Failure To Thrive (Not Gaining Weight/Height)

Archived Q&A and Reviews


Worried about whether baby is growing enough

May 2007

Hi--pls. tell me if I'm being paranoid or if this is a real cause of concern. I have a 10-month old son who has always been in the 5-15th percentile for height and weight. My husband and I are both Asian and petite(I'm 5'0'' and he's 5'7'') so this is only to be expected. However at his 9 month check-up, my son weighed only 16.5 lbs.(5th percentile) and measured 25.5''(NOT even on the curve). Since his 6 month check, he only gained 2 lbs and an inch(I think). His pediatrician is unconcerned, saying my son looks well-nourished(I agree).

I try not to think about this too much--my son is hitting all his developmental milestones, is a happy and active baby and a good eater but there are days when I worry about whether or not he is growing enough and if there is anything more I should be doing. Is my pediatrician right? Will my son eventually catch up with his peers? I don't want to give my son a complex about his height and I'm afraid all my worrying will do just that. But I'm also afraid of not worrying enough about something which maybe I really should be worried about. Advice from other moms with petite babies will be greatly appreciated. Thanks. concerned mama

So I had to laugh because I had the same concerns. My son didn't pass 20 lbs until over 16 months old! Our pediatrician told me that the curve was established some years ago by taking the measurments from caucasian children from Wisconson. There was no variance in ethnicity or culture in the measured group. Whether that's true or not, the best measurement is that he looks healthy and is hitting his milestones. And to be frank, his low weight will save your back a lot of trauma! At age three our son is pretty much the same height and weight as his friends who were ''pudgier'' as babies. It all evens out. sujata

Wow. Your post could've been written word-for-word by me and my wife a few years ago. We are both Asian, almost identical in height to you two, and have a son who has been below the charts (under 3rd percentile) in weight and height since he was one-month old. In fact, he was even smaller than your child at 9 months. We have had numerous doctor visits including regular visits with an endocrinologist, and the bottom line is that he is (and always was) just fine. Our endocrinologist's advice was always that if he looks fine and is developing properly, he's fine. That is, it is possible to be off the charts without actually having any growth problem. Since low weight/height is sometimes an indication of problems, doctors just automatically take note of kids under the curve, but that doesn't mean they automatically have a problem. Indeed, our endocrinologist tells us that many children with real growth problems exhibit some pretty obvious proportional defect such as abnormally small head, exceptionally thick torso, etc. Anyway, to keep this short, we never really did anything special other than feed him normal, healthy meals. Now, at 2 years and 3 months, he has undergone a growth spurt that has put him on the charts without any manipulation by us. And, he's always been far ahead of the curve in terms of language and behavioral development. My advice is to make sure you get all your answers from the doctors, but don't spend too much energy worrying about it. I'm sure your boy will grow to be as wonderful as ours. rl

My wife asked that I respond to this posting for I am a short man, but have never thought of myself as ''small''. My children, likewise, have always been low on the curve but i have never thought of them, or treated them, as if they were small. I guess my point is that even with a short stature, one can feel quite big in the world, as I do (thriving company, successful marriage, large network of devoted friends, etc). I do imagine this has been in part due to my parents never making my height an issue, as it's never been an issue for me in relating to my kids. Your child seems to be thriving - size will not likely be much of an issue for him if it is not for you . . . ''Big'' Man

I wouldn't be concerned, but you can always get a second opinion. At 9 months, my Asian girl was 16.5# and 26.5''. She is normal, and has always profiled as 25% on height, and 50% on weight. She is all muscle, which weighs more than fat. She has always been strong, but had the normal (not the typical doughy look that fat kids have) amount of baby sweet! At 9, she has a slim torso (''six packs'') and muscular legs and arms. I feed her whole, mostly homemade food (a lot of variety, not the usual ''my kid only eats blah, blah''). We allow her to have sugar junk once or twice a week in moderation so she doesn't fetishize the stuff. She is active when appropriate, and swims twice a week. She and one boy do the most push ups in her class (33+). She doesn't watch more than 2hrs of TV a week. If you follow similar healthy guidelines, you will start to notice that ''By Golly!'' there are a lot of bulky, fatty and sedentary kids. Yours won't be one of them. Good luck. anon

My DD was not on the curve for weight either; she was for height. Our ped was also not concerned since other milestones were easily being met. At 2 years she finally made it on the chart for weight, I think it was 25%. She's thriving regardless of size so we ignore it. happy with a wee one

Hi There, My 9 month old was 16.1 lbs at her appointment. Although I am worried, she does eat and is reaching all of milestones as well. She is extremely active and playful also. The way my doc explains it is to take a look around the world and realize that there are people of all different shapes and sizes that are the same age. She is not at all concerned and just said to add some fats to her meals. Although as mothers we will always find something to worry about, Im worrying a bit less about this and just starting to accept that she is a petite baby. I dont know if this helped at all, but feel free to email me if you want someone who understands and is in the same boat as you to vent to. mina

Dont worry, both of my girls are/were in the same situation. We are also Asian and not on the tall side- I claim to be 5'1 and my husband claims to be 5'6. Both girls had different pediatricians at one time and both doctors say that there's nothing to worry about since these percentile charts were based on Nordic standards, Midwestern babies researched durring the 70s. Just as long as there is progress, no matter how incremental, your child will be fine. Maybe we need to find these percentile charts from Asia. That would be interesting. kay

I completely emphathize with your situation. My 10-month old son, too, was small at birth (10-25th percentile) and has dropped to roughly the 5th percentile. At his 9 month check-up, he weighed 16lbs 9oz and was 26.5'' in height. I weighed him at over 10 months, and he had only gained 1/2 pound since his last check-up 1 1/2 months ago, thereby at 17lbs falling below the 5th percentile. At every check-up I've been concerned about his weight and height (more his weight, but concerned nonetheless), and every time his pediatrician has not expressed concern, saying that he looks and acts healthy and happy, he's meeting every developmental milestone, and the curve is no indication as to his final height/weight. My husband is 5'10'' and I'm 5'8'', so the last thing I expected was an incredibly petite baby. But according to the pediatrician, it's based on his genetic patterning/make-up, but there's no reason to be concerned.

I am doing the only thing I can be doing - giving him a well-balanced diet, and I've begun to emphasize proteins and fats more. I'm actually counting calories to see where he can get more protein/fat 'bang for the buck' so to speak. It doesn't sound like that was a concern for you, but I'm resolved to watch his diet even more closely than before.

It is disconcerting to say the least, and it's hard to put aside my concerns. I work hard at reminding myself that he's healthy (apparently!) and meeting all milestones and looks like one incredibly happy baby.... and leave it at that. I understand how you feel - feel free to email if you'd like. Hope that helps! Claudia

Has your baby been evalutated for human growth hormone deficiency? ''Well nourished'' is not a satifactory answer. Has you gone to a specialist for a skeletal and metabolic evaluation to see if there is something going on behing the scenes? Kaiser has a skeletal dysplasia clinic, as does Children's Hospital Oakland. There are some genetic reasons for this short size - check out for more info. Concerned, too

Hi, Concerned Mama. I can totally identify with your feelings, as I've been going through the same thing with a petite baby. I, too, was also afraid that all my worrying give my baby a complex. So I just decided to do some reading about baby nutrition, and took action. I recommend the book ''Nourishing Traditions'' by Sally Fallon and this website

If you are breastfeeding, can you increase the number of times your son nurses? If not, then (as long as he's not allergic) you can supplement with formula that you fortify with cod liver oil and egg yolk--see the recipe on this page:

You said your son is happy, active, a good eater and developing well, so that's great. It's a good sign. Personally, I've tried lots of recipes from baby cookbooks. There are some good recipes in the archives on BPN. Other advice I've gotten is to add butter or oil to everything, and maple syrup or honey. My baby likes yogurt, cheddar cheese, cream cheese, avocado, egg yolk, pureed sweet potatoes with lots of coconut oil or butter. I'm working on the pureed meat and salmon but it's often gotten rejected, so I just offer again next mealtime without pressure. I read that as long as they get a mixed and well-rounded diet, not to worry about them rejecting this or that particular food. After reading chapters on nutrition in the book ''Your Baby and Child'' by Penelope Leach, I felt better.

If you are still afraid of ''not worrying enough about something which maybe you really should be worried about'' (I totally get this) try having your child tested for food allergies, or even talking to a registered dietitian who works with a gastro-intestinal doctor. They can allay your fears, or help with recommendations either way. anon

7.5 month old not gaining, not eating

Feb 2007

My baby is 7.5 months and 14 lbs,i worry alot,i know i should'nt be stressing about it,but the thing is that he just does'nt seem very fond of food. He had started eating rice cereal,bananas,beans pretty well at 6 months( 4 months we had'nt had much luck either),but then he fell sick in the middle,and now all the progress that we had done,seems to have fallen through.He totally clamps his mouth shut,or turns his head side to side. I have caught myself trying to even pry his mouth open with the spoon,which i know is wrong,what do i do?? I sometimes sit there crying ,feeling so frustrated.I see cousins his age ,who are so fat and chubby, and then start comparing. I think i should be the one seeing a doctor :) I know that he can eat, so am baffled as to what to try. I've tried feeding him on the bouncer,high chair,cold, warm cereal, peas, bananas,rice..Is his weight normal?? Paedtrician does not seem concerned.. Anyone in the same boat as me?? Stressed mom

Hello stressed mom,

I just want to share a couple of things I have learned as a first time father (we have a 14 month old daughter). First of all, baby's go through phases - sometimes they eat like a brick layer, sometimes almost nothing. I understand your concern as I have felt it myself, but I assure you it is perfectly normal for their food intake to fluctuate.

Second, 14 lbs for a 7.5 month old baby is perfectly normal. If you still worry I recommend seeing a doctor. They have tables of the correlation between normal weight and height and I'm sure you'll find that your baby is doing just fine. Our girl is tall and slender. We worried at one point if she was gaining enough weight. We went to see the doctor and everything was fine. No, it was perfect. She's just a tall, slender girl that's all.

One thing I noticed; you're feeding your baby banana. We had a problem with our girl getting congested from eating banana, which incidentally made her eat less until we fed her prune-mush and cleared the system. Maybe your baby doesn't have problems with bananas, but I wanted to mention it. Good luck! Martin

At that age your baby should be getting all of his calories from breastmilk and/or formula. It's perfectly normal for him to not be interested in solid food at all. If he is skinny maybe he needs more breastmilk or formula, but if his doctor is not concerned I wouldn't worry. Is his weight consistently in the same percentile as it used to be? In other words, if he's always been in the bottom 10% for weight, then it is normal for him to remain in the bottom 10%, but if he used to be in the 75% and has now fallen to the 10% then I would be worried. anon

I am in a similar situation. My 6.5 month old daughter weighs just shy of 13 pounds and I definitely go through my moods where I compare her to the rounder babies ad wonder whether something is wrong. We ended up starting her on solid foods quite early (4 months) to try to fatten her up a bit. What we later learned from our doctor was that the prepared baby foods are quite low in calories but extremely filling, so she did not end up gaining any weigh as we had hoped. Her belly was brimming with the new food so she would nurse less, but the breatmilk would have had more calories... Our doctor is not concerned. She said as long as our daughter is reaching developmental milestones (rolling, etc.) that it just wasn't that big a deal. Those weight charts can really trip you up. All they really seem to mean is that if you lined up 100 babies in order of size, our would be near the front of the line. I would definitely discourage you from getting into any power struggles with your son over food. You want him to grow up enjoying food and looking forward to trying new things. I know it is easier said than done, but if you know in your heart that he is healthy and strong, try to relax a little and enjoy the fact that we can carry our babies around for that much longer without killing our backs. Kellie

My son was very similar in that he lost weight as he moved to solids and that he really, really disliked food for a long time.

One thing I learned is that breast milk and formula have a higher calorie content than food, so it is not unusual for a baby to stop gaining or even lose some weight as he moves to a solid food diet. How does the saying go? ''Food is just for fun until one year of age.'' Something like that. As long as milk intake is good, don't worry too much about the food, at least for the first year.

The other very hard lesson I had to learn was to let food go. I came to this after months of crying at every meal with him. The BPN archives have great advice on this topic. My version: don't force food into your baby, don't insist on being the one to feed him, and don't make him stay clean. I found that trying to do so made the problem worse rather than better. As the stress level rose, each meal became worse and worse. Instead, put a bowl of food in front of him, a plastic sheet on the floor if necessary, and let him play. Can he self-feed? Even shove a hand in a bowl of cereal and lick it off? Let him try. He may distrust the situation for a while (my son did), but eventually he will relax again. If he screams and cries, get him out of the chair and try again later, or not until the next meal. Your child won't starve himself.

Only now, at 13 months, is my son beginning to try a variety of foods willingly, and even then only if he is in a good mood. He didn't eat dinner tonight, and that's okay with me.

It still upsets me to think about how much time we lost fighting over meals, how much stress we created, and how much pain we both went through. It's just not worth it. Relax. Expose your son to food, let him learn how it feels in his hands, and occasionally how it tastes in his mouth. It will get better. learned to relax about food

Google search: NCHS growth charts. Click on clinical growth charts. Scroll down to birth to 36 months- Boys color PDF.If he weighs as much as you say he does, he would be slightly underweight according to the charts.Talk to the doctor and let them know how concerned you are. anon

i, too, have a very light baby (around the 5th percentile) and have worried at times but realize that some babies either just eat less or weigh less. the pediatrician isn't concerned so i try not to be either. does the baby have wet and poopy diapers? seem healthy otherwise? have energy?

i wouldn't force baby to eat and i would just try different things to see if anything appeals.

if you trust your doctor and they are not worried please try not to be either! anon

My son was a very picky eater, which would totally stress me out. I did a lot of research and reading on it and here's a summary of some of the things I found out:

- Six months is a rough guideline for introducing solids. Some kids are ready earlier, some later. Also, at your son's age he should be getting most of his nutrients and calories from breast milk/forumla still. Have you looked at the nutritional value of rice cereal? There's barely any calories. At 6 -7 months rice cereal is more to get them used to the concept of eating solids, of exploring textures and tastes.

- Babies are animals with natural instincts. They eat when hungry and will usually stop eating when full. They learn bad eating habits from us, such as eating when you're not hungry, and as they get older they know it's a weak spot for us. Like kids who won't eat so a parent will break down and give them a cookie, just to get something in their stomachs. That's the start of a bad cycle. My son would sometimes go a couple of days refusing just about all food. I would keep offering him stuff w/ out any pressure and would leave stuff sitting out for him to graze on if he wanted. It was EXTREMELY hard not to break down and just give him something not so healthy just to get him to eat something. I'm glad I didn't do that. He is now 4.5 yrs and is very good at eating until he's satisfied; give him a piece of cake or ice cream and if he's full, he won't finish it. He has very healthy eating habits.

- If your pediatrician isn't worried, you shouldn't be.

- Toddlers are often way too busy playing to want to take time out to eat. And they use so much energy playing and growing. So until age 2 it's important that they have a diet high in fat in order to get enough calories. My pediatrician gave an example of looking at a gram of fat and a gram of proteien, the fat will have way more calories.

Don't stress, your son will just pick up on that. Momma of an ex-picky eater

AS a naturaopathic doctor mother .I would not stress.I would try to keep any foods to single food not rotate at this age .Is your child breast feeding ?? how many calories are you consuming and any fishoils ,garlic encourage s infants to nurse longerThatis the ultimate food at this age my 1st daughter was only 18 lbs At 1 year and remains a petit 3 yo at 27 lbs.and is the brightest in her class youcould call me. be well Analisa

Don't worry! I bet that you're going to get lots of reassurance on this. This sounds very very familiar. I introduced solids to my son at 6 months and he basically refused them for at least 2 months, then slowly accepted a few things, but still seemed to be eating almost nothing. That gradually changed, and he ate more, but would still often refuse an entire meal (turning his head clamping his mouth shut). It's definately frustrating and scary as a parent, but if your pediatrician isn't worried, then try not to worry yourself. My son is small too--has been in the 10th percentile since he was born, and still is at one year, but my pediatrician said ''somebody's got to be in the 10th percentile!'' Also, at 7.5 months, most babies are still getting the majority of their food from milk or formula so the solid food is just practice--probably your son, like mine just isn't ready or interested yet. Keep offering, but don't force it-- he'll catch on eventually. And I bet he's doing fine on his own growth trajectory. Letting him decide when he's ready to eat can start good eating habits now.

I know exactly how your feeling, so hang in there and know that it will get better, especially if you can let go of some of the worry! M other of another food refuser

Dear Stressed Out Mom,

For the record, I hate postpartum hormones. They cloud judgement and make like not so fun. You have my sympathy.

If you're worried about baby's weight, and your pediatrician isn't, get a second pediatrician opinion and set aside lots of couch nursing time (or offer the recommended formula amount), and get a great book on different yummy baby foods to make. If two pediatricians are not worried (i.e. perhaps the adults in your family are small.... - I WISH my child had been a whopping 14 pounds at 7 months), then take a deep breath, take a walk in the sun, and put in writing your blessings. Perhaps the first could be that 2 pediatricians are not worried about any of your baby's developmental milestones (are you worried about development, or only weight?). Take care. mom of 2 little chefs

I'm sure you'll get lots of reassuring responses to this post, but I thought I'd add mine in, too. Our daughter is 16 months old, and is not even 20 pounds yet. She barely registers on the weight charts... bottom 5%. She's active, and skinny, and very very healthy. Our pediatrician is totally unconcerned, and after a few phases of worrying, we aren't either. Some kids are just small and thin and that's just fine. All that being said, I would make sure that you're approaching feeding in a healthy way. It sounds like it's really stressing you out, and your approach may begin to stress your child out too. I suggest you read ''Child of Mine'' by Ellyn Satter. It's a really great resource, and has made all of the difference in our approach to feeding our child. One of her key pieces of advice to parents is to... ''just mellow out.'' The book is long and kind of hard to read, but the essential messages are great. Good luck! Don't worry! Satter fan

Hi, first of all, I want to say that you are not alone. I too was very worried about my 6.5 month old and her weight gain since the very beginning. She is a fussy eater and is so much smaller than other babies her age. She is also in the 14lb range. I have come to realize though that every baby is different and its really ok. They will follow their own path. Despite being tiny, she is crawling around and slithering and very inquisitive. She smiles and laughs alot, and is generally happy. Therefore, I figure its ok. Talk to you doctor and do what he or she recommends as far as feeding. One of the things my doc told me to help calm me initially is to look at adults, --there are people of all shapes and sizes in the world---babies are the same way. Hope this helps..... mina

It's perfectly normal for a 7-month-old not to eat solid foods at ALL. And even babies who do like solids should still be getting almost all of their nutrition from breastmilk (or formula) at that age. I have one child who age solids eagerly from the first day, at 6 months, and continued to eat pretty much anything all through his toddler and preschool years, and one who refused to have much of anything to do with solid foods until 10 months and is still a very picky eater. They're both totally healthy.

Weight loss or slow weight gain is also not a big deal when it's for an obvious reason, like an illness, or increased activity level when a baby learns to crawl or walk. If your baby's doctor is not concerned, you almost certainly should not be. Some babies are kinda chubby, others are long-n-lean, either can be healthy and normal. It's not about how many pounds the baby weighs at a given age, it's whether he is growing at a reasonable rate. Every baby has a somewhat different curve.

Make sure your baby is still nursing, or consuming bottles, at about his former level and producing plenty of wet diapers. And continue to offer solid foods at family mealtimes, but don't push. He'll eat 'em when he's ready. Holly

i was amazed when my daughter was born at my biological NEED to see my child consume food ALL DAY LONG. i could not relax unless my child was eating. all the time. tons of food. and my child was never low end of the weight charts. i think what you are experiencing is a completely normal concern.

that being said, during one of my (very 'rational' and sane) kvetch sessions about my child not consuming much food (and i think she was rather sick at the time), my mother told me a story about taking me as a toddler to the pediatrician because i 'wasn't eating.' the pediatrician's response was something like that last he had checked there were no children in this county dying of starvation.

i really liked the book 'super baby food.' i learned how to offer my child a healthy balanced diet from the beginning. there were many interesting topics to read about diet and eating issues. and some of it i definitely skipped over. but it gave me a guideline to believe i was heading in the right direction and everything would fall in place. even on the days my daughter refused to eat.

if your baby is giving you a big smile that lights up your life, you are doing a lot of things right. i want MEAT!

4-month-old not gaining enough weight

June 2006

My 4 month old son weighs only 10lbs, 12oz(24 inches long), which is only about 8 or 9 oz more than what he weighed at 2 months old. We are working with a doctor and lactation consultants (l.c.)since his weight gain has been a problem from the start. He was born at 7lbs, 14oz, all natural birth and latched on perfectly within 5 minutes of being born. The l.c. says I have good milk supply, he latches on well, and seems to get a lot of milk. We are mystified. At about 4 to 5 weeks of age, after working with an l.c. to help him gain weight and being unsuccessful, on the l.c's advice, we switched over to formula exclusively for a couple of days. He gained weight and we weaned him off formula, back to breast milk exclusively. Developmentally, he is ahead of the game (according to pediatrician), grabs things, rolls extensively (he rolled at about 2 months), coos, smiles, giggles and generally shows no signs of being unhappy or underfed! He is starting to teeth early, which does make him cry more than usual. He is a marathon feeder and I often have to limit him to 20 minutes at each breast. I feed him every 1 to 3 hours except at night when he sleeps from around 9pm to between 3am and 4am and then back asleep until about 7:30am. I have checked with babysitter (comes about 8 hours/week) and husband, and they agree with my perception that I feed him very, very often. Until I see the pediatrician again this week, we are trying: nightime feeding to be 8 oz. formula,take away pacifier,in the care of Dad or babysitter, supplement with formula as needed if run out of expressed breast milk. My other problem is that I only pump around 2.5 oz at a time and my breast milk goes bad in the freezer. I am crying a lot trying to figure this out and feeling anxious about breast feeding: is he gettting enough, should we just give him formula freely, will I mess up breastfeeding since it is supply and demand, etc. I don't want to be rigid about breastfeeding, the goal is for my baby to gain weight. Any advice or similar stories? Any babies who were this small at 4 months? K

Dear mom of a small four month old: Please don't worry about your son, it sounds as if he is developing very well, hitting all the milestones, and that he is a wonderful little boy. My guess is that he is more physically agile and able than many of his more weighty age-peers. Our daughter was born at 7#4oz, and at four months was not yet 10#. We were really concerned and celebrated grams with little jigs. I wanted to exclusively breastfeed, our lactation consultant emphasized BM was the BEST thing for my baby. I internalized to mean that BM only was the only ''responsible'' thing I could do for my baby.

My father-in-law is a very respected pediatrician in his community, where he has practiced for 50 years. This is what he told me with respect to growth curves: Rate of weight gain (and other growth indicators) is the key, not the amount. As long as she was at 10% or above she should be fine and small is OK. As long as growth curve ratios remained stable and in-sync with one another (10% for height, weight and head circumference) and did not slip out of sync (for example if her weight gain suddenly outstripped her height), or she did not suddenly shoot up in her total percentile (from 10% to 25% in three weeks, for example), she was OK. It would be good but not necessary for her to slowly move from a lower to a higher growth curve ratio. It was ok for her to fluctuate slightly between curves (btw 10 and 15%), it was not good if she sank below 10% at any time, nor for her to swing around on the growth curve. He mentioned that the growth curve that is in use came out of the 1960s studies in the Midwest, and that it is based on formula fed Caucasian (Scandinavian) American babies, and it therefore is an inflated curve when compared to babies who are not white, American, or formula fed (formula fed babies commonly gain more weight more quickly). I think the WHO has recently produced revised infant growth curve charts. sara

My long message, Part 2: FIL reminded me that breast milk is best, but that as long as she was getting some breast milk every day she would be OK. If there was legitimate concern about the RATE of her weight gain, her diet should be supplemented with formula. He suggested we use LIPEL low birth weight formula. (I think that is how you spell it) So we did that, which was good for us as a family in many ways it freed me from the boob (though I pumped too), allowed my husband to feed her - relief for me and bonding for them, got her used to the bottle and to formula, and better prepared her to start day-care at 5 months.

FIL mentioned that she would gain weight at a slightly faster rate when she started eating solid food (6 1/2 months), which was true. BTW, she has become less interested in breastfeeding since she started eating solid food. I started my period at her 7 mo mark, and that seems to have decreased my milk supply as well I now pump 1-2 times a day for a total of 7liquid oz on a good day; and she nurses about two to three times a day as well. She is now nine months old and has FINALLY doubled her birth weight and then some... 16#8oz. (25%!) She is in daycare, and I am surprised by how petite she is compared to the other babies her age. She is growing, she's bright, curious, funny, very physically active and adept (standing with support to balance without support), and very verbally curious. She is still small, but she is MIGHTY. It sounds like your little boy is the same. a wee and wonderful kid. sara

Hi, I'm sorry you're going thru this. My first baby also had trouble gaining weight and it was because I wasn't producing enough milk. He did not gain any weight at all for the first month. I was in total denial b/c I so wanted to exclusively breastfeed him but my peditrician told me that the most important thing for babies was to gain weight. Otherwise, there could be lasting impacts on his development. What I ended up doing was to supplement each breastfeeding session with formula. Like you, I was only producing 2-3 ounces and so would also give him a bottle of 4 ounces of formula. I had bottles prepared in the fridge and would warm them up in hot water as I was breastfeeding. He gained weight immediately and is now a healthy 3.5 yr old. With my 2nd baby, I didn't have any issues with milk production at all. The fact that your baby gained weight immediately while on formula may an indication that you're not producing enough. And while I too was heartbroken about it in the beginning, the most important thing to me was that my baby was healthy. Afterall, I was formula-fed and I'm doing ok. Breast-feeding is natural but it isn't perfect and just thank-goodness there are other ways to ensure our baby's survival Amy

My son was about that size when he was four months old, and he is still small now at 11 months. It is really nerve wracking, and I know exactly how you feel, especially the concern about whether your breast milk is the culprit. But I decided to stick with breast feeding, and I'm sure many others will advise you the same. Isn't the goal for your baby to be HEALTHY, not just to meet some statistical average? If he's doing well developmentally, and isn't crying all the time, really and truly, as hard as it seems, don't worry about it.

But I did want to give you two tips. First off, you might try just letting him completely drain one breast at each feeding, rather than breaking him off of one breast in order to offer the other in the same feeding. The fattiest milk is usually the stuff left at the end, so it is good to let him get as much as he can from one breast, and then just start the next feeding with the other one two hours later, or whatever.

The other tip is about introducing solid foods. I didn't realize just how much less fat and calories are in solid foods than in breast milk (or formula). Around 4 to 6 months is when people generally introduce solids, and so we did that at about 4 1/2 months. Well, at his 5 month check up, my son's weight had dropped down to the 5th procentile (from the 10th). So, in retrospect, I probably should have waited on offering any solids, or offered only really fatty stuff (like whole milk yogurt - I recommend Trader Joes natural yogurt over Yo Baby). Avocados would also be OK, but try to avoid carrots or things like that. Rice cereal has plenty of carbs, but no fat, so unless you add fat to it (like with flax seed oil) your baby won't be maximizing the calories.

Anyhow, this is something you'll struggle with for the next year, probably, and if you are anything like me, you'll look at all the other chubby babies and wonder what the difference is. But you can try to take comfort in knowing that in a country of overweight people, being naturally thin probably isn't so bad. And then there is the bonus of actually getting to use all the baby clothes you have, since he won't outgrow them so fast! Mom of a ''Mick Jagger'' baby

My baby is also in the below 5th %ile for weight. Is your pediatrician concerned? Mine was not as my baby just is on a petite growth curve. If your baby is healthy I think you should just continue the breastfeeding plus supplementation with formula. If you are still worried call the advice nurse for your doctor's office/hospital and ask if it would be ok to start solids (cereal). ps my baby nursed every two hours all day long until at least six months old and was still skinny as a rail little baby's mom

When I read your post, I was reminded so much about my daughter at that age, who was also was born at average weight but put on weight slowly in the first year. I can happily tell you that she's now a 20 month toddler who's weight is FINALLY on the growth chart. My advice to you is that there are really two possible scenarios:most likely this may just be your child normal growth pattern, but there is always a small possibility that your child is having some type of problem that you can watch for. What we did to answer this question was 1) watch the stools for ''greasiness''- this can be a sign that the child is not properly digesting nutrients 2) continue breastfeeding- I know it's hard to feel confident about this but it's probably providing exactly what the baby needs, 3) look for ONGOING signs of low energy or unhappiness- it sounds from your post like you have a very happy and maturing child 4) take the baby to the pediatrician more frequently than normal, just for healthy check ups and weigh ins- our ped happily saw us once a month for most of the first year. If your ped won't do it, consider finding another. This is also a good time to start discussing solids, although you probably won't start that until somewhere around 6 months.

These are the things that worked for us, and it turned out that our daughter was just a petite person, but she is developmentally and physically perfectly healthy. I can't tell you not to worry, because sometimes you will, but hopefully reading the things we've done for our child will help you with yours! Good luck! mom of lil' one

First of all, relax. The baby sounds just fine. Weight is not everything and the fact that milestones are being met/surpassed bodes well. If he can gain weight with formula then it seems that says he is capable of gaining weight, depending on what he takes in. I think you should look at your own nutrition. Is the milk he is getting rich enough? Moms need to take in a heck of a lot of nutrition to make great milk. It sounds like you're feeding him a lot, but that means less if the milk isn't top quality. Please see and compare your diet to the one listed there, which is based on what traditional societies fed nursing mothers. Most of the things there are easily added to the diet and make a huge difference in the quality of the milk your baby receives. Perhaps if he gets more fat and calories in the breastmilk he will gain some weight Anon

Help, 9-month-old baby not gaining weight!

Jan 2006

Hello, I am very worried about my 9 month old. She is gaining weight very slowly. In fact, after going through her records, I noticed that she has actually lost weight in the last few months. In November, she weight 14 lbs. 12 ounces (clothes on). This Monday, during a doctor's visit, she weighed in at 14 lbs. 8 ounces. It baffles me because she seems to eat quite well. She is taking solids 3 times a day. With lots of encouragement, she usually eats about 2 containers of baby food. Her milk consumption is low, however. She only drinks between 14-16 ounces of formula a day. And, although I've been told that it's normal, she also has 3-4 bowel movements a day.

I need to mention that she's had lots of medical problems. In September, she had heart surgery for a patent ductus. She bounced back from the surgery quickly and gained 2-3 pounds in less than 2 months. We were all so happy to see her thriving. But since then, she isn't gaining anything. She also sees physical and orthopedic therapists for torticollis and clasped thumbs, although both problems are no longer issues. She also has an abnormal aortic valve (mild case) and a tethered cord. We have gone to genetics for these issues but they have not pinpointed a specific syndrome. They think she's just had the misfortune to be born with these complications. In addition, due to the intubation from the heart surgery, her left vocal cord was damaged. But, like I said, it doesn't seem to be impeding her solids intake.

Anyway, I would appreciate any advice regarding the lack of weight gain. Could it be an infection? I just don't know. For such a little one, she's gone through so much. I just want to figure this out and move on. Thanks for any recommendations.

Bless your heart for worrying so much! Honey, your poor girl has gone through a lot and sounds like an eating champ! If the docs aren't worried, I wouldn't worry. But if it makes you feel better, keep offering her food (and spoon feed her, if need be- my skinny little 3 yr old still eats 4x more food when I put it in her mouth and hold her in my lap, than when she feeds herself). At your daughter's age, she's getting more mobile, growing, making brain cells, etc, and you can have tons of food going in at it all burns up. While my daughter didn't lose weight at that age, she didn't have heart surgery either, and she gained very, very little, and very slowly for the next year. And between 2yrs and 3yrs, she gained nothing! But she's perfectly healthy. somebody's gotta be small, and your poor little one has had her share of challenges. Feed her avocados, scrambled eggs with lots of butter, whole milk yogurt, whole milk. And if she eats some veggies give her some ice cream if you want to. It will at least make you clear that you've put in 110% of the effort. That's how I figure it for my kid.

Hi- My six month old son is also having trouble putting on weight. We think it is because of a rare skeletal disorder he has, which makes his rib cage rather narrow. He therefore breathes a lot faster than other babies his age, to get enough oxygen. In expending so much energy breathing, his calorie needs are high. I would think your daughter also needed lots of calories to recover from her surgery; congratulations on getting her weight back where it was pre-surgery! I just wanted to share a trick our pediatrician recommended. She said we should add flax seed oil to all of his solid food. We just mix in about half a teaspoon to a teaspoon into a jar of stage 2 foods. We also sprinkle rice cereal on his food. The doctor also recommended full fat yogurt, though our son so far doesn't like the taste of it - I haven't tried YoBaby! yet, so I'm hoping he likes that. Anyhow, we've just been doing this for a few weeks, but he does seem already to be getting a bit more baby fat. Best Wishes- Mom of a slender baby

First, I'm sorry you've been through so much with your baby! That sounds so hard. But I can't help wondering what your pediatrician is telling you regarding the weight gain, and whether you don't trust his/her opinions/advice, and so are asking us (who really don't know enough about your baby's situation or in most cases, about medicine to really give you informed advice)? Also, don't forget that your stress level affects your baby a great deal, and if you are anxious when feeding her she will pick up on this, and it may even make her eat less. Offer her snacks all throughout the day, finger foods, etc. and not only three meals. Your baby is at an age where she is getting more active, and where weight gain does tend to slow down. Also, your baby does not seem so tiny to me, since mine has been consistently at the 5th percentile for height and weight, at just over a year now, but he's thriving wonderfully. If you don't trust the advice your doctor is giving you, I hope you will find someone you can put more faith in so you don't worry so much, as babies need calm h Anon.

I don't want to frighten you, but when you did genetic counseling, did you look into Cystic Fibrosis? ''Failure to thrive,'' (i.e. failure to grow) while eating a normal (or more) amount is classic CF symptom. Some ways to tell before you get the test (it's an easy pain for the child.) 1. Are the poops really really smelly and bulky? 2. If you lick her, do you taste a lot of salt? If you haven't done so already, please check this out asap, as the earlier you catch it the better off she will be. Amanda

There are a couple of possibilities: A.) baby has contracted a parasite or another enteral visitor. Your doctor needs to check this one out. But you probably would have it as well if that was the case. B.) Food allergy - a 14 month old is eating a lot of different stuff than he was a few months ago. Have you MD check him for milk protein and gluten allergies. Other foods that can cause problems are corn and soy. These allergies may not always manifest as rashes. Sometime they are just internal allergis that upset the absorbtion of food. Food allergies are often subtle and overlooked. C.) Any number of other problems which are too numerous to list here. cindy

3-year-old not eating enough - gastrostomy tube?

Sept 2005

Hi, I was wondering if any of you parents out there have any experience with gastrostomy tube feeding. We're facing this decision with my 3 yr old son right now because he is not eating enough to grow. I've read a lot on the internet but I'm wondering if anyone has personal experience they can share with me. Thanks

Hi there. I certainly feel for you, it is difficult when your child will not eat- it is hard on you as a parent, as well as your child! Having said that, putting a g-tube in a young child seems pretty extreme unless absolutely, positively nothing else has worked. I work in healthcare daily with adults who mostly all have G-tubes or J-tubes or both, although some have naso- gastric tubes. The insertion of the tube is done as a surgical procedure with anesthesia. Some people recover quickly, while others always have pain at the site. Here is the problem that I see with a young, active child: the g-tube can become infected, or pulled out and then you really have trouble. Even when you are not using it to deliver food directly to the stomach, the tube apparatus is fairly long and dangles around and gets caught in clothing. It also requires maintenance: daily cleaning, and flushing everytime that it is used for food. Sometimes it plugs up for no good reason and requires a physician to look at it.

Sometimes it gets pulled only partway out and needs a physician to look at it. Another problem is that sometimes putting a lot of food directly into the stomach causes bloating, cramping, gassiness and the liquid food itself leads to looser stools.

Also, I have worked with some kids who simply throw up the liquid that you have just put into them. So, it really is not a perfect solution. What has your physician done so far to try and find out why your child is not eating? Does you child gag or cough when eating? Is it certain textures or flavors? Does you child drink liquids alright or seem to have more trouble with those? Has an Ear, Nose, Throat specialist done an exam of your child's mouth, throat, palate? If even one little thing has been identified as questionable, did they do a barium swallow study? Has an x-ray or scan been done of the upper GI tract, especially the esophagus? Has a gastric reflux diagnosis been looked at and ruled out? Does your child complain of pain or any other bad feeling after eating, or throw up often? There are so many things to think about and look at before deciding to put a piece of plastic in a toddler's tummy. And even if this is what you end up needing to do, you still have not gotten to the root of why the child is not eating. At the very least, if you have looked at all of these things and more, they could try a naso- gastric tube for a trial to see if the child tolerates the feedings. That will only work though if your child leaves the tube in (same actually goes for the g-tube which is lightly tacked into the body with stitches.) As the parent, you have to do what you feel will best help your child. But please speak up and ask the Dr. to exhaust all means before turning to this, it is not a perfect solution by any means! My heart goes out to you, this is not an easy decision you are dealing with. healthcare mom

sounds really fishy unless this child has some other problem that is contributing to her not eating. she may just be small for her age. she may be a picky eater, many toddlers eat very little or eat very sporadically infact its the norm for this age group to eat very little several days in a row and then have a decent eating day. unless there is more to this than you actually wrote in the original post I'd at least get another opinion. before you subject this child to surgery and tube feedings. anon

1-year-old has dropped below 25 percentile

Nov 2004

I have a one year old baby boy who has always been on the thin side, but now his weight is off the charts and his height has dropped to below the 25th percentile (it was around the 50th). My pediatrician said to stop nursing him at night (he frequently wakes to nurse) and to add butter to his vegetables. The baby eats very little in the way of solid food. Is it wise to try to decrease breastfeeding, and if so, then what is the best way to put weight on an infant in a healthy way (i.e., as opposed to increasing saturated fat)? Concerned mom

Lowfat diets are not appropriate for children under two. Your child needs fat, including saturated fats, to build his brain. Giving lowfat milk can lead to so-called yuppie malnutrition syndrome. Don't worry about the butter. My kids didn't show that much interest in food until they were weaned, but there are things you can do to get them to eat without weaning. One thing I did that made a difference was to not nurse them in the morning when we woke up. Breakfast first, then nursing. Try whole fat yogurt mixed with fruit. I had to make smoothie pops out of it to get my younger daughter to eat it, but she loves the smoothie pops and every time we made them I offered her a drink of the smoothie. Eventually she tried it and now she likes it. So we make a big batch and drink some and freeze some. She will also eat frozen blueberries and peas but not the fresh. Pumpkin muffins made with flax meal and those Omega-3 fortified eggs are another way to get good brain-developing (and weightgaining!) fats into them. Some say that a child may have to try a food 40 times before he or she will accept it. We have started having regular food nights, a taco night, a spaghetti night, a roast chicken night, so that they get regular opportunities to try new things, and now they eat all these things. I started getting the Trader Joe's Middle East Feasts every week and now my kids will eat falafel and hummus. It took at least 15 exposures before they would take more than a nibble of a falafel. Usually they ate only the pita bread. But now they eat both the falafel and the hummus. I am hoping that the tabouleh will follow one of these days. Oh yes, and then there is ranch dressing and ketchup. Everything is better to a toddler when dipped in ketchup or ranch or put on a toothpick. My 4yo even dips oranges in ketchup. Ugh. Good luck, susan

This may not be the answer you're looking for but my daughter was in the 10th percentile when she was 12-14 mos. We started making milk shakes- as natural & organic as we could find, for her as well as adding pediasure(enfamil makes a supplament like this too) to her milk...just a little... also, when I weaned her she began drinking massive amounts of whole milk & she began to not only sleep better but also gained weight & is now on track w/her weight. Good luck, chubby cheeks again!

You don't mention in your posting whether your child is generally healthy, nor how active he is. If the child is active, and he has been more or less following his own curve consistently (below the 'normal' but in line with the general pattern), I would try not to worry. I know that this is easier said than done, but I was in the same position and finally started to believe all the doctors who told me not to worry: my son was thriving in all other non-weight/height respects. He was on the 3rd percentile for weight, probably about 25th for height, and as a BMI type index, very much 'under the curve'. He was, however, consistently following his own growth curve from about four months on. (And was born as a relatively big, 8 lbs baby.) Today he is still a skinny, healthy 2.5 year old, and he is bright, social and verbally quite advanced. I was also told to stop night feedings at about 6 months, but didn't listen until 9 months (and then did it most for selfish reasons so that I could sleep through the night). It had no negative effect on his weight, and perhaps (though the details are now fuzzy) encouraged him to eat more solids. A final thought: we were also told to put oils on all his food (in our case, olive oil). Sounds disgusting, and not quite healthy, but you have to remember that up to about 2 years babies really do need fat, and quite a bit of it. Fat is critical in mylination -- the covering of nerves (in the brain and elsewhere) with fatty coatings so that information is processed quicker and more efficiently. If you otherwise eat in a healthy manner, adding a bit of fat will do no long term damage. Been there

I love the book ''Super Baby Food.'' You might try it--she recommends lots of ground nuts (assuming your child is not allergic), flax seed, avocado, etc. She also has recommendations for toddlers.

In response to your child\x92s 'low weight and height gain'...Just in case, I would recommend that you have your child tested for celiac disease, which is an intolerance to gluten. While this may sound rather extreme, a symptom of celiacs is short stature and failure to thrive even with proper diet, due to degeneration in the digestive system. While it is statistically remote that this is the cause, it is a condition that can be the root cause of many symptoms (eczema, digestive problems, gas etc..) but is often overlooked by physicians. I hope that this is not the root cause of your child\x92s slight underdevelopment, but I would hate to have it be the cause and go undetected and continue to jeopardize your child\x92s long-term health. For more info see : anon

Try avocados! Butter isn't terrible for young toddlers, either, just get organic. Basically, it is a trial and error sort of deal. Introduce a variety of foods, and if he isn't interested in certain ones, try them again 3-4 weeks later. Cream cheese is good on toast, bagels, or fruit. You can make smoothies with Organic Brown Cow yogurt, too. Make sure you eat in a certain place at specific times for meals, too. Sometimes they just need more of a schedule. I would try eating your meals with him, too. Don't worry about the charts...plenty of children have been classified as ''failure to thrive'' and are perfectly happy and healthy! Good luck! M

I have had poor clients whose doctors called CPS and their children taken into protective custody for failure to thrive. I have one client now where one of the allegations is she gave her 15 month old 2% milk without consulting with the doctor first. Social workers get angry when I argue that pediatricians say nothing to my upper class friends whose ''nutritional choices,'' including all soy diets, often result in low weight gain and ''failure to thrive.'' These friend's choices are rarely questioned by the same medical community that calls CPS on poorer parents. anon

16-month-old hasn't gained weight or height in 6 months

April 2004

Our pediatrician is ''a bit worried'' because our 16 month old son hasn't gained any appreciable weight or height in the past 6 months. He started out around the 90th percentile and is now about 50th. He is otherwise healthy. He's not a big eater but is still breastfeeding regularly. Her advice is to cut down on breastfeeding to make him hungry and want to eat more. Not only is this hard to do when my son is insistant, but it feels counterintuitive. Has anyone else gone through this? Any advice for reluctant eaters? Should I be worried?

Uh, you should definitely not stop breastfeeding. Especially, if he's not getting enough nutrition from other than you. My son was also not a big eater around 11-16 months and depended on the breast regularly. He was also at 90th percentile at birth and slowed down to 50-75th, but was still bigger than most of the babies his age. Growth definitely slows down after the first year. I wouldn't worry too much about this. I used to (and still do) try to supplement for what he's not eating by eating them myself and BF to him, started him on an organic formula along with the breastfeeding, and just try to feed him the food I know he will eat (better than nothing, right?). This phase has passed and now he's showing interest in a lot of other foods. Please don't discourage BF unless you really want to stop. Have patience, you're doing a good job and keep trying to introduce different foods at a comfortable pace; he'll come around. mama of a very good eater.

I wouldn't be worried. Your child seems to be fine and healthy - obviously what he is doing works for him, so why force him into something else? anon

If your son seems healthy and active, he's probably just on his own growth curve. Call a la Leche League leader first of all to ask her advice. Secondly, try feeding him solids more often, such as every two hours, making sure to give him hughly nutritious foods such as fresh cooked veggies, fresh fruit, whole grain pasta and bread, chicken, almond butter, avocados, etc. to increase his appetite. I have found that my 13 month old prefers fresh food to reheated, canned or frozen food. Jennifer

Advice just seems to vary from doctor to doctor. Our 16 month old went from around 50th percentile to 22nd, and our doctor said not to worry, that 22nd was still fine. You have to keep in mind that toddlers are more active and therefore need more calories (thus the recommendation that toddlers have a high fat diet, as you get more calories/bang for your buck), and they are also into power tripping and saying ''no'' when you want them to eat even if they really are hungry! So we also have been on a mission to get our son to gain weight. I haven't gotten him weighed since is 15 month check up last month, but visibly we can see has gained weight from doing the following:

- We let him snack whenever he wants, and on days when he refuses to eat a regular meal I just put out something on a plate for him to go to while he's playing. This morning he refused his usual cereal so I made a waffle, put butter and jam on it and left it cut up on a plate on a chair. Over the course of an hour he ate it. It really helps to teach them some basic sign language regarding wanting food/drink, and at this age they pick it up quickly. My son now brings his fingers to his mouth to let me know he's hungry, rubs his hands together like he's washing them to say he wants water, and moves his fists up and down like he's milking a cow to say he wants milk. At this age their food demands/wants seem to fluctuate from day to day, so it helps that he says what he wants. Maybe a couple of days go by where he barely wants milk, the next he signing for it every couple of hours.

- Give him more bottles of milk throughout the day. Supplement your breastfeeding w/ whole milk or soy milk. They really can get what they need from whole milk at this age.

- We put butter or olive oil on/in everything. Butter in his Cream of Wheat, cook carrots in oil instead of steam them, etc. It has been hard for me to loose my knee jerk reaction to fats and remember that they really need them. I don't remember the exact numbers, but our doctor gave us the example of something like 1 gram of protein has 4 calories and 1 gram of fat has 10, so it is more efficient. anon

I have friends who've been in similar situation and have found that the solution is really not to get the child to eat *more*, but to make what the child does eat count for more. In other words, encourage more calorically-dense and possibly higher-fat foods for the solids portion of your son's diet. Avocado and yogurt are a better choice than applesauce. Adding olive oil and/or flax oil to his food can help.

To the extent that cutting back on breastfeeding works, it only does so if the breastmilk not being consumed is replaced with higher-calorie-per-ounce foods. And much of what most toddlers eat isn't more calorically dense than breastmilk. If your son tends to ''snack nurse'' a lot during the day, it might in fact be easier to get him to eat a better overall diet if you institute more of a schedule; on the other hand, plenty of toddlers are perfectly healthy on a diet that's still 90% breastmilk, so as long as your son is growing and developing well, and isn't actually losing any weight, do what seems right to you. anon

15-month-old losing weight, is anemic

Feb 2004

I've got a 15 month old girl and ever since she was 9 months old she's only weighed 17lbs. I never thought of it as a bad thing. She was healthy, active and ate a lot of food. I've never had any trouble feeding her. But when I took her into the doctor for her 1 year shots my doctor said she was under weight for her age. That is when she fell off their chart. Now she is just getting over pneumonia, and we also found out that she is anemic. But now we're at home, she seems to be doing better but she will hardly eat or drink anything anymore, and I don't know why. I've tried everything I can think of. She's now back to eating all baby food and pureed food. She was eating hard food before and now it's a struggle to get her to eat anything. I hope you can give me any information that could help. jennifer

We are in the same kind of situation with our 2-year old. He ''fell'' off the chart at 18 months after steadily going down. So the doctor asked for some blood work and for a gastro- enteorologist to see him. He just had had the stomach flu and was teething his molars so he had stopped eating altogether. Eventually, his molars came out and he started being hungry again in the last few months. He's scheduled to see the doctor again next week. I have put off the gastro-enteorologist appointment in part because his blood work came out fine. Now what I did do is offering him food every few hours and I got him back on formula instead of milk. I am not stressed about it because some people have to be small so others can be tall and he is doing amazingly in other areas. m

I would suggest getting advice from a gastroenterologist (geez I hope I am spelling that correctly). My son had a similar problem where at one years old he started gasping and coughing whenever he tried to drink his bottle. After 4 bouts with pneumonia in six months a scope was done and we found that he had a condition called aspiration. Whenever he would swallow liquid or food particles would get into his lungs and cause respiratory problems.

Long story and not to alarm you but at 16 months (he was weighing approx. 17 lbs still too and had the ''failure to thrive'' diagnosis) he had an operation to insert a feeding tube because ingesting anything orally is not allowed with that condition. So it is important to check everything out with the right specialists. We went through Children's hospital in Oakland.

He has been without the feeding tube for about five years now and fine physically just check everything out to make sure it's not the same situation. Sharlene

I do not want to alarm, but possibly help. If your child does have 'allergies' that have been detected, and wheat is one of them...please ask your MD about the possibility of Celiacs disease.

It may be possible that your child is not only alergic to wheat, but may also have this disease that can effect the digestive system. If you had been (and are) feeding your child wheat and oats cereals then the damage can be causing the symptoms you describe- lack of appetite, loss of weight etc.. The wheat damages the colon and inhibits the absorbtion of nutrients and fats. The good news is it will regenerate if 'gluten' (wheat,oats,rye) are no longer in the diet.

I too have this condition and was miss diagnosed for a while, showing 'normal' blood tests. I would encourage you to talk to your MD, talk to a GI Dr., and read more about this Celiacs on the web. It may not be the answer to your problem, but I would hate to have any child suffer do to a misdiagnosis. Please feel free to correspond for more info. If you do find that this is the cause, I have much to share how to live with this. We are keeping my son (2 years) gluten free also. Eileen

1-year-old not gaining weight

July 2003

My baby is now a year old and still only weighs 17 lbs. She was 16 pounds at 6 months, and has only gained a pound 6 months later. I've been having a lot of difficulty feeding her. When I first started her out on solids (at 5 months), she was a good eater until she hit the 6 month age mark. Since then, she doesn't want to eat no matter what I do or put in front of her. I try to distract her with toys, videos, whatever and slip food into her mouth. The only thing she really likes is oatios and rice chex. I should also mention that she has a ton of food allergies too (that's another topic). She's allergic to dairy, eggs, wheat and nuts. I try to feed her fatty items, such as soy margarine, avocado...sometimes she'll take it, sometimes she just won't open her mouth. Her pediatrician has run about 9 blood tests on her and everything came back normal. He also checked her stools for blood and that came back negative. We're waiting for more tests on whether there may be parasites found in her stool. I'm not sure what else I can do to get food into her. I started feeding her soy formula recently (whatever, to get calories into her). Since she doesn't take the bottle, this has been a slow process as well. Today I managed to get 4 oz of formula into her by giving it to her in a cup. Does any parent out there have any advice you can give me on this. It's been very frustrating, and I'm starting to get really worried. She's very thin and continues to not gain weight. In fact, she's now off the charts in terms of weight for her age. Thanks very much, I really appreciate any help you can prvodice. may

I know it can be frustrating to see your baby slip off the chart. I hate those charts- they should do away with them! 17 pounds does not seem that small for her age.

My son is 17 months old and has been off the chart since he was 10 months old. He now weighs a mere 20 lbs, however, he is very bright and active and he has been hitting all of his developmental milestones right on track. My son is half Filipino and half American (my husband is 6'' where I am only 4'11)I am very petite so part of being small could be in the genes. As long as your daughter is plotting her own chart- it might not be as rapid as you would like but perhaps she might be small by nature (if you and/or your husband are small, also she could just be a small baby but grow to be a bigger person. If your daughter is alert and active and happy then I think this should be your measurement for her.

Still putting genes aside, good nutrition and eating well are very important to a growing baby.My son although not a picky eater, does not eat that much and has no interest in anthing but bread, fruit and yogert. He too did not take to formula from a bottle (he was bf until 13 months) but he does like milk now from a sippy cup. Our doctor recommended putting formula in his foods for more calories. I understand your daugther has food allergies so perhaps the soy formula added into her food might help.

As one small baby mommie once told me, we should be so lucky our babies are easy on our backs and that we can use the Baby Bjorn for awhile while other big babies have busted out! Good luck!
Proud Small Baby Mama

I suggest going to (professional publication of the National Center for Infants, Toddlers and Families). They have fantastic advice on feeding, (among many other things), such as
Let the child touch the food & eat with fingers. Talk in a quiet and engaging manner. Be engaging, but not overwhelming; take care not to overwhelm the child with talking or behavior. When the child is self-feeding, remain present in the situation, but don't take over. Let the child decide how fast to eat. Let the child decide how much to eat. Respect the child's food preferences. Respect the child's caution about new foods. Remember, all children learn to eat eventually.
this obviously does not address any medical issues your child may have (e.g. allergies), but I hope it helps.

my daughter also weighed 17 pounds at her one year checkup and she has no known food allergies. our doctor said she looked very healthy and attributed it to our being ''petite'' people. I am half chinese on my mother's side and that seems to have dominated her size gene. she is now 2 3/4 and weighes 24 pounds. sometimes I worry when I see the kids she has been around since she was just a wee thing because she is quite tiny in comparison. as long as she remains vivacious and eats decently (many days a frustrating task as she is a very selective diner) I'll just adore her skinny little arms and legs. at least ''uppies'' is still manageable! gael

My kiddo went through a similar phase (no weight gain at ALL from 6-9 months) although he didn't have allergies. I found that the key to improvement was to not get emotional about it, offer frequently, NEVER to force food, and to give him as much finger food as he could eat (ie meatballs, soft apples, etc.). Part of it was a fierce independence. Distraction also helped. I hope some of that helps. He's now a 2 year old and healthy as can be although he'll never be huge (25% ht and 5% wt).
another mom

Have you or your pediatrician thought about oral-motor issues with your child? It is possible that there is something 'mechanical' or sensory going on that makes eating/swallowing, etc. complicated. Sometimes medical doctors don't think of this right away or wait until they have exhausted and out-ruled all medical avenues before they make referrals for this. Pediatric occupational therapists would be the ones to consult about eating and oral-motor issues. Feel free to contact me if you have further questions. Good luck.

What a challenge you are facing. It really helps to do this with support and I would recommend seeing a pediatric dietitian who can guide you and offer some advice. For example, many young children like waffles and pancakes, they are soft, you can top them with butter. Offer food every 2-3 hours, let the child be in control of the amount, the more you fuss, the less they eat. Read books by Ellen Satter, dietitian and therapist.

I can totally relate to your experience. My 21-daughter has been an extremely fussy feeder from the beginning. She refused the bottle from very early on, despite all of my efforts. I had to return to work at month 4, so I started her on solids very early and used the pumped milk in other foods (see below). Even now that we are on a toddler diet, she continues to be extremely picky about her food. She even dislikes the more common kid favorites such as macaroni and cheese and peanut butter and jelly sandwiches. Fortunately, she has no known allergies (though we are vegetarians and our diet may be more restricted in other ways).

Some principles that have helped us survive

1) Make as much of the pureed foods at home as possible, using fresh veggies/fruits. From the beginning, she refused to eat any of the bottled foods but would manage to eat some of the home cooked food.

2) Spice everything. I found that my daughter really likes strongly flavored foods, and through trial and error, I have found her favorite flavors.

3) Keep her on a routine. I found that she would prefer to do anything but eat. (I found it wasn't true that ''she would eat when she was hungry.'') But, with a little vigilance on my part about routines, she has come to expect eating certain things in certain orders at certain times during the day (e.g., breakfast, then fruit, then snack, then milk, etc. all within roughly same time periods each day).

4) Distract her throughout the feeding (I always put her in a highchair so I can control her) with lots of animated discussion, related to either her toys, books, or tv shows on hand. I also make sure no one else is in the room during feeding and that I am not distracted by anything else (such as phone, spouse, etc) b/c she will quickly stop eating.

5) Use sippy cups and glasses for beverage items and mix as much formula/milk into solid foods as possible - b/c my daughter refused the bottle, I trained her to use a sippy cup and then a glass for drinking very early on. Also, while I was at work, all foods served to her (including the fruit purees) until she was regularly drinking soymilk from a glass (see below) would be mixed with some breastmilk so she would get at least a few ounces with the solid feedings.

And, here are some quirky foods that seem to work for her (and are not on your list of allergic foods)

1) Instant oatmeal and quinoa flakes hot cereal (I buy both buld at Whole Foods). I put a sweetener (such as Molasses), spices (cinnamon,nutmeg and cloves) and cook it with a combo of whole milk and water. You can also make it with soymilk.

2) Baby cereal, formula (My daughter likes a particular organic dairy formula I use) and a large banana, all blended together. The consistency is pretty thin and I spoon feed her. Even though she has outgrown these foods, I still feed this to her everyday because she still likes it.

5) Soymilk to drink in glass (she refuses any cow's milk and she only likes Silk Soy, which is fortunately readily available)

6) Superfood Juice from Odwalla (curiously, she seems to really like this and b/c it is very nutritious I try to give her some every day, usually after a vegetable serving).

6) Tofu-based products- She likes tofu products quite a bit, such as baked tofu and veggie dogs . She has been eating thin slices of baked tofu since she was a year old.

7) Dried beans of all kinds (boiled and seasoned with different spices). When she was young, I would puree some boiled rice and different beans together with spices and some breastmilk.

Hope this helps. Good luck and hang in there. While your daughter may not ''grow out of'' her fussiness anytime soon, it will get marginally easier as she grows older b/c there will be a wider variety of foods and food preparation methods available to you. And, while I always worry about my daughter's weight (she too is really low in the charts), the pediatrician has never been worried and says that she is an extremely healthy, curious and physically active child.

mom of an extremely fussy eater