Underweight daughter

User - posted on 12/17/2010 ( 28 moms have responded )

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My 15 month old is the in 1 percentile for her weight and 6 percentile for her head circumference. The pediatrician wants me to try to "fatten her up" by adding things like butter and cream to her diet. I disagree. It seems unhealthy to me. Why should I add unhealthy calories to her diet and teach her bad eating habits? She is very tall for her age (79 percentile), and she is healthy. She eats good and is developmentally on track. Should I be concerned with her weight and if so, what other suggestions do you have besides loading her up with fat?

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Sylvia - posted on 12/17/2010

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Ugh, no! Unfortunately some doctors don't seem to have a very good grasp of statistics :P Somebody has to be in the bottom few percentiles -- that's what percentiles *mean*. Are you and baby's dad smallish people? If so, why would you have a huge child? Is she healthy, gaining, and developing normally? If so, why the fuss about this one aspect of her growth? (It sounds to me like she's been concentrating on getting taller lately. What's wrong with that?) Is she breastfed, but being measured against an old-style growth chart based on formula-fed babies? If so, it may be the chart that has issues, not your daughter.

My daughter was 6 lb at birth and has always, always been at the bottom of all the growth charts -- but tracking the WHO breastfed-baby curve perfectly. It took her 2 years to get to 20 lb; at her 8-year-old well-child checkup she weighed in at 48 lb. There is NOTHING WRONG WITH HER. She has two not-very-tall parents (and some of the women on DH's side of the family are way short -- it's in the DNA). She's very, very active and burns lots of calories. She's not, like, a genius or anything, but she's bright and capable, does well at school, is active and strong and competent. Is she skinny? Yup. Is this a problem? Nope.

Weight isn't everything. If everything else is normal, I wouldn't stress about her weight!

Lucy - posted on 12/17/2010

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My son is very similar, he's always been tiny. He is now 3 and has just hit 25lbs. He is very healthy and eats plenty, he's just little :)

It can be surprising, though, how many calories and good fats (polyunsaturates and fatty acids) a child of this age needs in their diets, it's about 1000-1200 calories a day!

Although I wouldn't recommend upping your daughter's saturated fat intake significantly, children under two should have 3 servings of dairy foods like cheese or yoghurt every day, and never the low fat versions. You can also help your little one get everything she needs by giving her foods high in good fats like avocado, oily fish, olives, smooth peanut butter, sunflower seeds, corn etc.

Sabra - posted on 12/17/2010

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I agree with everyone else here There is no real need to add extra unhealthy fats to her diet. My daughter 14 months and just about the same as your daughter tall and weighs little. Just make sure she is getting some fats (but the healthy kind like whole milk) as it is essential for brain development. If your daughter is skinny it's the way she is meant to be as long as she is healthy. Either ignore her doctor or find a new one.

Tracy - posted on 12/17/2010

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Is she otherwise healthy and developing normally? If so then I see no reason to introduce unhealthy foods into her diet. In fact, the only real change I'd make is her dr....

[deleted account]

if you want to fatten her up, try getting her to eat healthy fats, avacado is a good one. i wouldnt add unnecessary cream and butter to her foods, i agree that seems unhealthy. or you could give her a pediasure a day. but if you feel shes healthy and eats enough, then thats probably good and shes just growing fast.

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Evy - posted on 12/19/2010

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I had the same problem with my oldest daughter since she was born she was always underweight, and she kept on being underweight 'til she was 12 yrs old, after that she was just right for her height and age and she was very petite, but very healthy, never did I give any fat to eat to gain any weight. When girls specially start developing, their whole body changes, I have 2 girls, and the younger one was just right for age from birth to now!

Marilyn - posted on 12/18/2010

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Get a second opinion! I had a pediatrician tell me to spank my daughter for wetting at age 7.(Spanking is now illegal in New Zealand) The second pediatrician did not believe the first had told me that. And he did tests which proved my daughter had minor spina bifida and had absolutely no bladder or bowel control. Today she is 35, has two kids and is perfectly normal although her daughter is showing signs she may have a similar problem.

Sylvia - posted on 12/18/2010

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It's true, little kids do need more fat in their diet than adults do -- "good" fat, though. They definitely should not be drinking skim milk or eating things labelled "low-fat" or "fat-free" (particularly because these things often have extra sugar, salt, or additives to compensate for the lack of fat). But there's a big difference between giving kids homo milk (3.25% milk fat) and giving them cream (which might mean anything from 10% to 35% milk fat).

I would never not give a kid butter (if said kid would eat it, which mine won't), but I wouldn't start putting butter on everything s/he ate just because s/he was on the 5th percentile, KWIM?

Keshia - posted on 12/18/2010

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Im not sure what percentile my son is in hes 17 months and only weighs 18lbs and 29in he doesnt even fit in 12m pants yet hes allergic to milk so i think it could be hes doesnt get enough of something to help him grow but he drinsk soy and takes a daily vitamin hes perfectly healthy though his doctor said theres nothing to be worried about he will just be small for a while and maybe as he gets older will hit a growth spurt

Jodi - posted on 12/18/2010

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"You know, I sometimes think health professions are too hung up on weight. It's almost like, the kid's fine and healthy, oops he/she's not the right weight, there must be something wrong..."

I agree, Kathy. Just a few weeks ago, my daughter had her Kindy health screening, and I receive a letter saying she is underweight, and a whole heap of nutrition brochures about what I should be feeding her. I just rolled my eyes and put them in the recycling bin. Honestly, she's a perfectly healthy 5 year 9 month old. Just because she has a low BMI doesn't mean there is anything wrong with her.....

As long as they aren't losing weight and they continue to grow, and they are not getting sick, I don't think we should make an issue of it.

Heather - posted on 12/18/2010

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Actually fat is healthy. Fat helps the body absorb vitamins. When adults eat too much fat, its unhealthy but for your baby fat will be great for her health. I would definitely feed her butter and cream. My son was in the second percentile in weight and a nurse told me that if we have no family history of peanut allergy, I could feed him peanut butter so I started feeding him straight peanut butter once a day.

User - posted on 12/18/2010

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What is she drinking? Try carnation instant breakfast, it is like chocolate milk and 2 of my children used it as a supplement for a yr.
As well as to be referred to a endocrinologist who can run blood work and bone scans to estimate what her growth rate is and even how big she will be. My daughter is very small as well and it is reassuring to know that it is just genetics!!!!!

[deleted account]

I would increase the fat intake but not with butter and cream. Why not eggs and avacados those have healthy fats. Fish especially salmon is great for that.

My daughter is finally in the 15th after months of hard work. We found that she just need to eat about twice what a normal child her age eats. She eats about as much as a 3 year old and she's almost 13 months.

Grace - posted on 12/18/2010

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My son has always been small and underweight, he is now nearly 11, when he was born he was 1 week overdue and whenever I had him out, people would ask if he was a preemie due to the fact that he was very slender, petite in frame and had very fine features he was very long though. He is still petite, still has very fine features, and still tall. He weighs under seventy pounds, which is nothing compared to my daughter who is only 11 months older and weighs 120 lbs and is also very tall. Kids grow at their own rate, all three of my children are very healthy, eat healthy, and yet are all very different, just as we all are. The world would be a very boring place, if we were all the same. You are the Mom, Kelli, you know your daughter, better that anyone else, even your doctor, so ask yourself, is your daughter happy, content, eats a healthy and varied diet? If your answer is yes, she is fine.

[deleted account]

You know, I sometimes think health professions are too hung up on weight. It's almost like, the kid's fine and healthy, oops he/she's not the right weight, there must be something wrong...

Mia - posted on 12/17/2010

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Oh I hear you! My boy was prem so we've been battling with his weight gain for many reasons. My paed is more than happy with him, he's on the 10th percentile for weight and is tracking upwards, although the dietician wants me to add extra calories to his diet. He eats well, loves his food, eats, plays, poos like a normal kid so I am over the push for me to fatten him up. His brother is only on the 5th percentile and they're both similar size to me as a bub.

But what's been suggested is what the dietician told me, add extra butter, cream etc to foods, cook pasta and roll it in oil (the good sorts of course), you can fortify formula if she's still drinking that and there's a supplement called polyjoule here in Oz that you can add to stuff also. Honestly I'm over it and won't be going back to dietician unless necessary, his paed is happy that's all I need to worry about I think! Good luck!

Renae - posted on 12/17/2010

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Adding butter and cream to a toddlers food is a very common practise for dealing with underweight babies. Most doctors will tell you the same thing, in fact all pediatricians and pediatric dieticians will probably tell you the same thing.

Kids need fat in their diet. You are thinking about "healthy eating" from an adults point of view, we have finished growing and fat just gets stored as fat on us. In kids however, the fat gets used up. Yes it is possible to give a child too much fat, but you would have to be feeding them a huge about of saturated fat. Toddler formula is also usually recommended as a dietary supplement.

I would recommend that you see a pediatric dietician. That way you can be sure you are feeding your child a healthy diet and giving her something to grow with.

Percentiles are only a guide and your child may stay in the 1st percentile forever and be perfectly healthy. However, the reason doctors become concerned when the child is outside of normal range (15th to 85th) is that the possibility of health problems, now and in the future, greatly increases as the child becomes more under or over weight.

You can always seek a couple more medical opinions and see if they all say the same thing.

[deleted account]

My older son is very small in height and weight, if he isn't on a really high calorie diet he actually will lose weight.

I would suggest getting a second opinion but if she isn't getting whole fat cheeses or whole milk she should be.

Sherri - posted on 12/17/2010

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My friends OLD pediatrician did this as well for her son. Wanted her to introduce 1/2 heavy cream and 1/2 homo milk for his drinks. etc. needless to say this is why it is now her OLD pediatricians office.

Kate CP - posted on 12/17/2010

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They need the fatty foods for brain and organ development.



Edited to add:

It's important that she get things like whole fat cheeses, butter, and yogurt and NOT light/lite milk, margarine, and low fat yogurt. She needs good, healthy fats. Kids this age burn more calories just growing so they do need a higher fat/caloric diet than an adult.

Jodi - posted on 12/17/2010

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I wouldn't worry if she has always been in the lower percentiles. My daughter was born 3rd percentile, and has frequently in her life dipped below that. She has also had times where she is higher than that, up at about the 10th. But she has always fluctuated around those percentiles. She is now almost 6 and is still right down around the 5th percentile. I don't worry about it. As long as she is eating well and not sick, it is just who she is. I was never a big kid, and was always very lanky, so I figure it's just meant to be.

Iysha - posted on 12/17/2010

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I also agree with the ladies about percentiles...I am 5' and my daughter's dad is 5'10....not on the big side. When I was pregnant, the hospital doctors kept saying my daughter was not to par with size for her gestation...I would have had her at approx 6lbs if she was full term. My OBGYN had said that my baby was a little small but that she wasnt concerned because I was small...she doesnt think 6lbs would be a bad size for a full term baby...it's not like she expected ME to have a 10lb baby!!!

Iysha - posted on 12/17/2010

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My daughter is also underweight but her pediatrician instead told me to give her more milk because she was drinking mostly water and she also suggested using preemie formula. It has extra calories but she would be drinking the same amount of "milk." I was instructed to give 16-20oz a day.


Also, Angela is right, as long as she isnt being "starved" and is getting proper nutrition, her weight shouldnt be a problem. Maybe she is just a small girl, which isnt a bad thing at all.

Nicole - posted on 12/17/2010

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Someone has to be in the 1%. I think as long as she is healthy and eating well good for her.

Theresa - posted on 12/17/2010

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Has she been following the same growth pattern? In other words has she always been around the 1% for weight? If she hasn't had a big change in the weight percentile then I wouldn't worry about it. If that's the case then I would look for a new doc. My daughter has always been low on the percent. She's mid 20's, so not that low. But her doc has said since she's following the same growth curb to not be concerned. I've never heard of a doc being concerned as long as there wasn't big changes in the curve. And you said she's eating well. I agree that you shouldn't load her up on crap and teach her bad habits that may turn around and bite her in the butt when teen and adult hormones kick in and metabolism drops.

Laura - posted on 12/17/2010

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I, too, agree with what has been said: If your daughter is eating healthy foods and has no problems then the only thing that may need fixing is your doctor! Your daughter most likely is just small--my daughter was (still is) small for her age, too. What is important isn't so much size and weight but overall health. Kids are great at eating what their bodies need and not much else which is certainly better than most adults.

As for the diet suggestions, Lucy points out some excellent healthy fats. Be mindful though, that saturated fats ARE needed in the diet for brain function and over all health--just not in the massive quantities that the average person consumes! Whole dairy foods (which is what my entire family eats) are an excellent source of these fats when eaten in their proper portions. Too often, though, people eat 2 to 3 times the amount which is where the problems start. Cheese has as much fat as butter, unless you eat a low fat/non-fat cheese. I cook and bake with butter (as well as olive oil) only and the amount I use is actually small compared to the serving size suggestion. The baked goods are only for special occassions (like Christmas!) so even that isn't really part of our regular diet. The point is that butter isn't neccessarily bad to use. The cream just seems like an odd thing to suggest--I don't know too many people who consume it regularly. I generally only buy for a particular recipe. The best bet is to use Lucy's list and use whole milk products in their appropriate portion sizes. Butter and cream may be whole milk, but they lack much of the nutrition that whole milk yogurt or cheese has. Hope this helps and good luck!

Angela - posted on 12/17/2010

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My daughter was in the 2 percentile for her weight. The doctors all said she was small but that is just the way she is designed to be. She is now nearly 3 and is doing fine, she's still small but her development is fine and she eats a healthy varied diet. Doctors forget that percentiles are guidlines for children's height and weight, not hard and fast rules. If your daughter is happy and not suffering with any health problems relating to her size then there isn't any reason to 'fatten her up', she may just naturally be built that way. You are the one who knows your daughter best, trust your instincts.

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