Am I under feeding my 2 year old? Worried af

[Nc4post99]

Hi,

So DD is 2 and a wee slip of a girl. Little bit of a backstory for her, measured small in pregnancy so was induced at 37 weeks and weighed 5lbs- 1st centile weight and 5th length. Bad tongue tie resolved at 3 months. At 6 months 9th centile all around, except head at 25th. At 10months, just under 25th for length and weight head just above- she ate well at that point. At one year check Real tough time from HVs about her size (they wanted her bigger) and breastfeeding, told to force feed her which led her to have quite a bad food aversion. She fell a centile and she’s never recovered. We paid to see a private paediatric dietitian ( looked at her diet and observed her eat) and private paed who weren’t concerned about Dd but were infuriated at the HV suggestions.

Now at 2 she’s still in 12/18 clothes and just looks so small compared to her peers, a lot of people comment on how tiny she is and how they think she’s 1. She’s got bundles of energy and is quite developmentally advanced for her age (3/4 word sentences).

We have her 2 year check coming up and whilst milestones don’t concern me, I’m worried about the comments on her size. She’s unwell constantly (colds, coughs, the runs etc) so GP requested a full blood culture to check all is ok there so we’ll get the results if she’s deficient in anything this week but I just wanted to check that her daily diet looks ok or if we’re under feeding her.
We do 3 meals and 3 snacks a day, nursery have no concerns of how she eats. She isn’t breastfed anymore but has at least 10oz of cows milk in the day+ 2 petite filous yogurts + portion of cheese. She has a large cup of oat milk before bed (too much dairy can cause anemia apparently)

This was yesterday;

Breakfast- bowl of cereal -1 weetabix (but we alternate rice crispies, coco pops for a treat, shredded wheat etc) with about 3oz of blue top milk and half a medium banana ( the bowl is one of those blue munchkin adhesive ones)
Snack - slice of buttered malt loaf with a cup of blue top milk
Lunch- 3/4 slice of buttered toast with a scrambled egg (scrambled in butter) veggie sticks (hummus on the side but she left that) half a large apple and a petite filous.
Snack- cheese and crackers (3 circular crackers, you know the kind) with some cheese about the size of 2 index fingers. Small cup of milk.
Snack 2: box of raisins and 2 squares of dairy milk (doesn’t normally have a lot of chocolate but we went to a park where there was a fair so it was a treat, this also isn’t typical but we fed the ducks at the park and she ate one of the hot dog buns we’d bought for the ducks lol, she normally wouldn’t have that much for a second snack)
Dinner : nachos (dw not Doritos, I made the ‘chips’ from white tortillas that I sliced, spritzed with oil and baked. Topped the chips with tomato salsa, then veggies, then cheese and some shredded chicken from the day before and then more cheese) she probably ate about half a tortillas worth (just a normal
Size one from asda) with toppings. She then had some grapes about 5 and another petite filous
Bed-5oz of oat milk

Does this look ok to you? If not please tell me. Some days she eats really well but others not so much, not full on refusal anymore (thank god) but just smaller quantities.

I guess I’m just after a bit of reassurance if this looks ok or if actually I’ve been under feeding her.
Also any sort of ‘encouraging’ her to eat more leads her to dig her heels in and refuse. Lately we’ve been letting her ‘cook’ ie assemble things like the nachos and she’s taken a real interest in it but it’s not helped up the quantities xx

Does she have more fruit and variations in veg on other days?
The diet seem ok but I’m uncertain as to the amounts required if she needs to gain weight as such.

That's more than my DS2 would have eaten at 2! He was always petite too. I think at 2 he was in 9-12 and some 12- 18 months clothes. He was still wearing some 12-18 months stuff when he started school. And he was 8lb 2oz at birth.
Hes 14 now, 5ft 6 but very slim. Very active. Always has been. I personally don't think your DDs size is a problem. And she seems to be eating well.

I'd he more concerned about about constant illness. Coughs and colds are fairly normal. But the runs isn't.

Quantity wise, that looks fine to me for a two year old.

So fruit wise, we’ll rotate with berries, grapes, oranges, apples, pears, bananas, plums, peaches and sometimes tinned fruit or fruit salad (in juice not syrup)
Veg wise: carrots, bell peppers, peas, sweetcorn, mixed beans, kale, broccoli, cauli, cucumber, cabbage, potatoes and sweet potatoes, butternut squash

Above are the ones she eats well, although we do offer others like avocado, tomato, leeks, mushrooms etc.

Quantity wise a lot of the time she’s quite articulate so a lot of the time she says finish, or no more or done

With constant colds I would look to see if she has any food intolerances. Especially dairy.

@CiaoForNiao

That's more than my DS2 would have eaten at 2! He was always petite too. I think at 2 he was in 9-12 and some 12- 18 months clothes. He was still wearing some 12-18 months stuff when he started school. And he was 8lb 2oz at birth. Hes 14 now, 5ft 6 but very slim. Very active. Always has been. I personally don't think your DDs size is a problem. And she seems to be eating well.

I'd he more concerned about about constant illness. Coughs and colds are fairly normal. But the runs isn't.

The GP said it can often be the result of a virus but she had such an awful burst of it (literally) in July it burned her bottom and she’s never had nappy rash in her life

Looks absolutely fine! Surely she’ll hound you if you’re underfeeding her? If my DD is hungry, I know about it (had a 9am request for shepherd’s pie today…). Other days she’ll not want anything from afternoon snack time onwards but still sleep through and not demand breakfast first thing. I think so long as you’re offering enough (and enough nutritious) food, that’s fine.

I would be looking at getting more protein into her breakfast rather than cereal. Beans on wholemeal toast, or an egg, a slice of that chicken. Plus the milk, plus the banana.

Might help her to keep going until lunch so you could cut down on the morning snack a bit and increase her lunch.

I would also try to cut out the petit filou (a triumph of marketing) and getting her onto proper natural yogurt , preferably one like a good Greek full fat that hasn’t been processed with added thickeners

How big are you and her dad? How is she tracking on the percentiles? I'm not sure I understood but if she's always been small then she will still be small. My DD was small as I'm only 5'2" and she was a rubbish eater, but at 7 she has caught up now.
And I would have complained repeatedly and bitterly about being told to force feed her!

@Arghlife

With constant colds I would look to see if she has any food intolerances. Especially dairy.

The paed said it was just nursery. What would the signs of an allergy be? Would it show up in a routine blood culture? She was predominantly breastfed as a baby and never reacted to any diary I had, she had formula here and there without a problem too but not from 3 months on xx

More than my DS would eat. He was 2 in July. He is in 18-24 months clothes at the moment but the waist is often quite loose on him. He was prem and weighed 5lb at birth. His appetite is so different to his older brother’s, who was a human dustbin.

Some of the babies (now toddlers) who DS2 went to baby yoga with, so are all a similar age, are also still quite small and in 12-18/18-24 month clothes despite all having turned 2 a couple of months ago at least.

It sounds pretty normal.
Average day for us would be:

Breakfast
2 weetabix with milk
Big portion blueberries
Yoghurt

Lunch
Chicken curry and rice
More fruit eg large portion of grapes, or couple of slices pineapple/melon

Supper
Ham and cheese sandwich from
1 splice bread. She’ll eat all the filling but not all the bread usually
Yoghurt
Cucumber
Fruit

Snacks would be raisins, the odd biscuit, crackers/rice cake, occasional baby crisps. She would probably have 2 snacks most days.

I think she sounds like she's eating well and that her diet is varied. The odd treats are fine and she sounds like she's getting decent amounts of carbs/protein/fat. Good that she's being checked out though. She may just be diddy? Terrible advice from the HV to "force" feed her, that's genuinely shocking

@viques

I would be looking at getting more protein into her breakfast rather than cereal. Beans on wholemeal toast, or an egg, a slice of that chicken. Plus the milk, plus the banana.

Might help her to keep going until lunch so you could cut down on the morning snack a bit and increase her lunch.

I would also try to cut out the petit filou (a triumph of marketing) and getting her onto proper natural yogurt , preferably one like a good Greek full fat that hasn’t been processed with added thickeners

Her dietitian said no whole grain until 5 as it can fill little ones up for too long.

She’s iffy with beans tbh, she’ll eat them but we have to split them 50/50 with hoops.

She loves all yog, we’ve only got her into the fromage frais style ones really recently because they were super handy with pot sizes but we can swap her back to Greek easy i think.

@toomuchfaster

How big are you and her dad? How is she tracking on the percentiles? I'm not sure I understood but if she's always been small then she will still be small. My DD was small as I'm only 5'2" and she was a rubbish eater, but at 7 she has caught up now. And I would have complained repeatedly and bitterly about being told to force feed her!

So @toomuchfaster I’m 5’3 and pre pregnancy pregnant with dc2) 55kg dad is 5’10 rocking a dad bod right now due to lockdown and too much chocolate but he’s a slight build.

She’s around the 9th centile for both, think she’s dipped a bit below not a huge amount but enough to worry me x

@burritofan

Looks absolutely fine! Surely she’ll hound you if you’re underfeeding her? If my DD is hungry, I know about it (had a 9am request for shepherd’s pie today…). Other days she’ll not want anything from afternoon snack time onwards but still sleep through and not demand breakfast first thing. I think so long as you’re offering enough (and enough nutritious) food, that’s fine.

I think she might take after me and forget to eat, although sometimes she’ll come to me and say snack and she’ll always ask for more too

She's eating more than my 18mo and he alternates between 75th and 91st percentile so I wouldn't worry! Typical day for him is

Breakfast - cereal, peanut butter toast or scrambled eggs on toast

Snack - fruit, rice cakes, cheese, yoghurt, breadstick or a combination of

Lunch - fish fingers, potato and beans, smoked salmon/cream cheese/toast, or similar

Snack - as above, sometime maltloaf or raisins

Dinner - can be anything but often things like pasta in a tomato and veg sauce

However, he will often only eat a small amount of what's offered, especially at dinner, and he's currently refusing milk so is only drinking water! We also don't eat meat and only small amounts of fish so I try and make sure he has nuts/dairy/eggs everyday.

So today she had:

Breakfast Blue bowl of cereal with blue milk and some raspberries

Snack: whole pink lady apple, few slices of cheese and a small cup of milk

Lunch: pizza (made from a flour tortilla, tomato purée, spinach leaves and 2 big grown up handfuls of mozzarella. Cucumber sticks, tsp of hummus and a fromage frais.

Snack: box of raisins
Snack 2: milk and she shared a sweet potato brownie (bought some from a food fayre a while ago and froze them) with her dad and a small banana

Dinner: shredded beef (about a serving spoon size portion) 2 roast potatos, 1 Yorkshire and some peas and sweetcorn (left her kale today)

I think her dinners are ok, but it’s lunches, should she be having a full cooked meal of lunch and dinner? DH and I wfh and family watch her at home 2 days a week, other 3 she’s in nursery. So we tend to have quite quick things, you know omelette and wedges, sandwiches, jacket potatoes, pizza (as above) pin wheels, scrambled eggs, quesedillas etc. We only eat halal meat and a lot of the halal options for sliced meat are really really heavily processed so we don’t buy them. Our lunchtime proteins tend to be eggs, cheese, fish (tuna) and beans or any left over meat that’s not being used for dinner. Does that sound ok?

HVs have just made me doubt myself so much x

I think she sounds fine and it's your anxiety about it that is the issue. I totally understand why you're anxious with the history around but it's important she doesn't take on this worry as she gets older. Who is doing the two year check? Can it be someone who you don't have history with? A fresh pair of eyes could reassure you that everything is fine. Neither of you are particularly big and the thing that gets forgotten is with averages there has to be people above and below to give the middle. I'm sure you are aware of this but often HV are awful and there are many threads on here about it.

Isn't blue top skimmed milk? Shouldn't she be having full fat at her age?

My eldest was induced for IUGR at 37 weeks and weighed 5lb 3oz. She was teeny for ages and still in 12-18 month clothes at 2. She never ate a huge amount, I think your child's intake is fine. Mine started eating more around 2.5 and she had a big growth spurt at 3 and now at 3.5 she's in 3-4 clothing and doesn't look small compared to most of her peers.

I think she's eating fine, I really wouldn't worry.

@DameAlyson

Isn't blue top skimmed milk? Shouldn't she be having full fat at her age?

Blue top is full fat in most places.

Honestly it's all fine that's a great range, she'll eat what she wants. Stressing about it will only feed into the aversion. Just put the food down and don't watch what she eats. I've had 2 that were the same if not worse. Very prem and have tracked .4th percentile their entire lives. They're fine 😊

@DameAlyson

Isn't blue top skimmed milk? Shouldn't she be having full fat at her age?

Blue is full fat. Red is skimmed

Remember they only tend to have one big meal a day at this stage xx