So, someone please make me feel better about my low weight toddler

[UnseenAcademicalMum]

Hi all.

I know this has probably been done a million times before, but I'm feeling low at the moment due to too many remarks about how small ds2 is.

He is 2.4 years and weighs 10.1 kg (roughly 22 lb 5 oz).

He is usually mistaken for being a child half his age. He simply does not have ANY interest in food or in eating (and not much in drinking for that matter). He often goes from 8 am to 4 pm without drinking anything. Then, when I give him some (oat) milk (he is dairy allergic) in the late afternoon he reacts as though I am trying to kill him .

A typical days eating for him goes something like this:

7.30 am 4 oz oat (calcium enriched) milk
9 am 3 miniture breadsticks (during the school run with ds1)
10 am snack (half a pot of soya yoghurt or half a pot of pureed fruit of similar)
during the morning - a few breadsticks, cut up meat, dairy-free chocolate buttons , twiglets . Not massive amounts but enough to taste.
Lunch - sucks on food but eats little. Eats maybe half a pot of soya yoghurt.
Mid-afternoon as morning plus 2 oz oat milk
Late afternoon - 4 oz oz oat milk
6 pm - as lunch
8 pm - 2 oz oat milk

Someone, please make me feel better . God knows what I am doing wrong. DS1 always has been a fantastic eater.

Would he eat some porridge or cereal/toast in the morning? Seems like he's a grazer, obviously complicated by allergies. Sure someone who knows what they are talking about will be along soon.

Your DS1is a fantastic eater. You're not doing anything wrong. DS2 is bringing his own personality to the table.

It is low on the centiles though - has he always been at roughly that level? If not, when did it change?

Is he energetic and lively?

Does his weight follow a percentile curve without too much variation? My DCs dr always told me that children are all different, the important thing is that they consistantly follow a curve line.

I could have written this post two years ago about our dd2 and something similar 11 years ago with ds1.

Ds1 is now average height and average weight and his story is long and convoluted but it did end well.

Dd2 was still breastfed at 2 so I didn't have any idea of actual amount of milk consumed but the solid food your ds2 eats in a day sounds about the same at dd2 at the same age.

I decided not to have her weighed regularly because it was just stressful. I would get wide eyes and lots of questions. Instead, I decided to concentrate on how she behaved.

Is your son full of energy?

Is he starting to talk? Does he talk about what he might like to eat? (I know that I cannot stand the texture of soya yoghurt and neither could my dds.)

Can I assume that you are a vegetarian? (I just don't see meat listed in the foods he eats.)

My post is probably not very helpful but I wanted you to know that you are not alone.

Is his oat milk just the one that you get over the counter in healthfood shops etc? Because I think that it may not be very high in calories... could you add some soya cream to it maybe? 4 tbs each day would give him 100 extra calories.

Have you tried making food into a bit of a game? As in, making smiley faces and pictures of things with his twiglets, buttons, and maybe some pieces of fruit to dunk in to soy yoghurt.

Would he try avocado or fried bread? You could fry chunks of bread in olive oil and it tastes lovely and soaks up loads of fat - could be about 180-250 calories a slice!

For protein, I think the soy yoghurts and chunks of meat are better than nothing and maybe it's wise to focus on getting lots of fat into him whihc boosts the energy alot. Sausages are good, and chips

Sorry... I see the meet part now.

meat even. I should really go back to bed!

Thanks for all your replies.

He started off on the 9th centile (3.1 kg which is about 6 lb 13 oz) and was exclusively breastfed to 23 weeks, but stopped gaining weight at about 16 weeks. I started weaning him (on avocado, which he now hates) at 23 weeks in an attempt to get him to start gaining weight again and it worked for a short while. He was then breastfed to 13 months and gained weight slowly from till then.

He has since got worse from then. The various hypoallergenic milks he tried made him sick, so now he has oat milk (we do add oat cream to it to boost the calories, but he still doesn't drink much).

In terms of development, he talks very clearly and is constantly moving, but is very shy (apart from with his big brother) and I think does all the things a two year old should do, apart from eat.

He simply doesn't seem to associate a requirement to eat with survival and when left to decide how much he wants to eat himself will simply eat less and less. We tried once to see what happened if he was just left to it and he went 4 days without eating!

I'm really stuck to know what to do .

My ds is 2 and a half and weighs 24 pounds so probably not dissimilar. He has had health issues (allergies, chest infections, reflux). However he eats very well most of the time, and it seems to make little difference, he just seems to be small. I agree that the best indicator is whether your ds is generally healthy, has lots of energy and runs around a lot. If he does, I am sure he is ok.

Do you have a dietician for his allergy? We saw a community dietician who was really helpful while DS was allergic to milk and eggs. A dietician will be able to reassure you and also give you tips.

One thing that does occur to me is that for a 2+ year old, he is still having quite a lot of milk. My DS has never drunk cows milk - he stopped having neutramigen at 2 and wouldn't drink cows milk although he does have it on cereal. Our dietician was happy that he got enough calcium elsewhere in his diet so it didn't matter. I wonder whether your DS has the oats milk and is then too full. For example, if he has milk mid afternoon, he probably then won't want to eat his tea.

An average day for my DS would be:

Breakfast - 8am - weetabix and special k with milk, sometimes a fruit smoothie or piece of toast too

Mid morning - snack, fruit (at nursery)

Lunch - sandwich, snack (ie today he has a slice of pizza, or it might be hummus and breadsticks, or a mini piece of cheese) and a piece of fruit and a fromage frais

Tea - 5.30pm - whatever the rest of the family has, so for example homemade chicken curry and rice, or spaghetti bolognese, or fish fingers and mashed potato, roast dinner etc. For pudding, usually fruit, or perhaps something like a mini trifle as a treat.

Bedtime - yogurt (extra calcium and he has his reflux medicine mixed in with it)

DS is on the leap study so his diet has been analysed by the dietician on the study and they were happy that he was getting a balanced diet nutritionally.

It seems to me your DS has lots of milk and lots of snacks and then doesn't eat his main meals. Does he not have any cereal at breakfast?

Like I said, my DS eats all that and is still under the 2nd percentile for weight, so I would try not to worry too much, but if you want some little changes that might help, I hope these suggestions are useful.

I actually know of worse cases, OP (which are turning out ok even if parents are losing hair over it). A little boy slightly older who eats nothing but milk and yogurt (is now on strong iron supplements). Very bright and developing perfectly well, just not interested in nutritional variety.

My own 2.5yo had a screaming fit last night because we offered him... pasta. Yup, that's too strange a food in his mind.

My 2.6yo DD is the same weight as your DS, how tall is he? My GP isn't overly concerned as she is also short so whilst she is very light she isn't skinny, is that the case for your DS too?

Hi purplearmadillo. It is useful to hear someone else in a similar position.

Unfortunately, ds2 simply refuses to have anything to eat at breakfast at all. It doesn't seem to matter whether we offer him something before milk, after milk or anything, he simply won't eat anything!!! Sometimes he will also stop drinking his milk at breakfast time after only 2 oz as well. I mean, I understand he might not be an early morning eater (dp never eats breakfast either), but I would have thought he would be thirsty in the morning!

We are under a dietician and a paediatrician (and a gastroenterologist, and an ENT specialist). I asked the dietician what we should do if we couldn't get the 12oz of milk per day she suggested into him and she simply said "he needs to have at least 12 oz". He doesn't have water or juice during the day on the advice of the dietician so that he doesn't fill up on liquids with no calories.

Whilst he was drinking Neocate (special hypoallergenic formula), he did seem to have a problem with reflux (throwing up 5-6 times per day), and I think this experience may have put him off eating, but that is only a guess. Certainly the paediatrician was surprised at the ease and speed with which he was sick when the paed was checking his mouth.

I was thinking about trying to get him a referral to this feeding clinic in Birmingham (it is a bit away from us, but I'm willing to try anything), but I don't know how I'd go about getting a referral. Also, does anyone have any experience of them? Do you think they might be able to help?

That's interesting re the 12oz, we were never given that advice. Does he have meds for reflux? My DS stopped being sick when he moved onto more solid food but this was when his chest problems started and we have later discovered that he was refluxing into his lungs. It wasn't so noticable as he wasn't actually being sick, but if eating is causing your DS pain, that might explain why he's not keen on eating.

We are in London so I don't have experience of Birmingham but we have found that all the medical professionals were very willing to try to get to the bottom of DS's problems. If Birmingham is your closest centre, you should be able to ask your GP to refer you there.

In terms of centiles, my DS has was on 25th when born, then dipped at about 4 months for no particular reason and since then he's ranged between top of the 9th and around about the 0.2 depending on how well he has been etc. No one has ever questioned it as being an unhealthy weight, it does just seem he is of a slight build.

At the moment he's not on meds for the vomiting because that seems to have improved (though not stopped entirely, but he has gone from 5-6 times per day to maybe 3-4 times per week) since he stopped having Neocate, so I said to the gastro that I'd prefer to wait and see, which he agreed with.

At lunch today though, he told me he was hungry and then told me that his tummy hurt. I'm not sure if that was a result of being hungry (though he still wouldn't eat), or whether he had a pain due to something else .

It is interesting that you say your ds started with chest problems when he started on more solid food, as that is the gastro's next plan, to push him a bit with more solid food (he still eats an awful lot of stuff with very smooth texture i.e. soya yoghurt, pureed fruit etc as he doesn't seem to eat enough stuff with any real texture to it).

Birmingham isn't my closest centre, but I've been reading about the work of Dr. Gillian Harris who seems to do a lot of work with children who have developed food phobias and I'm wondering if this is a problem for ds2. I saw a programme that was made some time ago called "My child won't eat" and one of the children on that seemed very much like ds2. This is why I was thinking of trying to get a referral there. I feel very let down by the current HCP team who are looking after him.

I have seen a programme about her too, she seemed very good. I hope you get some answers, I know that DS's health makes me really anxious and I also get very upset when people comment about his size (he has a second cousin who is a year younger and bigger than him and all of DH's relatives made a really big thing about it which I found really sad).

Will your GP refer you to a dietician? There are high cal supplements that are milk free. Pro cal powder has been a lifesaver and goes into everything! (? lactose free though) Still not on chart weight wise at two but on 9 for height so you can imagine the skinniness!

Sorry see you are under dietician. Ours said give breakfast, mid morning snack, lunch, afternoon snack, tea, bedtime snack. ha ha ha ha

purplearmadillo, I recognise exactly what you are saying with the comparison. My (half-) sister has a boy just over a year younger than ds2. They visited recently and made a big thing about how their boy eats everything - its sooo amazing and he's growing sooo fast blah, blah, blah. It's petty and mean, but I'm hoping that she has a really picky eater for her second child too.

SayItWithWine - how much does your lo weigh, if you don't mind me asking? Our dietician has been reluctant to give supplements so far, as she wants everything to be done naturally . IMO all her attitude has done is made things worse as we've been more or less forced into a position where we don't relax with food in a desperate attempt to get something into him, which of course makes things even worse! If we knew that some of his calories were covered with supplements I think we would relax more and that would help immeasurably.

Must say though, I'd love to be able to get three meals and three snacks into ds2. Doesn't matter what I try, there's no convincing him that breakfast is a good idea. Mid-morning snack is not usually too bad, but lunch is a bit hit and miss, afternoon snack is normally more "leave food lying around the house and ignore and sometimes he will eat of his own accord", dinner is pretty much like lunch and he has 2-3 oz of milk before bed instead of a snack (I think he'd throw up if given yet another snack). I'm completely out of ideas. DS1 used to (and still does) love his food, whereas ds2 just is not interested. He'd be the happiest boy alive if he never had to eat, I'm sure of it.

I haven't read all the replies but I can reassure you.

Lots of toddlers are very fussy/minimal eaters but are all varying sizes- what and how much they eat does not necessarily correlate to how big/small they are.

My dd (now 4.2yrs) weighed 22lbs aged 2.5 and I was worried at how small she was. She is also allergic to dairy and is on soya. However, she is always hungry and eats loads (or at least she did then!!) The dietician said everything was fine.

She has always been small and like your ds she is mistaken for being younger than she is. At 4 she is still a skinny minny and in 12-18mth trousers etc but I don't worry about it any more.

My other 2 are by no means large, in fact most people think they are light/thin but they seem chunky to me compared to dd1 and they all eat pretty much the same.

Thanks thatsnotmymonster. It's good to know I'm not the only one. In our case, ironically ds1 is often mistaken for older than he is (75th centile for height and weight - but then dp is tall). I used to be small (pre-ds2), but not to the extreme that ds2 is (and was quite a chubby child).

My DD2 was just the same and weighed just a little less. She too was lactose intolerant. I think the problem is they learn when quite young that when they eat it causes discomfort.

She grew out of her allergies by the age of 7, but always ate very little.

She is now 21 and 8 months pregnant and weighs under 9 stone. She is perfectly healthy just small.

Thanks Lynli.

I've decided to start keeping a food diary (though the last one I did for the dietician, she didn't have any suggestions with), but I'm hoping that it might help to at least figure out how much he actually eats.

I think a food diary is a good idea, as you can then discuss it and see what the dietician thinks next time. It has reassured me that DS is ok despite not drinking any milk.

I hope so. I'm really trying to back off on his food intake atm and just see how he goes, but its really hard and I am worried that he will get even smaller . Eating is something so basic, it really feels shitty when a child just doesn't seem to "get" it.