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Underweight 3 yo - at my wits end!

19 replies

TeddyIsaHe · 07/11/2020 21:25

Dd is off the bottom of the scale for weight. She was 25th centile when she was born, and tracked that quite reliably until about 6 months ago. Nothing has changed in routine (apart from covid!) etc.

She eats really well, with typical 3yo fussiness. She still has full fat everything, has plenty of butter, nuts, seeds, whole milk - all the stuff to pack in some calories. But I cannot get her weight up.

She’s seen a dr, and has had 1 blood test which came back fine. She’s booked in for a full blood count next week, and coeliac test.

I just don’t know how to get her weight up. Has anyone else had a skinny child and it’s been fine?

OP posts:
WitchesBritchesPumpkinPants · 07/11/2020 21:27

What are her energy levels like?

TeddyIsaHe · 07/11/2020 21:29

She’s very tired after nursery, we get home, have a snack and she’s in bed and sleeps a good 10-12 hours without waking, and still has a nap for 1.5-2 hours in the day over the weekend if she can.

This was one of the reasons I started worrying so much.

OP posts:
SocialBees · 07/11/2020 21:32

How tall is she and how much does she weigh? My DS1 has always been skinny. He's now 15yo, 6 foot tall and nearly 9 stone, so still skinny but very healthy and active!

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rottiemum88 · 07/11/2020 21:36

I was always a very skinny child and had to be weighed and measured regularly by the GP until I was about 7 according to my mum. I was otherwise healthy and eventually they decided that I was just going to be on the smaller end and left me be. I'm not a particularly large adult, but at 5'4" and 8.5 stone I'm well within the normal range these days.

It's not a bad thing that your DD is having tests to rule out anything underlying medically, but it's worth bearing in mind that when it comes to size there are always going to be those that are outliers to what's considered normal. Ultimately, if you know she's eating well and is otherwise healthy and active I'd try not to get a complex about "getting her weight up". Children's weight tends to regulate itself pretty well on its own.

InTheLongGrass · 07/11/2020 22:07

Would she eat more if offered?
My oldest has always been slender (around 9th centile) but not as small as yours.
At that age, he typically had breakfast at home followed by breakfast, snack, lunch, tea at nursery, then dinner again at home. Nursery usually involved seconds, and occasional thirds.
Aged 11 he will out eat me on some days - and I'm not slim.

You are definitely doing the right thing getting her checked over, but it might just be her. Keep offering high calorie, balanced food. We also still do puddings everyday. Snacks include fruit AND something else more calorie dense.

MolotovMocktail · 07/11/2020 22:32

What is her height like? Sometimes poor growth or weight gain can be due to obstructive sleep apnoea, they burn so many calories trying to breathe overnight and can’t always make up the loss in the day. I would ask about it given she seems tired too.

grassisjeweled · 08/11/2020 01:28

How big are you? (assuming you're her mother)

grassisjeweled · 08/11/2020 01:29

Also, how many calories is she actually taking in? It's all well and good, full fat, etc, but she needs to be packing in the cals too.

TomNooksBalanceBook · 08/11/2020 01:36

I was that skinny child. At 7 a doctor worried I had anorexia I was skeletal (I wasn’t, never have been)- I’m now obese in adulthood and just like I couldn’t help being skinny being fat is out with my control (for reasons I won’t divulge but not food) - don’t make her weight a problem. If she eats well and enough to survive for now and keeps good health then it will all be ok

CustardyCreams · 08/11/2020 02:50

My DD started out as a chubby baby and once she became a busy toddler she slid right down to 25th percentile weight, whilst still tracking 85th percentile height. I was very anxious as a few times she dropped to 15th percentile (growth spurts, I guess). I suppose if she had been shorter she would also have been off the charts, and like you I would have been desperate. As it was, I was simply told to track her ratio weight/height and only take action if it suddenly changed or she lacked energy for daily life. I was a skinny kid too and no one thought twice about it.

DD was in full time nursery and I was told she ate the food they served, occasionally she might have seconds. She burned off all her food.

She was a fussy eater until age 9 years old when I’d say she relaxed a bit about trying new foods. It has been hard coping with the fussiness but one thing for sure - you cannot force someone to eat. She is still skinny, compared to her peers, and eats smaller portions than some kids, but she endless energy. Just in the last year, my (endless) patience has been a little rewarded and she has discovered some new “likes” - she now raves about butter chicken curry, chilli con carne, kiwi fruit, fajitas, Chinese crispy duck. She still has a list of food a mile long she won’t eat, but I feel sure that by not pressuring her and simply encouraging her, she will in time find more food she likes. (Except mushrooms, for which
a hysterical hatred will always exist.)

I have survived the last 9 years as follows:

  • provide snacks, and always offered a second full dinner when she got home from nursery
  • ensured she gets daily childhood vitamins supplement. She now has this in a drink form at breakfast
  • made sure she always eats and drinks something, no matter how small, before leaving the house in the morning.
  • gets her 5 a day, one of which I allow fruit juice (up until age 4 yrs, she detested fruit juice but then decided she loves it).
  • squeezed in dairy daily. She decided to drop school milk age 6, not liking it, so instead either a small milkshake, a small hot chocolate, a piece of cheese or a yoghurt if we don’t have a milky meal (cauliflower cheese, macaroni cheese and spaghetti carbonara feature heavily in our lives)
  • squeeze in oily fish once a week, for years she would only eat tuna or fish pie but recently she has branched out and now likes salmon, trout and smoked mackerel. Yayyy for being patient!
  • make mealtimes fun and relaxed, yes I do let her eat while watching TV, and yes I do eat with her, even though it often means I now eat dinner earlier than DP.
  • always have snacks and a water bottle in my handbag. Cereal bars, grapes, blueberries, banana bread, crisps, flapjack, apples, banana chips, raisins, KitKats - so no, not always healthy but a normal mix of yummy stuff to stave off hunger. She does need to snack between meals, no surprise as she has very little fat to burn.

I do NOT weigh her any more, I slowed down weighing her regularly around age 5 and she has only been weighed three times in the last two years, each time to fit her appropriately for ski hire! I have always carefully talked to her about food and she knew from an early age which foods help her bones grow, which foods help her run around, which foods build her muscles so she is strong, which foods help her brain etc, etc.

It hasn’t always been an easy journey and I am dreading teen years so I have been very cautious about how I discuss weight issues with her and reinforce positive body image focused on health not weight.

So in short - yes, been there, and it is fine.

CherryMaple · 08/11/2020 06:41

My DD was born at the top of the centile chart, and then slid down to just above the bottom with a lot of concern by health professionals about her weight. We added grated cheese, custard and double cream whenever we could. Five a day is important, but snacks need to be high calorie - for underweight kids, the usual advice does not necessarily apply. Cake not rice cakes. Biscuits. Baby bel...

Coldwinterahead1 · 08/11/2020 06:44

My DS is tiny. He was very prem though and always been on the 2nd centile. Eats like a horse but super slim, it's just the way he's built. He's very healthy though and has never been sick in his life and he's 9.

ApplestheHare · 08/11/2020 06:48

What are her energy levels like when she's playing, etc? My dd is 19 months and sleeps for 12 hours at night and 2.5 hours during the day, but she's as active as she can be while she's awake, and a good eater, so I wouldn't worry about your dd if she's got the energy to do what she wants to do.

TeddyIsaHe · 09/11/2020 07:21

She’s 3ft2 and just under 2 stone, which puts her under 0.4 centile.

She eats absolutely loads, a typical day would be seeded toast with peanut butter, a banana and a glass of whole milk. Then at nursery she’ll have 2nd breakfast, snack, lunch, snack, dinner and then when we get home she’ll have another dinner of sandwiches/pasta/crumpets etc.

Her energy levels aren’t massive. If we go out for a walk she’ll start losing it after about half an hour and complain of being tired - this might just be 3yo moaning! But she prefers to sit down to do things rather than being active all the time.

She looks underweight as well, which is the worrying thing. Her spine is very pronounced, and I can see every single rib/hip bones etc. If she was just slim I wouldn’t worry as much, but it’s the fact she’s growing height-wise but her weight seems to have plateaued.

OP posts:
SocialBees · 09/11/2020 07:27

Hi OP, is the 0.4 on the centipede chart in the red book? If you calculate her BMI on the NHS website, I think she is in the healthy weight category.
www.nhs.uk/live-well/healthy-weight/bmi-calculator/

SocialBees · 09/11/2020 07:28

Centile not centipede, obvs!

ODFOx · 09/11/2020 07:39

[quote SocialBees]Hi OP, is the 0.4 on the centipede chart in the red book? If you calculate her BMI on the NHS website, I think she is in the healthy weight category.
www.nhs.uk/live-well/healthy-weight/bmi-calculator/[/quote]
The bmi chart does not apply during active growth years.

Carry on doing what you are doing OP. It may be that she is supposed to grow to be a supermodel or it may be that she isn't absorbing all the calories you are packing in to her. Ruling out any malabsorption issues will put everyone's mind at rest. If she does have coeliac or a lactose problem they are simple enough to avoid once you are used to it. Good luck!

NJool · 09/11/2020 10:43

One thing to check though is what she’s actually eating at nursery. Sometimes the feedback can be misrepresented and their idea of ate all lunch would be different to yours. And also considering nursery portion sizes.

TeddyIsaHe · 10/11/2020 09:50

Her nursery are really good and keep a detailed note of what she’s eaten (down to the amount of grapes etc!) so I know she’s getting really good size portions there.

Her bloods are on Thursday, so hopefully we’ll get a bit further then.

If they come back clear is it worth asking for a referral to a paed? I just have that ‘feeling’ that something is up, but obviously not knowledgeable enough to know for sure.

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