Very small 8 yo DS

[iamamug]

Would just appreciate a bit of advice.
DS is 8 and suffered as a baby with an undiagnosed illness which caused very severe projectile vomiting. Lots of investigation, no proper answer other than 'several intolerances' - also not specified!
Through trial and error we have established that he is intolerant to eggs and nuts - not dangerously so - they just 'hurt' his mouth and make him sick.
At 4 he had his tonsils and adenoids removed and grommits fitted and the improvement was spectacular.
My ongoing worry is his size. He is really small - prob about the size of a 5 yo. He eats a varied diet and is getting much more adventurous with food. Eating used to be a massive issue as he nearly always threw up his whole meal and had to be fed again!
He is asthmatic and has allergies that make his asthma worse/itchy eyes etc.
Just after a bit of help from anyone in a similar situation re building him up a bit. He won't eat butter or cheese so can't throw that on everything. Any ideas?

Your poor DS, sounds like he's had a very rocky start with his eating and tummy. (And poor you, too!)

It sounds as if his early growth could have been pushed back a bit dew to his vomiting and perhaps poor digestion due to his intolerances. Any chronic period of being unwell can prevent a child from building up energy reserves and laying down new tissue.

This would be a simplish answer although I do think he needs a bit more investigation, it sounds like you've been fobbed off a bit? His hormone levels and iron levels etc need to be checked even if they were a few years ago as things can change very quickly with those, especially in children.

If it does turn out to just be delayed growth, he will almost certainly be able to catch up (as would a premature baby) with the right nutrition and help.

The fact that he can't eat butter isn't as much of a worry as it might seem! He can get lots of healthy fat from fish oils and vegetable oils such as olive... avacado is also pretty high in calories and fat for a fruit, does he like that?

Ideas for boosting calories and nutrients(sorry if I list anything he can't have)...

Breakfast: Use breads made with wheatgerm and seeds if he can have them, veg oil stirred into porridge or weetabix, cream if he'll take it in milk, bananas, yoghurt or soy yoghurt, dried fruits such as figs, apricots (good for iron and calcium!)

Lunches: ham and avacado sarnies, drizzle of oil in sandwiches, hummous on oatcakes, milkshakes

Dinners: stir in a tbs of two of cream or oil in to his portion - it doesn't affect the taste at all. Fruit juice with his meal.

Serve a pudding often, fruit crumbles and custard are quite healthy and high energy!

Snacks: ham and oatcakes, hummus and veggies, oat biscuits, bit of chocolate now and then

Sorry if they are no good or you already do them! I have to have a high calories diet for health reasons and use these things to up my intake easily whilst not having to eat loads of junk! x

Asked to be referred via your GP to a dietician. They can prescribe supplements such as high calorie drinks (lots of flavours) A protein powder that you can mix with just about enything which will increase his calorie intake. All the things that smashie has advised are also excellent. My baby grandson has turned the corner with his weight (we hope, weigh in next week, but looks a little rounder!) with the protein powder particularly.

Sympathy. My son had something similar (but no allergies) and it took him years to catch up though now he's 8 he's on a par with the other kids. I built him up by giving him 3 very healthy meals a day - as rich in protein as he could handle, and then let him fill up on what some people would call rubbish, but he really needed the calories and wouldn't snack on good stuff if he wasn't hungry. But... if I had to do it now, i think I'd out more emphasis on starchy foods as they are easier to digest, and the high fat stuff the dietitians recommended kept him bilious and nauseous for longer than he should have been. So maybe try him with pastas, white bread with butter and jam, flapjacks.

Whatever food he loves, give it to him often and try to up the portions gradually.

Some things that worked for us: make a rich milkshake if he's thirsty with banana and toffee or vanilla ice cream and full cream milk

Make your own ice cream with whipped cream, sugar and fresh pureed fruit.

Make crumbles and cakes half with flour half with ground almonds or soya flour if he's allergic to nuts, as these are richer. Put cream cheese on wholemeal bread and jam for sarnies, rather than just butter, as it has more protein.

Bananas, pastries, especially egg based ones, home made muffins with loads of added fruit and soy flour.

If he's thirsty give him full fat milk with a spoonful of cream stirred in, or smoothies.

It's really hard to get the balance right, as a too-rich diet will keep him feeling queasy and off his food.

I worked out that although his diet was fairly limited, my son liked foods from all the groups, so it didn't matter that he lived on humous and poached salmon carrots and apples, as they were all good for him, so there was no need to turn meals into nightmares by giving pears instead of apples etc. So long as he likes something high in protein, some starchy foods and a few fruit and veg or juices or veg based soups or sauces, that's fine.

Hope he gets a growth spurt soon, but even if he never does - so what? People come in all sizes.

Thanks so much for some great ideas.

I try not to make an issue with him about his size as he is obviously now aware that he is the smallest in the class. However, I am interested in the protein powder thing - he loves milk shakes so could easily disguise that.
He will eat cream and full milk so we use that a lot. My husband is a super cook so we eat very well at home but I don't discourage chocolate/crisps etc (as long as they don't fill him up and spoil appetite for mealtimes)
Incidentally, we have just been out as a family for a chinese meal and he has eaten ribs, duck pancakes and fillet steak!!

NOt massive amounts of each but there is a clear preference for meat. He loves the skin on chicken, duck etc and will eat the fat off lamb chops. There is actually nothing wrong with his diet and he eats a wide variety of food - just not very much!

He tummy must be so tiny that he gets full very quickly. We have had a habit for many years of giving him breakfast before bed. As he could always keep cereal down he has a bowl before bed .
Lots of full milk and a few more carbs.
I will definately use the advice and thank you so much!