How can I get my 15 month old boy to eat more?

[Gemmona]

My son is 15 months old. He is small, right at 1st percentile on the charts and has been since he was tiny. He's never been that into eating (I watch other babies his age piling into their food) but he just loses interest really fast and wants to get down ('det da') from his high chair after a few mouthfuls, or starts pointing at everything else in the room. I have taken on loads of tips, like lay out only a few small bits of finger food at a time, etc, keep calm and don't stress, and so on. He's so skinny I can see his ribs. Health visitor says it's ok but it just breaks my heart to see him so thin. What shall I do? The only thing he will eat and finish is yoghurt and Weetabix. Othewise, he's well. Hares around, starting to walk, won't stop chattering, sociable...

Watching with interest as my DS (1) is exactly the same. I have taken to feeding him gold top milk to try and fatten him up!

Hey Stokey38, good to meet you. That's a good idea! I am feeding him Greek yoghurt with as much banana and tiny bits of bread as I can fit into it without him spitting it out. The book 'What to Expect' says to 'make every bite count' so that's what I'm doing. It also says not to use too much high fat dairy cos of their cholesterol though, but I'm ignoring that advice as I'm sure it must be aimed at big eaters. What do you think? Have you had any advice?

Seeing ribs is okay, as long as they aren't protruding out massively. DS didn't eat anything in big quantities no matter what I tried until he was 22 months. I was lucky, I suppose, that he was still breastfeeding so I knew he was getting vitamins etc from that. If you aren't breastfeeding is he still on formula? I think I'd be tempted to carry on with it just so you know he is getting something.

It would be really counter-intuitive if toddlers had evolved to starve themselves, so many of them go through this phase, it must be within the realms of normal. I know it's easier said than done just to relax over it though!

If it helps, DS is 2.9 now and eats huge amounts.

Nut butters (peanut, Cashew, Hazelnut), high calorie, high fat ("good" fats), High protein, are good ways of getting more calories into a baby with a small appetite. He may not be getting enough protein for growth, if he's not eating much.

Olive oil - add it to everything you can - easy to do if you make his food, but just as easy to add a teaspoon to a jar of baby food!

Don't use any "low fat" versions of food, yogurt, milk etc should be full fat.

I am shocked your health visitor thinks it's "ok" to be 1st centile and clearly underweight, as it would suggest he is "failing to thrive" - and I would say that should be looked into - a GP could refer DS to rule out any medical reasons for his weight/stature, and you would get feeding advice appropriate to his needs from the consultant.

This happened with my DS2, 3rd centile and clearly underweight at 18 months, he was referred by GP and had various checks (heart was checked, lungs, whole body examined), nothing was actually wrong, got advice on how to get more calories in to him as he had a small appetite. Had 6 monthly reviews for a couple of years to track his growth.

He's 16 now and just under average height and I'm sure he would never have reached anywhere near average if we had stuffed him full of nuts and olive oil until he was about 8 (when his appetite improved).

Hi BertieBotts, he's on cow's milk. Maybe I should get him back on the 1 and upwards formula, thanks for the advice. Unfortunately I only lasted 3 months on bf as I messed up a bit with that tricky old 'topping up' and ended up drying up. Really good to hear that your DS is eating well. Can I ask - was he small at the start, and if so did he catch up with the kids of his age group in size? I know he doesn't want to starve himself as he sort of grazes when I leave bits of sandwich lying around. But he's really not big on the whole sitting in high chair / set meal time thing...

I mean "if we had not stuffed him full" in the last paragraph!

Thanks, nuts is a good tip. I've tried peanut butter - he didn't like it at first but does when mixed with something sweet like pureed apricot... The health visitor said if he's on the chart and staying on exactly the same percentile as he started on then he is considered ok. But I will follow your advice and take him to the GP anyway. Olive oil a good tip too! I cook with it but will add extra. Is that just for the calorie factor? I think I'll try to get some sesame paste down him too. Any other nut butters that are easy to get hold of?

Someone has to be on the 1st centile oldmum, just like someone is on the 99th - does it necessarily mean failure to thrive?

If he's always been on that centile then maybe he is just small and healthy?

Yes, it's just that, the more calories, the better (if they can't eat a lot volume wise, need to make sure they are getting plenty of fat and protein).

Ok, while I'd agree that falling through the centiles is a "bad thing", and something that would be picked up faster by HV, being on the same centile (always small) doesn't rule out problems which may have affected his size as a new born/before birth...... so probably still worth mentioning to the GP - the Underweight as well as small may hold his stature back more as he gets older. Of course if you and his father are both 1st centile, it's would be what you would expect him to be........ lots of factors and obviously your HV will know more than me!

Peanut butter can be really sticky and hard to swallow, but mixing with olive oil before spreading on toasty fingers makes it a lot easier to eat. My DS also liked it mixed with yogurt! Kind of hard to mix (start with a spoon of each, mix in a bowl with spoon then add more Yogurt gradually).

I don't think the weight centime means much without correlating it to height etc. As Rita says, if he's always been at that level ...

My DS dropped from just over 50th to below 25th at 9 months which got the HV really excited, especially as he is on the 90th height wise. I think basically it was because he got a lot more active.

A child who is not having enough to eat would not be as active as OP says her son is.

Have you tried including him in the preparation process? My son is enthralled by cooking, even just putting cheese on toast under the grill and if he's been a bit uninterested in his lunch I get him to help with tea. Obviously given the age of your son he'd be mainly observing, but you can get him to put the cut up veg on his plate etc.

My son is going through a phase of not liking to use his spoon and fork (just into the challenging 2s) and so we're trying to stick with foods he can dunk in ketchup or yoghurt dip, which always makes food more interesting doesn't it

That sounds like a scary drop but I've heard it can happen when they start moving. The fact that he got really hyperactive and didn't drop is the one thing I hang on to in hope. He does seem pretty excited by cooking, will get him more involved. Thanks!

Maybe get his height measured too - if he's 90th centile for height and 1st of weight then there might be a problem, but I'm not sure fattening a child up just for the scales is necessary.

A child who is Failure to Thrive isn't just small, they are sickly, listless, lethargic etc.

My DS1 was small - and never ate that much - always had loads of energy through -I did find it quite stressful at the time

• do you give him the same things you eat as that can help sometimes - or even let him have things from your plate

and at this age I would say grazing is fine - wish I had done more of it for DS1

A

MY HV told me to put him on a high protein diet so lots of eggs, cheese and checked about the gold top and she said for one so young, it's fine and just to get the calories in him. To be honest he just goes through phases but has never been a big eater. He dropped from 50th to 9th but he is happy and healthy and reaching all his milestones. My DD wasn't such a great eater until about 18 months and now she eats everything she can get her hands on and she is still 9th centile for weight and 95th fror height so I think it's just the way they are built.

I'm not an expert in any way, but I'd probably stick with the stage 1 formula or follow on milk, not the 1+ stuff, as that's artificially sweetened and probably not designed to make up a large portion of their diet.

DS was always small, but not quite the 1st centile, he seemed to hover between the 9th and 25th mostly. I haven't had him weighed for ages now as my old HV (she was a dragon!) kept insisting on weighing him all the time, and stripping him down to do so and just approached it in a crap way rather than trying to make it into a game or anything and made him terrified of the scales. I keep meaning to get a set of bathroom scales so I can weigh him by carrying him on and subtracting my own weight!

Doesn't "failure to thrive" mean crossing two centile lines and displaying other signs of being unwell? It's a worrying term that shouldn't be banded about oldmum.

As rita says someone has to be on the 1st centile. That's how averages work. In this instance one in a hundred babies will be on or below it. Doesn't mean there is anything wrong with them. Especially if they are happy and active like the op's ds.

Gemmona to my non expert opinion your ds sounds fine. But i can understand your concern.

My ds (16m) goes through phases of waking up hungry in the night, despite bf on tap, so we try and encourage him to stock up in the evening. I have a light touch with this iyswim, as i don't want him to eat beyond his appetite, but he just gets bored of being in the high chair.

When he gets bored we let him down and he wonders around. When he comes near us we offer him forkfulls from our plates. Then he goes off for a bath. We make him a plate full of little snackets. Stuff like cheese on toast, bits of left over spanish omlete or whatever he likes at the time. We just leave it where he can get at it. Cutting it up small means he can just pop a small bit in, rather than drag it round the room. Though it's still a bit messy!

It's suprising how much he'll eat like that over the course of an evening. And when he doesn't at least i know he had plenty of opportunity and just wasn't bothered. Maybe something like this could work for you (if you're not doing it already that is). Even if your ds doesn't eat more at least you can rest assured he was full, not bored. I do know someone who even as an adult can't be bothered with food and would rather have a pill to do the job. Bet he was on the 1st centile and he is, of course, fine.