk (about half a cap full) it took a bit to figure out the right amount. I think after about 2 weeks I was able to figure out how much she needed. If we go away for a weekend even missing it for a few days will put her right back into constipation mode. We put it in 10 % cream -- the odd time we will buy Pedisure or a type of Toddler nutrition drink, but they get pricey. Every glass of milk is the 10 % cream. I think she drinks maybe two 200 ml a day (maybe). The Lax-a day is very effective for children, not habit forming, and AMAZING results for our daughter. It just gets everything moving, and it changed the way she eats, since she wasn't constipated and felt falsely full. I can't say enough about this stuff, it really changed her around. Oh it is over-the-counter at least here, I'm sure it is there too.

I find since we started the above she seems to be getting that extra fat, yet keeping herself regular. I find I don't feel like I have to watch everything she eats anymore, there are some days she eats more and other days she eats less but it feels more balanced now.

Hope you find something that works for your child too !


(nuts like cashews, 1/2 peanut butter & 1/2 powdered milk rolled into little balls, liverwurst pate type spread, almond spread, juices. I was bad and would give her a Reeses peanut butter cup the odd time, or some chips. )