Take the 2-minute tour ×
Parenting Stack Exchange is a question and answer site for parents, grandparents, nannies and others with a parenting role. It's 100% free, no registration required.

Our toddler isn't gaining weight, and our doctor told us to fix it. We stopped breastfeeding and she gained a kilo in just two weeks, but since then (soon two months) she hasn't gained anything again, possibly even lost a bit.

The weather is fantastic and she is running around like crazy both inside and outside, which I'm sure isn't helping, but we need to get her to eat more, but she isn't really that interested (except in baby formula milk, which she loves, and gets during the night, the recommended 500-800ml).

Everything else seems fine.

share|improve this question
3  
Did your doctor not give you any advice on how you could fix it? –  Mongus Pong Jun 13 '11 at 10:57
    
@Mongus Pong: Yes, she needs to eat more. Besides that nothing non-obvious. See also Karl Bielefeldts answer. As answers should be generally useful, obvious stuff is also welcome, but I'm looking for non-obvious insights that can help here, personally. –  Lennart Regebro Jun 13 '11 at 11:25
    
How old is she? –  jny Jun 13 '11 at 13:40
    
@jny: 14 months –  Lennart Regebro Jun 13 '11 at 15:31
    
How much does she weigh? –  Shauna Jun 14 '11 at 20:32

17 Answers 17

I noticed in one of the responses that you said you quit offering snacks. Here is a sample of our meal schedule for our 15 month old twins. We seldom offer snacks but stagger meals and milk. By staggering them we get more high calorie/protein milk in them on a regular basis.

  • 7:30 AM 8oz of milk with liquid vitamins (Poly-Vi-Sol) added in
  • 8:30 AM Breakfast (Whole milk plain Yogurt with fruit puree, protein such as eggs or ham, fruit, carb such as peanut butter toast)
  • 10:30 AM 8 oz of milk offered
  • [11-1 Nap time]
  • 1:30 Lunch (Avocado with banana, protein, veggie, carb, fruit for dessert)
  • 3:30 8 oz milk offered
  • 5:30 Supper (Protein, veggies, carb, fruit for dessert)
  • 7:00 8 oz milk offered
  • [8:00 bed time]

We offer 8 oz of milk each time but other than in the morning it is seldom that the full glass gets drank. Water is always available in the play area to be drank when thirsty.

I Googled "high calorie foods for toddlers" and got some great hits that had some good ideas on foods to offer. We make sure to always offer a wide variety of foods at each meal.

Our biggest trick is just what you said in a comment, we offer the meal and then after it is gone we offer fruit to get a few extra calories in. Freeze dried blueberries are a favorite.

share|improve this answer
    
can you explain the "liquid vitamins" a bit more? What liquid vitamins do you include and why? –  Swati Jun 16 '11 at 17:09
    
@Swati we give our children a liquid multi-vitamin called Poly-Vi-Sol(I added a link in my post). Originally it was because I was breastfeeding and my doctor was worried they weren't getting enough Iron. Now they don't need the extra iron but I like that they get an extra dose of Vitamin D every day. Because it tastes pretty bad we add it to their morning milk. –  Amy Patterson Jun 16 '11 at 18:37
    
Speaking from my own childhood, make sure that your child is not getting too much milk (32 oz might just qualify as too much!). Calcium can block iron absorption leading to anemia. I had anemia as a child and it took our pediatrician a while to figure out the problem until it was mentioned that I was drinking about a gallon (64 oz.) of (powdered) milk a day. Note that I was older (and larger) than your child, I'm not a doctor, etc., so take it with a grain of salt, but if you haven't already done so, I would verify with your own pediatrician that this diet is safe! –  Ben Hocking Jan 14 '13 at 1:21
    
We gave the boys 32 ounces of milk until they were a 1.5 years old and started eating more regular food, with the last 6 months being a transition from pumped breast milk to cows milk. By 2 they were down to 24 ounces a day and eating regular meals. The doctor did approve the transition diet and ran regular iron tests on them. I was anemic during the pregnancy so he was concerned about it. Thank you for your concern and it is good for people to know to be careful about the amount of milk their little ones get :) –  Amy Patterson Jan 15 '13 at 19:36

Busy toddlers burn lots of calories. A child that is not gaining weight steadily can be in danger of not meeting their nutritional needs. This is the reason for your physician's concern.

Getting your little one to eat more is likely to be very difficult. Therefore, making each mouthful have the greatest caloric impact is the most likely to add those needed ounces.

Here are some strategies for adding calories.

Add 1 or 2 tablespoons of nonfat dry milk powder to casseroles, muffins, cooked cereal, pancakes, puddings, mashed potatoes scrambled eggs, meatloaf, whole milk, milkshakes, yogurt, and even her formula.

Add a powdered breakfast drink (such as Instant Breakfast®) to:milk, milkshakes, smoothies, or ice cream.

Add extra margarine or butter to: cooked cereal, rice, pasta dishes, sandwiches, potatoes, and vegetables.

Add cheese to: casseroles, meatloaf, crackers, sandwiches, hamburgers, soups, mashed potatoes, and vegetables.

Spread cream cheese or peanut butter (watch for allergies) on: crackers, muffins, fruit slices, pancakes, graham crackers, and pretzels.

Include supplements, such as:Boost® Pediasure®, Carnation Instant Sport shakes® & Breakfast®, and Yo-J®.

For extra protein, offer more of these foods: eggs, milk, cheese, peanut butter, cottage cheese, puddings, legumes, ricotta cheese, meats, & yogurt.

These strategies are recommended by dieticians. You may even want to ask your physician for a referral for a dietary consult with a dietician that can help you with a very specific plan for your child.

share|improve this answer

Is her weight out of proportion to her height, like she is malnourished? Or is she in good proportion but in a low "percentile" or just stalled for a little bit? The former is a much more serious problem, but a lot of doctors freak out about the latter just as much.

Children gain weight the same way adults do, with foods very dense in calories such as high carbs. Make sure she is getting vitamins in, but make a lot bigger proportion of her diet in higher calorie foods than you would consider healthy for yourself as an adult.

Also review some of the threads on picky eaters. If kids know they will get their favorite foods if they hold out long enough, they will go hungry so they can get more of their favorite. It can be very difficult to do, esspecially with a child that needs to gain weight, but if you limit her portions on her favorites, she will eventually get hungry enough that she has no choice but to expand her diet during the day. It's a short-term trade off for a long-term gain.

share|improve this answer
    
+1 for good general comments, but we already do this. :) –  Lennart Regebro Jun 13 '11 at 7:17
    
+1 Always consider weight in relation to height. This low weight issue certainly is a greater concern for a little one with a higher percentile height. –  demongolem Sep 19 '13 at 21:07

Our toddler's appetite seems to vary in large swings from month to month, but when she's in a phase where she seems to be eating too little we've noticed that different eating positions can affect how much she eats. Sometimes she will only focus and eat much if she's in her high chair w/tray; sometimes she hates the high chair and will eat more feeding herself finger food on a blanket on the floor, sometimes she best likes to sit in my lap and have me feed her facing away, sometimes she is most interested in trying to feed herself with a toy fork; and if all else fails we'll sometimes put on a video for her and feed her while she's watching, as she's somewhat distracted and will eat without scrutinizing it. So, maybe try mixing up the feeding style?

share|improve this answer

It sounds like your pediatrician may not be specific enough to be particularly helpful. I'd suggest:

  • Making a food diary. List the food, portion size, and time of day. Perhaps you think your child is eating more than she actually is. (It's a pain in the rear at first but you get used to it; my parents had to do this for me because of allergies and it becomes second nature pretty fast.)
  • Taking a long, close look at family history--on your side and her mother's. Were all the babies lean/skinny/tall/underweight/small-framed on one side of the family? My baby's a peanut but on my husband's side, many of his female relatives have a small frame, so we're not too concerned.
  • Making a consultation appointment to sit down and discuss just this topic. Bring a notebook with questions pre-written down, and take copious notes.
  • If the pediatrician isn't being specific/helpful enough, look for another pediatrician.
  • Getting a referral to a pediatric nutritionist. Preferably someone who can get your baby on prescription supplements if necessary (e.g. a nutritionist who works with a doctor, or one who is legally licensed to prescribe)

I know how concerning it is when your child seems on the low end of the bell curve, weight-wise. Fortunately, right now our ped isn't concerned (she said SOMEONE's gotta be on the skinny end of that curve!) but I've been cheering every bit of weight gain I can get. My baby looks healthy and is very active, but I think it's just normal parenting paranoia to be a little concerned in the back of your mind. I wish you the best of luck and hope you can get some solutions soon!

share|improve this answer

Loads of good answers on here. Just wanted to add one thing that we were given in advice when our son was this age and we were all keen to see more weight gain. Make sure you don't use whole grain foods all the time. we were surprised because we had assumed they were healthier but too much fiber can be a problem for small systems. we went back to white bread etc (along with the supplements etc that people are talking about here) and saw an improvement.

that said, he's now 5 and healthy but still small and still not interested in food. At this age the fear is obesity so no one tells us to 'fix it' any more!

My husband had a similar growth profile (my mother in law kept his charts) and he says that the important thing is to remain calm. Once your child realises its an issue you will have struggles for life (we struggle with this aspect too despite our best efforts to avoid)

remember, you can offer the best but you can't make them eat it

share|improve this answer

Our eldest daughter was told the same thing (Gain Weight!) at the 12, 15, 18, 21, and 24 month appts- (we actually went every month because she was not on the weight charts <1%).

We found Pediasure was an excellent addition to her diet. It contains a whopping 9grams per serving as well as fiber & protein. PediaSure also has lots of vitamins and minerals. It does not contain dairy or wheat.

We replaced all whole milk with Pediasure for 6 months, & then continued with mostly Pediasure. She is now well into the 40% for her age (3.5years). After the age of 3, we cut back on the Pediasure, just 1 bottle and we switched to the lower fat version (Side Kicks).

For more info: http://pediasure.com/

share|improve this answer
    
This is not available in most countries, and hence not a generally useful answer. –  Lennart Regebro Jul 5 '11 at 17:27
1  
I agree with Lennart, but the answer opens the idea to look for similar products in the reader's area. –  Torben Gundtofte-Bruun Jul 6 '11 at 8:57
    
Pediasure is available online and can be shipped internationally: international.drugstore.com/search/… –  Lauren Jul 11 '11 at 2:25
up vote 2 down vote accepted

The best success we have had is in giving her one thing at a time.

Ie, instead of giving her potatoes and meat, we give her potatoes. When that got boring, we try a bit of boiled carrot. And when she doesn't want that we give her some meat. And when finally she wants no food at all, we give her a bit of yogurt as dessert.

This has kick-started the weight-gain again and she took an a lot the last month.

share|improve this answer

I noticed that someone suggested offering lots of fruits. Fruits are not good for weight gain. My son is very underweight and we found we were feeding him too many fruits and he was not gaining well at all. We thought it as healthy for him, and it is in moderation, but not to pack on the pounds like he needed. Our pediatrician recommended carnation instant breakfast, cheese and butter (real butter) on everything possible. We tried Pediasure, but he doesn't like the taste and its pretty expensive. I've seen some people try adding cream instead of milk in mashed potatoes and I'm going to try that one next. Hope this helps!

share|improve this answer

Have you tried ...?

  • tons of fruits (if she's not interested in regular food, at least sweet fruits might catch her interest?)
  • fruits with full-fat/whole-fat yoghurt (gotta get those calories somehow...), consider natural (=unflavored) yoghurt to avoid sugars and whatever else they put in regular food.
  • asking the paediatrician for more useful advice than "fix it".
  • if she won't accept anything else than formula, get the richest sort you can find (for older children?) and serve during the day too (not ideal, but better than losing weight!)
share|improve this answer
    
She does eat, and she isn't picky, but she doesn't seem to eat very much. Maybe we'll try to give her fruits after she refuses to eat more of the main meal, to get her to keep on eating. I do worry this will make her picky, though. –  Lennart Regebro Jun 13 '11 at 7:19

I would add proteins (meat, beans) and more frequent meals (may be with healthy snacks in between if it does not spoil her appetite) to the answers since you mention that she is not picky just does not eat much in one sitting.

But if you daughter eats balanced diet and enough calories(and kids don't need that much) and does not have any known health issues, I would ask your pediatrician why her weight gain is a concern to her. If there are some underlying issues, stuffing the child is not going to help while creating potential problems in the future. Healthy children will not starve themselves and eat as much as needed. If the weight gain remains a concern may be your doctor could run tests to check for things associated with this problem.

share|improve this answer
    
We are actually going to try the exact opposite: No snacks at all. This is because we suspect it might spoil he appetite. :) –  Lennart Regebro Jun 13 '11 at 22:15
2  
If she's still eating during the meals, I'd say keep giving her snacks. Remember, kids' tummies aren't as big as adults. As such, they need to eat every couple of hours. Eating proper proportions multiple times per day shouldn't "spoil the appetite," especially if she's running around all the time and working it back up, anyway. –  Shauna Jun 14 '11 at 20:31
    
How is "snacks" the same thing as "proper proportions"? –  Lennart Regebro Jun 16 '11 at 6:18
    
@Lennart - "Proper proportions" meaning not having a meal between meals. For example, if meals are 500 calories each, snacks should be, say, 250 calories each, not 500 (numbers are just pulled out of the air). If a person's stomach can only hold 500 calories worth of food at once, trying to make them eat 750 at meals isn't going to do any good, because they're not likely to eat it, but if they only eat 500 and are hungry a couple hours later, they can eat that other 250 to refuel a little, then eat a full meal at the next mealtime. –  Shauna Jun 20 '11 at 13:00

It is also the same concern I have with my 22 month old son. When he turned one, he is not gaining that much weight. As we all know, as this age, they like to run around and explore things. They are very busy with a lot of things which burn up their calories, easily. What I did is that I devise a meal plan to ensure that he can get the right amount of nutrients at the right time, and I make sure that this scheduled is followed. Like I give him a bottle of milk, as soon as he wake up. When we take our breakfast, he also join us. He even has his own specially made chair, so he can join in the dining table. In this way, he is all the more encourage to eat because he can see us dining with him, as well. I also purchased some baby food stuffs, so if he feels like eating, he can just pinpoint it. My mom also bought him some chocolates, (I give it in moderation), for energy boosting. It is also important that your child gets enough sleep and rest, so he can re-charge. Anyhow, just continue keeping track of your baby's weight, so you would know the progress.

share|improve this answer

Why not ask your doctor for specific advice on how to help her gain weight? You might even be able to get a referral to a nutritionist if the pediatrician can't help. It also allows you to have prescription aids available if necessary.

share|improve this answer

Sometimes this is just the kid in general, my oldest tended to be on the taller/thinner side although he had a good appetite growing up. He was breast-fed until almost 1.5 years, my 14 month old still gets a little although he is a pudgy and has a great appetite. What we tried to do was give something else after our son decided he was not going to eat more of one thing, that way we kept him eating. I have noticed that when the kids are VERY active, their appetites sometimes go down even when expending lots of calories, and other times they are more hungry when not doing much.

A few times our old pediatrician told us to work on the eating and weight gain, sometimes we succeeded and other times we did not. We just dealt with it.

The way I look at it, if the kid is still growing, eating a wide variety of foods, then things are fine and every child being different will grow and eat in different ways. You seem to be doing the right things.

share|improve this answer

We just started our daughter on carnation breakfast and it seems to be helping. It's basically chocolate milk but is super healthy. She loves it and it gives her everything she needs. Good luck!

share|improve this answer

Toddlers do need snacks between meals, their stomachs aren't big like adults. But, maximize every calorie by being selective about only offering healthy foods with lots of vitamins, healthy fats, dense nutrients, etc. Make sure she is not filling up on goldfish crackers and the like, more cheese, fresh fruit, add butter to everything you can to get more fats that babies need, etc. And you may have to remind your child it would be a good time to snack by preparing a healthy snack and offering it at a time spaced apart from meals.

At 14 months I would still expect a significant portion of her calories to come from breastmilk or formula. Although it is generally regarded as acceptable to allow a 14 month old to drink whole milk, if you are needing to "fatten her up" I would stick to using the formula, which is better for them nutrition-wise. Often it is easier to get more calories in through adding liquid calories (just like it is for adults, eg: drinking soda, coffee, etc doesn't always seem hard on a "full" stomach), so perhaps consult your pediatrician about whether upping her allowance of formula per day would be ok.

share|improve this answer

Most pediatricians use growth charts based on formula feed babies and are thrown for a loop when someone is breast feeding their child, as the growth charts for the two are entirely different. Search for the "WHO child growth charts" and re-plot your child's growth on them up to the time your child stopped nursing.

share|improve this answer
    
I think you misunderstood the question. –  Lennart Regebro Jun 13 '11 at 7:16
    
@Lennart - Actually, his point is valid, and like answers on other SE sites where the best answer is actually "don't do it," the questioner's baby may not actually need to gain weight. Breastfed babies tend to be thinner overall, and at the year mark are notorious for being in the lower percentiles for their size and even losing weight, especially this time of year. Under most circumstances, it's not an issue and the baby doesn't actually need to gain any weight, especially if they're running around a lot. –  Shauna Jun 14 '11 at 20:27
    
@Shauna: She isn't breastfed any more, and she is also not gaining weight for months now. I fail to see what WHO's charts have to do with this. –  Lennart Regebro Jun 14 '11 at 20:35
    
@Lennart - From the wording of your question, you were still breastfeeding at your daughter's 12 month checkup. That would impact the outcome of that visit and would have just about everything to do with the growth chart and breastfeeding. You're also dealing with a child who was breastfed for a year and only recently stopped. Just like losing weight is a slow thing, so is gaining weight (especially when one's running around all the time while trying to gain weight). –  Shauna Jun 15 '11 at 12:20
2  
-1 for not answering the question. It's not about is my child growing okay. It's about a pediatrician(!) saying that the baby needs to gain weight. –  Torben Gundtofte-Bruun Jun 16 '11 at 6:15

protected by Community Apr 8 '13 at 1:24

Thank you for your interest in this question. Because it has attracted low-quality answers, posting an answer now requires 10 reputation on this site.

Would you like to answer one of these unanswered questions instead?

Not the answer you're looking for? Browse other questions tagged or ask your own question.