Changes in diet for underweight kids

I really thought my son would be fine at his weight check (4 yr well check today). He seems to eat well, definitely eats better and is more willing to try things than my daughter is, and I thought it looked like he was starting to fill out more...but he fell off his curve slightly again and is just under the 10th percentile for weight (he's around 60th for height - at least I think that's what it was - he's 28.9 lbs and 40" My daughter was 36 lbs and 43" - so no worries there.

Do you do anything differently when feeding your kids, if they are slightly underweight? Like I said, I thought we were doing good. Now I think I should make some changes, but not sure what really. The dr. suggested carnation instant breakfast daily. Have any of you tried this? Any other suggestions?

 

Pediasure or carnation instant breakfast made with whole milk is what we did for a long time. Along with other high calorie options. He about the same size as my two, but he's almost a year younger. So that's really great. And, he's on the chart too. Sometimes when adding high calorie drinks, it can decrease the appetite. So you'll have to try it and see if it makes a difference. I had to stop because the heavy drinks were causing reflux to rear its ugly head again.

I actually don't get concerned as much until their BMI drops to the "underweight" category. Which unfortunately just happened again. I think it's time to get them back to the endocrinologist.

We do a lot of sour cream, dressings to meat and veggies, olive oil and butter (if I can get them to eat it) added to veggies too. I'm not able to get them to gain really. I just pray their appetites increase enough for their metabolisms.

 

My two are completely off the charts for weight, one is off for height and the other is in the 10the percentile. Honestly, I don't do anything different. They both are healthy eaters and are doing well in school, and met all their milestones on time or early as they grew up. They are just tiny. I was always underweight growing up, the only time I've ever been a "healthy" weight, I was pregnant.

 

My DD was the same for a long time, 6% weight for 50% height, but she got up to 20% weight at the last appointment. I never worried about it... but she's 40 inches and 32lbs and pretty much has no fat anywhere, so I can only imagine what your son must be like.

Frankly I'm a bit wary of getting kids used to butter and other extra fats in everything.. IMO it promotes unhealthy habits that are hard to break, because they get used to the richer taste... I'd try and feed more whole fat foods (yogurt, cheese), switch back to whole milk... definitely try the carnation if you can, my kids hated it though so buy a small container... Another thing though is to look at your genes. If you or your husband are pretty slim, there just might not be anything you can do about it.

 

Timothy is officially in the underweight category for bmi. Sarah is borderline. The dr's have never said anything to me. (And we're finishing up dealing with kidney stuff for Sarah including surgery so the dr's have had plenty of chances to say something.)

I try to look at it in in context of the bigger picture. My dh and I are both tall and thin. Both of the kids are tall and thin. I've really been working to limit processed foods in of all of our diets. And I really don't want to start habits that will be hard to break when they are older. Both of the kids are active, especially Timothy. I think the combo of genetics, food choices, and activity levels is responsible for the kids' thinness.

If you're concerned, talk to your ped. after keeping a food journal so you can really see what calories and food choices are in reality. Then consider what habits you're willing to create.

Marissa

 

At Anthony's four year he was 36 inches and 30 lbs. I can't remember the percentiles, just that he was in the 1% for height.

The doctor suggested two snacks a day. I'm not very good at that though, but they do get one at school. She said not to give him empty calorie snacks either. Apples with peanut butter, yogurt, cheese, etc. She did also mention carnation instant breakfast, but for some reason, I'm not keen on that. I'm not too concerned about him, he's just a tiny kid. We go back in two weeks for a weight/height recheck. We will see if there has been any growth!

 

My two have always been on a low weight curve. When they were one and barely on a weight curve, one of the things that was suggested to me was carnation instant breakfast. I split a packet between two cups of milk 2x a day. I also gave them full fat yogurt, cheese and greek yogurt.
Pediasure was also suggested, but my kids did not like the taste of it. My friends have used it for kids to put some weight on and it's helped.
PS: With the Carnation, my kids only like the vanilla flavor.

At 4 years, my DD is now at 20th percentile for weight and my DS is at the 10th percentile. I still do carnation instant breakfast 1x a day. My kids are just not big eaters right now, they seem to have a good sense of when they are hungry and when they are full. Our pedi is happy as long as they stay on their curve.

 

My 15 yr old was labeled failure to thrive as a baby, my girls have always been tiny. Easton is tiny. My 15 yr old was taken off of infant formula at 7 months and placed on Pediasure by our old pedi. With the girls our old pedi told us to add heavy cream and butter and even lard to their food - umm no. She also sent us to the gastro dr who gave us some powdered supplement to sprinkle on their food. It only added 25 calories so I ditched that too. My new pedi is not concerned in the least and says that they are just small kids. They don't look malnourished, they don't act sickly, and we were not all meant to be the same size. My new pedi has never once pulled those stupid charts out. If I have a coupon I buy the pediasure, and they will drink it, I buy carnation breakfast but I use it when they refuse a meal. I breastfeed Easton and those charts based mostly on formula fed babies. All of my kids have free range in the kitchen, they eat when they are hungry, I keep healthy choices where they are easily accessible, but I don't do anything extra to make them gain weight.


Edited because I had help from auto correct LOL!

 

Kids are all weights and sizes. Everyone has their own curve. Many people will tell you not to worry their kids were little too and such. It's a hard call. Use your best judgement. If you feel he is not eating enough, fallen off of HIS curve, then do what you can to add some more healthy stuff to his diet. Mitchell was failure to thrive because he lost 3lbs when he was 18mos old. He was put on an appetite stimulant and 4 pediasure's a day. Now at 7 years old (today!! WOW!) he is 41lbs. Did the pediasure and appetite stimulant work? Who knows...he is still skinny and short. But he is back on the charts. Sometimes I wonder if when we take them to the dr and they have a huge drop....are they due for a growth spurt? Best way is to use your best judgement, offer more meat and potatoes and dinner and take it day by day.

 

The one thing that's unsettling to me is he wasn't always a tiny kid that was barely on the growth chart. As a baby, he was big - in the 75th percentile. He gradually dropped to the 50 then the 25. At one point he was in the 6th, then I think last year he was back on at the 10th and now he's slightly under the 10th - off his curve again. He probably fell off from the larger percentiles somewhere between a year and 18 mos. He weighed 24 lbs at age 2, so it seems crazy he's only gained 4.5 lbs in 2 years. I'd feel better if he was always tiny and stayed on his curve. As far as this yr vs last yr, the doctor said it may just be where he is in his growth spurt, he shot up in height and the weight hasn't caught up yet. But the fact that he grew so much in height proves he's eating.

I don't know where in his genes this comes from. Me and my husband were always bigger kids when we were their age. My daughter is pretty much following my trend - really tall for her age and normal weight. It wasn't until maybe 1st or 2nd grade I started becoming underweight - very tall and too skinny. From that point on I was never able to put on the weight and I was always considered underweight - up until becoming pregnant with the twins. (Now I'm close to what I was, but the twin skin and diastisis, doen't make me feel like it!) Anyway, I guess he takes after me, but I just wasn't like that when I was his age.

I don't like the idea of adding in a lot of high fat stuff either, even though I don't think he'll ever have a weight problem. I just don't want to send him down the wrong path. And I didn't like the idea of having to add the carnation into his diet either. But I guess trying a can a day for a little while is better than completely changing the way he eats.

The doctor didn't mention anything about going back for a weight check. It seems like a long time to wait until next year to make sure he's still on track. I don't know if I should take that as a sign she's not worried, so I shouldn't either? Or if I should make an appointment sooner to make sure he's not falling off track even more.

It's reassuring to hear there are lots of other kids with the same problem.

 

I knew a 6 month old who was 25 lbs. She gained maybe 3 lbs in 2 years after that. I think it's normal for bigger babies to fall off their own growth chart, otherwise they would end up obese at 4. So, I wouldn't worry about it.

From what you tell us though, it seems you have a very high metabolism, so there's no doubt your son got it from you. It's a good thing! I wouldn't stress out too much about it, just keep giving him snacks when he's hungry... what matters is that he's healthy.

 

My daughter started dropping off the middle of the growth chart around 9 months. She dropped completely off the growth chart around 18 months and we were sent to a pediatric GI (after much protest from myself - I had growth issues as a child that worked themselves out). The pediatric GI put her on an appetite stimulant and gave us several recommendations for boosting her calories. She does have texture issues (won't eat bread or anything that feels like it; she won't eat any dips; etc.). Her biggest problem was that her favorite foods were all fruits and veggies - carrots, cucumber, tomato, cherries, etc. She would eat yogurt (and plenty of it) but she couldn't eat just that. She would never take pediasure, kid essentials, or carnation instant breakfast. What ended up working for us was a couple of things:

1. We give her "super milk" (powdered skim milk mixed into her whole milk).
2. We make sure she still gets her yogurt and any cheese that she will eat.
3. We switched from toddler foods to bigger kid foods for the extra calories.
4. Hersheys. We started giving her one little bar of chocolate a day (which the pediatric GI signed off on at her last visit).

The pediatric GI has told me multiple times that I shouldn't be afraid to put butter in her food (being from the South, I was already doing this but that's a different story) or encourage her to eat dips or cream cheese (that's never worked for us though). His basic concern was that if her weight was insufficient, the rest of her body wouldn't grow and develop properly. 9 months later, we seem to have had our last visit with the pediatric GI as long as she doesn't regress after the twins come - she's back around the 15th percentile for her weight and 25th for height. But it's still a day-to-day struggle to get her to eat a sufficient amount for all of the running around she does.

All of that being said, I wouldn't implement everything we did unless the doctor expresses concern. I definitely didn't and don't want to take a healthy child that's slightly underweight and turn her into an unhealthy child that's the "right" weight. You might just try one or two things and see what his weight does over the next few months. If you still have concerns, you can always call the doctor or try some different ideas.

 

Jessy was failure to thrive caused by her heart issues. If you do pediasure I suggest it be the last thing you give them of the day other wise they decline other meals. We fed her when she wanted and what she wanted. She is very picky. She is better now than she was at 3 or 4. She doesn't eat any meat with breading. She loves peanut butter and luckily our school doesn't forbid it. She eats only carrots as veggies and fruit she will eat apples occasionally but she does drink juice

 

Some of my friends with little ones who have weight concerns swear by the blog www.chunkymonkeymenus.blogspot.com, written by a preemie mom.

 

thanks! I'll check it out.

 

When I asked about my DD's low weight gain, if there was anything I should do, the pedi told me not to add butter or extra fat into her diet. If she was eating healthy not to worry about her weight. I think that was the 3 year old well check. I'm am wondering if I get the same response at the 7 year old well check with the same pedi we saw at that well check. I think Sydney is the same weight she was last year but taller.

 

parents magazine had an article about that this month. if you need more ideas, maybe you could look online.

good luck, jl