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My 5 year old who used to be on the 91st centile for height is now below the 50th and we think the gradual decline has been since he started not eating so well. We believe he only eats just enough food to keep him going because he wants to get down and play. He also eats quite slowly compounded by his constant talking instead of eating! It's a constant battle to ask him to keep eating!

Should we feed him richer food to "fatten him up"? Should we let him eat as much cereal as he wants before bed regardless of how little dinner he ate?

Any advice welcome!

thanks.

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I've modified the title a bit. Feel free to roll it back if you feel it doesn't properly describe your question. –  Beofett Nov 2 '11 at 14:09
    
Appreciate the thought @Beofett. In the UK 5 year olds are not pre-schoolers. He is in Year 1 of the schooling system, which comes after Reception year. Before that is pre-school (i.e. 3-4 years old). –  noelicus Nov 3 '11 at 12:35
    
Ah, thanks for the clarification. Part of the reason for the edit is to align the title with the appropriate tag. I have updated the tag to primary-schooler, as it seems more appropriate (pre-schooler and primary-schooler overlap at the 5 year mark, for the very reason you described). Would you object to replacing "5 year old" with "primary schooler" in the title? Avoiding specific ages in the titles helps with search engine optimization. –  Beofett Nov 3 '11 at 13:09
    
So what does your pediatrician think? And what are the comparative weight percentile numbers? –  tomjedrz Nov 3 '11 at 13:32
    
Our 5 year old did this kind of thing and we stopped giving him sugar. He got his appetite back in a couple of days. –  gahooa Feb 1 '13 at 3:49

6 Answers 6

up vote 5 down vote accepted

I try to timebox my oldest into this, he has started doing the same. Often coming home now without all his school lunch, or snack eaten. When we sit down for dinner he is all over the place by squirming in his seat, eats slow and talks constantly - so its a battle to figure out what is appropriate for him to do. Mine doesn't get bored, but his mind is on other things, although on occasion when it's something he REALLY likes he will sit and eat. So we did two things:

  1. Lot's of praise for eating dinner in the timebox we set, my wife and I will put on the Oven Timer if he takes too long, he really doesn't like it
  2. Make him more of the things he enjoys, which works well, and I often sneak new things into his favorites. Since one of them is pasta with tomato sauce it's easy to throw other stuff in there

After meals he can have specific snacks, and he does have healthy habits there but I don't like to encourage him to snack too much. I often note to him that he should have eaten all his meal, if he hadn't, and then he wouldn't need the snack - and then I will give him a choice between two things I think he should have. Richer food is ok, but often the richer food is not as nutritious, I have started to talk more before dinner hoping this talks him out before then, but the boundless energy of kids is hard to suppress.

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+1 for making his preferences work to his advantage. The reprimand-and-choice is neat too. –  Torben Gundtofte-Bruun Nov 2 '11 at 14:16
    
Love the idea of "talking him out" :-) So when the time-box times-out do you just remove his meal? And after that he's allowed to snack if he wants? –  noelicus Nov 2 '11 at 15:24
    
Yes, no more meal and snack or not depends on time and activity. Generally he gets nothing more until the next meal, although we do give him drinks (like Yogurt Smoothies or Sidekicks) so he doesn't miss nutrition. The goal is to get him to recognize what mealtime is and is not. –  MichaelF Nov 2 '11 at 16:16
    
I like the discipline and I like the snack avoidance. Perhaps I am missing something, but I don't see how this addresses the actual question. It addresses the child not eating at mealtime, not the child having a poor appetite and not getting enough food to be healthy. –  tomjedrz Nov 5 '11 at 15:55
    
Hungry kids eat more and eat their meal, at least in my experience, you can give better and more rounded nutrition in a meal than in a snack. –  MichaelF Nov 7 '11 at 12:49

Depending on your house rules, you can tie in quick eating with a favorite after-meal activity. In our case, we ONLY let the kids watch cartoons after dinner before sleep, so the rule is "you can watch TV from end of food till 8pm". If they eat slowly, they don't have time left for TV.

Doesn't work perfectly but works well enough most of the time.

As far as nutrition - make sure they get "heavy" nutritious snacks (e.g. nuts, yogurt).


Oh, and if you have >1 kid, competition (who will finish the food first) may work, but it's not guaranteed. The caveat here is to be careful to stop 5-minute-long "I will win - no I will win" chats :)

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The reward afterwards simply encourages him to stop eating sooner, rather than finish eating quicker, unfortunately! Tried that one. Thanks for the snack tip. V helpful. –  noelicus Nov 3 '11 at 12:15
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@noelicus - oh, he only gets the reward when a reasonable (by our standard) portion is finished - which usually means 95% of what's on the plate(s). –  user3143 Nov 3 '11 at 12:25

We use the snacks ours like as a reward for eating their food, so if they don't eat their school lunches or mess around at dinner time they don't get a favourite snack after dinner. The better they do with their food the better options they get as a reward.

If they eat all their dinner, have their fruit and get dressed for bed they get a good chunk of discovery channel or a book read to them. If not, they go straight to bed. The fact there are three of them helps with this, as invariably, the one who has behaved gloats a little :-/

Admittedly they go through phases, so you need to be aware that sometimes they will need twice as much food, and other times they may have a few days of eating almost nothing. At the low intake times we just ensure they at least get cereal in the morning.

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This is a good approach. +1 for the note about phases and variable food needs. –  tomjedrz Nov 4 '11 at 14:24

I suggest would hesitate to be concerned because he has dropped from the 91st percentile in height to 49. He is still well within the normal range, and no two children grow with similar patterns. Discuss your concerns with your pediatrician, and if advised that there is nothing to worry about, accept that advice.

  • He appears to have plenty of energy, which means he is getting enough calories.
  • You mentioned no other indicators of development issues or health problems.
  • What is his weight percentile, and what was it when his height was 91?
  • Is unusual height likely based on his family?
  • Ask the grandparents about how the parents developed with respect to height, weight, and activity.

My suggestions:

  1. Examine how many calories he is getting in a day, and research whether that is enough for a child his age and weight.
  2. Discuss your concerns and findings with your pediatrician.
  3. Don't heavily push food beyond the child's desires unless advised to do so by the pediatrician.

Do continue to enforce mealtime rules around healthy eating, courtesy and respect. Those should include eating what is served regardless of whether it is a favorite, honestly trying every dish served, not rushing the meal, using good table manners, and remaining at the table until excused by a parent.

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+1 for "don't push beyond the child's desires". Unless he begins to look malnourished, I would let his own hunger dictate the amount of food eaten, and just make sure the food he does eat is nutritious. –  Sarato Nov 5 '11 at 3:36

We all stay at the table together until everyone is finished. No one gets up - except to go potty and wash hands again if needed. This means that whether finished or not there is not popping up to go play. Nothing else happens at meal times, just eating and sharing conversation about our day, the news or whatever it is that is going on.

Stress that sometimes it is mommy's turn or daddy's turn to share something about the day and that he should be eating when it is someone else's turn to speak. Make time to do this for at least one meal per day. 45 minutes to about an hour tends to be a healthy amount of time for eating and conversation. You can't do a lot more than already suggested about school - etc. He will get distracted. It is an unfortunate part of growth. However, they also won't starve.

You might also speak with the pediatrician about your concerns. It seems strange that you mention a change in percentiles in height and not in weight. Normally, the first thing effected would be weight. He may just grow at a slower pace than his peers, but if there is something else going on (even nutritionally) a pediatrician is the one that will have the best ability to diagnose and make recommendations.

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It is understandable for parents to be too much concerned about their child's percentile ranking. But as long as your child, is in the normal range, you have nothing to worry about.

Regarding the table manners, you need to discipline them on the do's and don'ts in eating, so your child can focus on his or her activities, and so they will not be easily distracted. Try to help them to have a routine, so they can eat on the right time and they would also know when is playtime.

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