still desperate to feed DS.....

[AliGrylls]

I have posted about DS before and my perpetual struggle with his weight. He is now 14 months old. Over the past 4 months I have actually stopped weighing him because he actually seemed healthy and had a lot of energy.

Anyway, this week he has been quite ill. Yesterday we had to pay a visit to A&E because he had a high fever and was having problems breathing. We got there and they found out what was wrong (apparently it was tonsillitis). The paediatrician weighed him and basically said he was underweight (which he has always been but I have resigned myself to believing it is his metabolism).

The thing that upset me though was the fact that both DH and I have tried ridiculously hard to get him to gain weight and for a period of time he will gain weight but then it is followed by a period of not gaining weight and dropping down the centiles (he has now dropped from 7th to 2nd).

He does eat well most of the time and will only not eat when he is ill so I am really feeling a bit stressed about this again.

Does anyone have any experience of dealing with a skinny child? I need some advice because I am really starting to lack confidence about how we are dealing with it.

I don't know if you breastfed your son, but it might be worth looking at the new WHO growth charts (visit www.who.int/childgrowth/standards/weight_for_age/en/index.html and click on charts, percentiles:boys link) . My DD started dropping centiles at about 8 months, from about the 40th to just above the 2nd. But when I plotted it on the new chart, she was following the same centile all the way through. Have you tried lots of fatty foods, like avocadoes, nut butters, etc. Also, eating little and often (lots of snacks) seems to be a good way of getting food into them.
If your son is looking generally well, and has lots of energy, I wouldn't worry too much though. He's probably just running around lots and burning off the fat before it reaches his tummy!

I had one severely underweight child (below the centiles for months) who didn't catch up until he was five or six, but now he is average height and weight for his age.

If you and/or your husband are slightly built that might have something to do with it. If he eats and is healthy, then don't waste time worrying about stupid charts. But if he is sickly or a poor eater, then you do need to make every mouthful count.

I agree with Heather that small amounts often work best. When my son wouldn't eat meals, I used to chop up single mouthful sized pieces of cheese, pear, apple, bread and cream cheese with jam or peanut butter at the beginning of the day, and post them into his mouth all day long while he played so he didn't notice the food was going in. Then if he showed hunger, I'd give him avocado mashed up with banana or full fat humous with greek yogurt stirred in.

if there was a food he liked, I let him eat it as often as he wanted. (For a few days he ate nothing but humous and breadsticks for every meal.) If they don't eat at all, calories matter more than nutrition, then nutrition is a close second, and introducing variety/table manners are way down the list.

I thought for years we'd never get past that stage but we did.

Thank you both for your sensible talk. DH and I were quite happy until we had to go to A&E yesterday and then we found out that his weight had dropped again. I really thought I had it sorted so stopped giving him all the high energy foods that he loved. He was BF'ed until 10 months and yes, you are right DH and I are quite small and there is definitely a fast metabolism gene that runs in my family. It is nice to hear advice from people who have experienced the same problem.

Really good ideas there by Reality chick - other foods/ideas you might try:

Add powdered milk or cream to his milk (about 1tbs wholemilk powder and 200ml wholemilk - adds 50 calories plus protein) or 2 tbs double cream adds 60 calories

Give him hot chocolate (2 tbs hot choc powder, 200ml milk, 1tbs fullfat milk powder)

Fried bread - 1tbs oil or butter and 1 slice of bread - 190 calories - serve with ketchup and or scrambled eggs

Put a heaping tsp of butter on his vegetables/mash, or a drizzle of olive oil, at every meal.

Greek yoghurt with banana and raisins

Peanut butter or any other nut butter, smooth, stirred in to hot cereal, on toast, with apple slices, spread on banana.

Try to give him something small to eat/calorific drink every hour or two between meals. He might not eat as much at meals but the calories during the day should make up for it.

My sister and I had (and I still have) problems with my weight due to a condition, but my mum would feed us up with snacks throughout play. We'd typically have breakfast of cereal and 'special' milk at 7, toast with butter and marmite at 9, a biscuit and more milk or juice at 11, lunch of cheese sarnies and crisps and salady bits, a yoghurt or two at 2, a cracker and cheese at late afternoon, Dinner, then a chocolate bar a bit later. More special milk before bed. It looks loads for a small person to eat but the key was the small portions and high fat. I don't remember specifically ever being hungry as such but I certainly never felt like I was being force fed.

Really hope you get some luck with his weight soon. He has been tested for anything which would cause his low weight hasn't he? xxx

I was doing all those things until he got to the 7th centile and I thought I had it in the bag and reverted to a "normal" diet then he started to lose weight again.

I have wondered if he has a lactose intolerance because he absolutely hates milk and won't drink it unless we tamper with it (by adding fruit and yoghurt). But then the only symptom he has is that he hates milk.

I'm sorry you're going through this, it must be very difficult for you.

I wonder if perhaps his body cannot absorb the fats from the milk, so he's not gaining much weight from it? All of my siblings had an issue with milk fat, which they cannot absorb properly. Are his poos very soft still?

I think riven had a thread a while back about high energy, high fat foods for her dd2, which would probably have some good ideas about things to include in his diet. It is good that he eats well though, rather than being a refuser.

My youngest brother was always very small, and very, very skinny slender, caused my parents no end of worry, as often he would eat miniscule amounts too, then genuinely be 'full'. He took a long time to normalise his weight and height, but he got there in the end- he is above average height now(5'11") but remains very slight, though has a lot of stamina, and is strong physically (and is a British record holder in his sport too).

I hope he recovers from his tonsillitis soon.

Oh dear. We spent another afternoon at A&E. He was really sick at lunch and looked so pale and docile. He refused all food I offered him even biscuits.

His poohs were really soft until a couple of weeks ago I practically stopped giving him milk altogether. At the moment he only really has milk in his cereal and his poohs are normal now. He definitely could have a problem. I will ask our GP about this when we have the follow-up.

Until he is better I think I will just let him eat entirely what he wants (even if it is ice cream) - I guess all calories at this stage are good calories.

Thank you all for your help I will definitely use your advice.