Cause for concern?

Last time we were at the Dr. 6/2 DD was 17.8 lbs and 26 in. Today she was 19 lbs and 28 in. She went from 25th % to the 10th %.

The Dr seemed a little concerned and is having me see the nutritionist. She said that even if she needs growth hormones.. Its normally done with kids when they are 5 or so.

I know she isnt tiny, but she only gained 1.5 lbs in 4 months!!! And 2 Inches in 4 months!!!

Oh and DS is 24 lbs and 32 in! Hes such a BIG boy!!!

Thanks Ladies!

 

Your doctor has her entire history so if she is concerned, then I would take her advice and see the nutritionist. A low percentile itself is not a problem; it's when they aren't holding their curve that the doctor wants to look at possible reasons. Nutrition is the first step and I'd say it's awfully early to be talking about growth hormones since there hasn't even been any testing done. FWIW, I know someone who went through the entire process and her boy was eventually declared normal so there isn't always a problem if their growth rate is slower than average.

 

Ah yes... the joys of the small child. This is my life. All of my girls are small for thier ages. The first thing to do is not panic. See the nutrionist. They will likely have you add some fat to her diet to get her to gain. Usually, they want to see if they are just going through a normal plateau in growth before they jump to anything serious. You may have to do monthly or even weekly weight checks.
For my kids, they are super active and busy. There is no such thing as sitting still. The smallest of them also has asthma. The asthma took a lot of her energy to breathe and she was already burning energy being a busy bee, so we had to sneak in some calories she couldn't "use" up. It took a while but she has been gaining slowly. She's 3 yrs and 9 months and weighs all of 31 lbs. Heck, my 9 year old went for her check up today and she only weighed 49 lbs at this appt. She's in the 5th percentile in HT and WT. I thought for sure that she didn't gain anything over the last three months, but she gained a little over a lb. Some kids are just smaller than others.

 

QUOTE(momma*nic @ Oct 1 2008, 11:34 PM) [snapback]1007829[/snapback]
Ah yes... the joys of the small child. This is my life. All of my girls are small for thier ages. The first thing to do is not panic. See the nutrionist. They will likely have you add some fat to her diet to get her to gain. Usually, they want to see if they are just going through a normal plateau in growth before they jump to anything serious. You may have to do monthly or even weekly weight checks.
For my kids, they are super active and busy. There is no such thing as sitting still. The smallest of them also has asthma. The asthma took a lot of her energy to breathe and she was already burning energy being a busy bee, so we had to sneak in some calories she couldn't "use" up. It took a while but she has been gaining slowly. She's 3 yrs and 9 months and weighs all of 31 lbs. Heck, my 9 year old went for her check up today and she only weighed 49 lbs at this appt. She's in the 5th percentile in HT and WT. I thought for sure that she didn't gain anything over the last three months, but she gained a little over a lb. Some kids are just smaller than others.

Is there anything i can start doing now to add calories and fat? Shes a pretty healthy eater.

Typical day:
Cherios or kix for breakfast along with fruit and about 4 oz of milk.
Rice cakes for snack along with juice (90%water)
Lunch is typically a sandwhich meat and cheese along with fruit and water
snack an apple nutrigrain bar
Dinner a meat veggies and starch (Both of them typically throw everything on the floor and only eat the veggies..) Plus 8 oz milk
another 4-6 oz milk before bed.

They were both on Nutramagen and she was never a big bottle eater.. The most i ever got out of her was 4 oz every 4 hours. I am a little worried because she didnt gain that much and her %iles dropped (it seemed like dramatically to me)

Thank you!

 

Hey Ashley,
The first thing that comes to my mind when I look at your "menu" is that those things are all LOW LOW FAT!! You want to add some fat into there every chance you get.

Will they eat mac and chz and stuff like that?? Add EXTRA shredded chz to it too. Also, try to get her to eat shredded chz often throughout the day. That has a LOT of fat and they love it. (A fun fact I learned in school: All babies like cheese. It is palatable to 97% of babies!)

Cottage chz (full fat, I get 4% milk)
Avocado
Shredded chz
tuna with chz melted on top

See where I'm going with the cheese?

Oh and my Ped told me that when we do the switch to whole milk, which we're in the process of; they need more fat and Omega 3 fatty acids so she told me to buy FLAX MEAL! I did and it's full of the "good fats". I put 2 scoops on their food per day. You can buy it at a health food store.

Try not to worry. Just work HARD on upping the fat/calorie content at every meal. I wouldn't do anything that's low in fat. Babies need fat for many reasons. Look into the Flax Meal, it's good stuff for their brains etc.

I worry CONSTANTLY about what my boys eat. "Are they big enough? Eating enough? Gaining enough weight?" That's on all of our minds, I am sure.

Hope that helps!!

 

My girl are small and one went from 30% to 10% when she started to walk and has stayed in the 10th%or less since. My pedi is not concerned- we had 6 mon last yearw/ only height growth- no weight but last time we went both H/W had increased. She is simply petite- as am I.

I agree w/ PP - you need more healthy FATS on the menu.

Whole milk (add extra fat w/ Ovaltine)
Smoothies w/ whole yogurt milk/fruit/milk
avocados (high good fat)
Cheeses of all kinds (cottage, yogurt, string, regular)
nuts (If Pedi approves) or butters (sunflower butter, almond butter, peanut butter)
flax meal addition
add butter (not margarine) to foods


Get the info from the nutritionist and use it, but try not to worry. My DDs are tall and skinny and are just perfect!

 

Mine both went down in percentiles from 9-18 months, and didn't gain a whole lot at all. I think it is normal. They've started moving and burning more calories, but their eating hasn't quite caught up yet. After 18 months mine climbed back up to their normal percentile and are still there.

I definitely don't think it would hurt to see a nutritionist. And I agree with the PP's on adding more fattening things to her diet. But I would hold off any growth hormone discussion for a good long while. She may just be at a normal age plateau.

 

I agree with pps...I don't think it's unusual to drop off around the one year mark, particularly with being more mobile and switching to milk. Mine have consistently been around the 3rd% (with the exception of falling "off the charts" for a couple of months).

Do not be alarmed. I am surprised about the growth hormone comment because that seems totally out of place and way early.

Definitely see the nutritionalist but like pps...more fats in her diet might help.

I ditto everyone on cheese...we eat lots of cheese and baby yogurt (full fat). I also add butter or olive oil to their foods as appropriate. Peanut butter if that's okayed...those kind of things.

 

I agree with the comments on the menu.

For breakfast try waffles, bananas, french toast, pancakes - anything of that nature. use butter not margarine.

for snacks try fruit, crackers, full fat yoghurts, cheese sticks.

for lunch/dinner - pastas with cheese, sauce , pizzas, fish sticks, ground beef or turkey sauce. always a fruit for after.

You can still be careful about what they eat. I try not to give mine sugar if I can help it and I try and use wholewheat or grains where possible.


I think you should be able to do this without the growth hormones but definitely meet with the nutrionist for more advice.

 

Wow, I can't believe he even brought up growth hormones. Mine has been seeing a nutritionist for over a year and has lost weight then gained and is still only in the 1-2% (its right below the 3rd technically but we are finally on the charts again). The nutritionist will be a wealth of information. They do have stuff called duocal which is a powder which can be added to pretty much anything and adds 25 calories to whatever they eat and is tasteless.
We rely a lot on pediasure bc Mitchell is just not a big eater. One thing we use a lot is shredded parmesan cheese. We put it on whatever he will let us. We try to add cheese and yogurt daily as well. Sometimes though, with these little ones, they will only eat it the way they want to, which is why we use the pediasure. He drinks about 3-4 a day. We use it as a last resort after he won't eat anything else. My other kids are tiny too, so some is just normal, but its good to make sure. His twin sister isn't setting the world on fire with weight either but nobody has ever been concerned thank goodness. My 9 yr old is in the 3rd % for height so I just don't grow them big!

 

Full fat everything. As an adult, it seems counterintuitive to us. We think, "I must eat low fat! Must eat healthy!" With small children, especially toddlers, they are still growing and developing. Add fat to everything! Cheese, butter, etc... Use whole milk not low fat. Eggs, cooked in butter, with melted cheese. Grilled cheese sandwiches made with butter. Mac n cheese, add nonfat powdered milk and cheese. Oatmeal, add non fat powdered milk. Pudding, add non fat powdered milk. Milk shakes made with whole fat icecream. Add a few teaspoons of Carnation Instant b'fast to a cup of milk after dinner, just before bed. Fill'er up. Pasta with extra shredded parmegian cheese. Cheese filled tortellini or ravioli make good high fat finger foods. Loose the rice cakes. You need calories. Graham crackers and applesauce. Graham crackers and pudding. Fruit with cream cheese spread for dip. Cream cheese and jam sandwiches (It's like a PB&J with a fruity twist.) You have to sneak the calories in sometimes. They get tired of the high fat "diet" just like we get tird of eating "right" all the time. Keep up the fresh fruit but add some punch to it on occasion. Canned fruit in light syrup is good with Whole fat cottage cheese. Whole fat yogurt, I usually find it in vanilla, is good with fruit or animal crackers. As soon as the ped has okayed PB, it's good for them. High in fat and calories, lots of protien... a perfect toddler food if there are no allergies. Waffles, pancakes, french toast for b'fast. They don't need syrup. Just the fat and calories from a more "dense" meal. Bagels with cream cheese. Mini bagels are the perfect size for little hands.
If I think of anymore I'll post them.

 

I didn't mention it before because this is about your child but I'm feeding two high-octane need boys who dropped from the 25th at 6 months to 10th at 9 months to 5th & 3rd by 12 months. Introducing veggies/fruits/cereal solids really took them down. Once I introduced lots of high-fat and calorie-dense foods, they started to recover and came in near the 25th again at their 3-year appt. Your menu sounds short in fat and calories to me.

Is she allegic to anything? Have you introduced eggs? Nuts? In a typical week, T&T eat scrambled eggs or omelette twice, pancakes or waffles once or twice, bagel with cream cheese once or twice, and cereal once or twice. On the days they eat cereal, they're hungry again an hour later. They also love sausage and bacon so that's worked in there once or twice a week. Lunch is usually either a sandwich (containing peanut butter or mayonnaise & meat) or dinner leftovers. Afternoon snack includes things like nuts, fruits, veggies with dip, or maybe a little cereal and whole milk. Dinner is whatever we're eating though I might pump theirs up a bit with some added cheese or sour cream. They get dessert more often than not (ice cream, pudding, a cookie, a slice of bread with Nutella, dried fruit...)

 

Ok.. They do eat a lot of cheese.. I do give mac n cheese everyonce in a while, But its so messy. They eat pancakes once a week. They HATE eggs. They didnt like peanut butter. I gave them noodles with butter cheese and spinich, the other nite.. And they just threw it on the floor. Then i made some mixed veggies and they ate every single last bit, nothing thrown on the floor. I give them peanut butter cookies they seem to eat those. They get animal crackers and gold fish. I have not tried bagels and cream cheese.I also give them eggos. The "menu" that i listed above is what they get most days.
They also LOVE french fries and hamburgers. I just dont get how he is gaining weight and she is not. He is more active while she is more fiesty..

Thanks for all the great suggestions!!!

 

A 13-month old doesn't yet know what they like/don't like so I wouldn't cross anything off the list. I've had some foods they liked the first time they tried them (like lasagna) and other foods they are still not sure about (mashed potatoes). Keep trying. I know it's frustrating.