At what point do I worry about dd's weight?

[Element]

I know not to worry about underweight dc. I know this. I always respond to posts in which the OP has worries about a little one not gaining weight by saying something like, "Don't worry! Some kids are just little!" I really do believe this.

 

I think I just need a little reassurance today.

 

Dd's BMI has always been at about the 3rd percentile, but I just checked her again and she is now below the 1st percentile (12.4 BMI.) She is my super-picky eater. She nibbles at food all day long and she says she's always hungry. However, she is growing (height-wise) just fine, and is at the 50th% for her age in height. She still struggles to open heavy doors but she can ride her bike a couple of miles on a paved trail. She has gained 4 lbs in the past 2 years so she is gaining... kind of.

 

I have asked her doctor in the past if her weight is okay, and he replied, "Hey, you're lucky. Most of the kids I see are on the other end of the spectrum!" and that was that. :confused:

 

She has continued to grow, and my dh always says: "As long as she's growing and learning, don't worry about her weight." Really, though, does there ever come a time when you really do have to worry about a child's weight? I'm not to that point, right?

 

FWIW, since I know these things usually come up in the "underweight dc" threads:

 

• She hates peanut butter, nuts, and legumes. "Protein drinks" like Ensure or Pediasure make her vomit but she will drink some of the smoothies I make and those don't seem to cause her any problems.
  
• Three years ago, she was tested for GERD and food allergies (due to constant throat clearing, which has been much better in recent years) and both tests came back negative. Her iron level was tested last fall and she is not anemic.
  
• She loves meat and processed food but I rarely buy either (although I have to admit, I'm tempted to start just so she'll eat.) She loves cheese but it makes her constipated.
  
• She is very moody (but I don't know if that has anything to do with anything.)
  

[Dory]

I would be worried. I've seen what severe underweight can do to the body. If she has a mineral or vitamin deficiency it can account for some weight loss, or perhaps a thyroid problem.

[Pegasus]

Is this the 7-year-old in your signature block? Honestly, I would accept your ped's comment and not worry. My eldest DD was under 5% on the weight curve, picky eater, the whole bit. As long as they are growing well and you aren't making eating a battle, all is good.

 

Some kids will just stay thinner than average. My DD started putting on a little more weight as she developed curves.

[Element]

Is this the 7-year-old in your signature block? Honestly, I would accept your ped's comment and not worry. My eldest DD was under 5% on the weight curve, picky eater, the whole bit. As long as they are growing well and you aren't making eating a battle, all is good.

 

Some kids will just stay thinner than average. My DD started putting on a little more weight as she developed curves.

 

Yes, this is the 7-year-old in my signature. Thank you. That is what I needed to hear. I do try not to make eating a battle, but sometimes it gets frustrating. For example, if dinner is fajitas, dd will eat a plain tortilla. Then she complains that she is hungry. I tell her she is welcome to eat what the rest of us are eating or she can make herself something. I'm not making her a separate dinner. She pouts, goes to her room, and gets herself some yogurt later. I don't consider that a battle, but she might disagree.

[littlebug42]

My ped always told me for my daughter that it became a concern when her height and weight percentiles were very different. For instance, my dd was always under the 5th percentile for weight and 10th percentile for height. She said this indicated that she was just on the small end of normal and no cause for concern. It would have become a concern if she was significantly higher on one than the other i.e, 75th in height and 5th in weight. As long as they were proportionate, they were fine.

[love2read]

Two of my daughters were like that and they both become obsessed with potatoes around age 9 or 10 and fattened up a little bit. One is out of college now and another an older teen; both are slender but healthy. Try hash browns, potato soup, baked french fries, etc. and don't worry about them being not terribly healthy because they'll spark her appetite a little bit.

[wintermom]

My dd is also pretty tiny and has definite preferences for foods. If your dd is complaining of feeling hungry, I'd try to increase her protein intake any way you can. You can make smoothies with fruit she likes, yogurt, milk and protein powder. You can get her some meat treats like pepperoni sticks, chicken/turkey nibblers, or sliced meats. Maybe she likes other kinds of nuts or seeds, such as pistachios, sunflower seeds, or almonds.

 

If she's only eating simple carbs her blood sugar may be swinging up and down, which may account for some of the moodiness. Protein will help stabilize things and reduce that feeling of hunger.

[OrganicAnn]

I would feed her meat since you said she loves it but you rarely buy it.

 

You can get hormone free, free ranged chicken etc if you are worried about things like that.

[Element]

My ped always told me for my daughter that it became a concern when her height and weight percentiles were very different. For instance, my dd was always under the 5th percentile for weight and 10th percentile for height. She said this indicated that she was just on the small end of normal and no cause for concern. It would have become a concern if she was significantly higher on one than the other i.e, 75th in height and 5th in weight. As long as they were proportionate, they were fine.

 

Okay, thanks. That makes sense. I guess I'll just make sure her ped knows the difference between her height and her weight percentiles the next time I bring it up to him.

 

Two of my daughters were like that and they both become obsessed with potatoes around age 9 or 10 and fattened up a little bit. One is out of college now and another an older teen; both are slender but healthy. Try hash browns, potato soup, baked french fries, etc. and don't worry about them being not terribly healthy because they'll spark her appetite a little bit.

 

I never thought of it like that- "sparking" an appetite. That makes sense. She doesn't like potatoes but maybe I can find something similar for her.

[Slipper]

If you're worried about her weight, take her to see a gastroenterologist. They deal with a lot of weight issues and can double-check to make sure she's doing well.

 

My daughter is no longer on the growth chart but is otherwise healthy and bright. They have checked for numerous things but have concluded that she's just small.

[Barb_]

My slender girls looked like bones and gristle from the ages of around 7-13 (boys should take even longer). It's hard to fill out when all your food energy is fueling growth. As a previous poster mentioned, mine started to fill out and get curvy with puberty. They are softer now, but still slender.

[mom2hunangirls]

One of my friends took her very picky eater to an OT. The change is amazing.

Her daughter would eat next to nothing and what she would eat was so nutrient deficient it could not have sustained her. (but was always hungry)

I was very close to that growing up and eventually learned to like all the stuff that put weight on but set me up for major struggles as an adult. I wish I had had the OT therapy my friend's daughter had.

[redsquirrel]

My eldest son is a pixie child as well. He has spent time in the 1% for weight and has always been in maybe the 10th percentile for height. I think my son is in the 5th percentile for weight these days. Now that he is just 12 I can see him starting to put on muscle, but still no fat.

 

He is NOT a picky eater but he is not a big eater. He is very active and obviously very healthy. When he was younger people would make all kinds of rude remarks about his size, I know how that hurts. I also know how it is to worry. I think when he was 7 and 8 I spent a lot of time worrying about it. Now that he is older it just doesn't concern me. He is growing and in glowing health so I am not worried.

 

Our doctor told me that he would be more concerned if there was a big change. For example if a child has generally been in the 50% and dropped down to the 5th would be concerning. If a child has always been in a low percentile that isn't as concerning.

 

It is going to be ok. She might just be a teeny thing. I am hardly 5ft tall (my son is tiny for a reason) and I am sure I was very petite at age 7. Someone is going to be the tallest and someone is going to be the shortest.

 

My younger son is a picky eater, has an OT and also eats like a bird. He is in the 30% for weight. He is slim but heavier boned. No one worries about his weight, but he also eats very little. My older, skinnier boy is always after my younger boy to eat more.

[sillymommy]

If she's only eating simple carbs her blood sugar may be swinging up and down, which may account for some of the moodiness. Protein will help stabilize things and reduce that feeling of hunger.

 

:iagree:

 

Also, you might try recipes from The Sneaky Chef. She has some cleaver ways of getting nutritious foods into picky kids. http://www.thesneakychef.com/

[JumpyTheFrog]

If she dislikes nuts and legumes and rarely eats meat (since you rarely buy it), it sounds like she isn't getting much protein. Would she eat meat twice a day if you bought it? How about lots of Kerrygold butter?

 

I think what would concern me would be the big difference between her height and weight percentiles. My youngest is maybe at the 7th percentile for height and slightly higher for weight. It doesn't concern me since he is at a good weight for his height. My oldest was small at the same age, but now is in the tall side. (My mom and I were both small toddlers as well, so it runs in the family.) Also, We eat plenty of meat, fat, and vegetables, and I'm sure he'll go through a huge growth spurt at 4-5 like his brother.

 

Anyway, you seem worried, so I thought I'd suggest trying more meat. A low meat diet isn't giving you the results you wanted, so it might be worth trying for a few months.

[Liz CA]

Do you know what her blood type is? There is a school of thought that blood type 0 should have meat while A for instance can thrive on little meat.

It's true for some people, others have suggested it's not sound science.

I don't know which it is except that you mentioned you buy little meat. My ds and dh are both type 0 and would not be happy without some meat.

I would steer her clear of processed food but perhaps she'd be okay with some meat.

[chepyl]

I would feed her meat. I get hungry very quickly if I don't eat meat, nuts and peanut butter dont work for me. I am hungry so fast after a PBJ sandwich. I was a toothpick when I was little. I was a picky eater, but I loved chicken and steak!

[JFJ in IL]

My dd is also pretty tiny and has definite preferences for foods. If your dd is complaining of feeling hungry, I'd try to increase her protein intake any way you can. You can make smoothies with fruit she likes, yogurt, milk and protein powder. You can get her some meat treats like pepperoni sticks, chicken/turkey nibblers, or sliced meats. Maybe she likes other kinds of nuts or seeds, such as pistachios, sunflower seeds, or almonds.

 

If she's only eating simple carbs her blood sugar may be swinging up and down, which may account for some of the moodiness. Protein will help stabilize things and reduce that feeling of hunger.

 

:iagree:

[J-rap]

My daughter was like that. She was off the chart (below 0, that is) for a number of years, both weight and height, and when her height finally started to slowly go up, her weight still remained at about 0%. The doctor really scared me, and had her go through numerous tests, even though my gut feeling was that she was okay. She actually had a very good appetite, but just never seemed to get bigger!

 

One thing that seemed to reassure EVERYONE was that her hair looked so healthy and glossy. Every doctor she met with commented on this. It was a sign that her body was getting the nutrition she needed. She was also happy, though she seemed to get colds all the time. Physically she was a little behind for a number of years. She couldn't even open the front door because her hands were tiny and just lacked strength!

 

After doctors at Mayo Clinic ruled out absolutely everything, I finally relaxed. One thing I did NOT do was make her eat the same healthy diet as the rest of us. She did have a good appetite, but I fed her things that the rest of us didn't eat: like hash browns for breakfast (I'd get the frozen kind that you just pop in the microwave), candy bars for dessert. I wanted her to enjoy eating and not make a big deal out of it.

 

Another thing that helped doctors and me relax is that we did have a couple very petite people in my family, like my mother.

 

Now this daughter is 17, very active, eats very healthy foods, is a size "0" but doesn't look bony -- just petite, and is 5'5" when she stands up really straight! She weighs 100 pounds. She still can eat a LOT. We tease her because she was still wearing her Barney toddler underwear until she was about 12! (Of course they did stretch as she got bigger. :))

[musicianmom]

I second the recommendation for an OT evaluation for sensory issues. My 4-year-old has had an evaluation and is about to start therapy specifically for picky eating. The OT told me that there are 32(!) steps to get a child to tolerate eating a new food. The goal is to have 30 foods (10 carbs, 10 proteins, 10 fruits & veggies) that the child will eat, so there can be a wide rotation among the foods.

[Cammie]

I also have a very small 7 year old. He has been in the 1-5% for height and weight for many years. We did a bone age test two years ago and also tested for gluten sensitivity. The endocrinologist was of the opinion that he was a healthy, if small, little boy. He is also a very picky eater. I refuse to make food a battle. We have had a little progress in introducing some fruits (apples, grapes) into his diet. He will eat chicken and peanut butter. He has more energy than anyone I know!

 

I know it is hard not to compare and worry :grouphug: but there are lots of us in the same boat as you!

[LucyStoner]

I would buy her meat.

[Element]

Wow, thanks to everyone for your responses. I really appreciate it.

 

She likes dairy and I had been hoping that she was getting enough protein through milk and yogurt. I thought the issue was not getting enough fat. I am now rethinking her protein intake and it is probably not enough. I need to research ways to add more protein to her diet.

 

Do you know what her blood type is? There is a school of thought that blood type 0 should have meat while A for instance can thrive on little meat.

 

 

I've never heard that before! She very well could be an O, since I'm an A Pos. and her dad is O Reg. I'm not sure what type she is; I'll have to look and see if I have that anywhere.

 

My daughter was like that. She was off the chart (below 0, that is) for a number of years, both weight and height, and when her height finally started to slowly go up, her weight still remained at about 0%.

...

 

 

Thank you so much for sharing your story with me. :grouphug:

 

Our families are always asking for updates on her weight, shooting concerned glances at me when they pick her up for a hug, or telling her to eat more. People I don't know very well will say something like, "Wait, she's seven now? How much does she weigh?" and things like that. As much as I feel that she is fine, after a while their concern starts to rub off on me. I think I just let it get to me this time.

 

I really am going to try to get more protein in her, though.

[Liz CA]

She likes dairy and I had been hoping that she was getting enough protein through milk and yogurt. I thought the issue was not getting enough fat. I am now rethinking her protein intake and it is probably not enough. I need to research ways to add more protein to her diet.

 

 

Eggs are good protein. This is how I like to get protein since I am not a big meat eater.

[Slipper]

Another poster's post reminded me of a few more things. My daughter will turn 11 in 2 months. She had a recent weight jump and is now 55 lbs. I forget her height, but it's below 0% as well.

 

However, her hair is not falling out (which apparently would happen if you became too small), she is physically active (soccer, cheerleading, karate, etc) and smart. (Apparently there is more brain fog when weight becomes too low). Shei s healthy, just small.

 

Our doc ordered some bone tests and she tests approximately 2 yrs younger than her physial age. Our only big concern (which isn't that big) is that her bones are a bit weak and she takes calcium daily.

[amo_mea_filiis.]

I hate that there is so little for lower weight kids!

 

I would go to a gi just to make sure there are no absorption problems. I would also keep a food/liquid/bathroom diary and calculate her intake. If she is eating adequate calories, i would be more concerned of malabsorption.

[mom2hunangirls]

I second the recommendation for an OT evaluation for sensory issues. My 4-year-old has had an evaluation and is about to start therapy specifically for picky eating. The OT told me that there are 32(!) steps to get a child to tolerate eating a new food. The goal is to have 30 foods (10 carbs, 10 proteins, 10 fruits & veggies) that the child will eat, so there can be a wide rotation among the foods.

 

yes! yes! yes!! Exactly what friend's OT said and did!

[KidsHappen]

Have you had her checked for Turner's Syndrome? It's wild shot but one that I would want to elimintate.

[Paige]

I think the rule of thumb is that you should worry if she flatlines on the height chart. Kids' weights vary widely and go up and down as they go through growth spurts. Growth spurts should be happening, however, for all kids. Kids who no longer show growth in height from year to year need to be evaluated. Growth slows down as kids age, but there should always be at least small increases.