Have I neglected my 3yo?

[Alicewither]

My DS 3.5 is short. I’m short (5ft) and his bad is 5’9, both families average height. For example, my mum is 5ft 1 but my sister is 5ft 10 so it balances itself out.

DS has never eaten much, I don’t think he’s actually ever ate a whole meal. For example, today he had
Quarter slice of butter on toast
Whole large apple
2 marmite and butter crackers
2 mini potato waffles
1 mini pot of custard
1 twister ice lolly
2 jammy dodgers

obviously this meal list sounds ridiculous and only sugary foods, I’m not stupid. He was offered other things at every meal and this was all he ate. For example, at lunch he had cheese wrap, carrot sticks, cucumber, yoghurt and potato waffles on his plate. All he ate was the waffles, which I’m extremely grateful for as at least it’s something savoury. His pudding was the ice lolly and he asked for more so he had some custard. Didn’t eat his dinner but sat at the table. Anything he eats is a win, and he needs to put on weight so fatty foods are good right now. I’m not concerned about his eating, if he was hungry he would tell me.

He also sleeps 7-8 hours at night, no nap. But so full of energy 24/7. Always been this way.

anyway, the thing I’m concerned about is his size. He’s 27lbs and 86cm, off the chart for his age. Not even the 0.4th centile for height. He was 8lbs 8oz when he was born. 12-18 months trousers, 2-3 for tops and jackets.

Do I take him to the doctors? Am I overreacting? Have I been neglectful to not worry about this?

Take him to the doctor
They can advise better about food
Does he have vitamins & Minerals?
Does he drink any milk? Have any meat?

That is very very little food for his age, and I would be concerned. I think the GP Is definitely the best option.
But no, you haven't neglected him op. You're giving him food, he's not eating enough of it, which could be medical. Neglecting him
Would be not providing food. Please don't beat yourself up. X

I don’t have any advice on the food but he only sleeps 7-8hrs a night?!
you must be tired!

I think a chat with your GP or HV (if you have a good one) would be sensible. You can't make a child eat, but if there is a frank problem then there are options. I have a family member who was a tiny child, her mother was given meal supplement powders for her. She's a beautiful woman in her 30s now.

You have not neglected him, but I think you would be right to get it looked into, just to rule out any medical reason for his low appetite.

Yes he has a daily vitamin, he loves milk but I give it in moderation as I don’t want him eating less than he is. He had a glass this morning, and will drink the milk out of his bowl after cereal (will only eat Shreddies). He’s always eaten a very small amount.
Meat he is very fussy about, he will eat sausages 30% of the time, and chicken 70% of the time, but that’s the only meat he will eat.

The other day he ate 3 of those cooked chicken straws you get in the fridge section of shops, but that’s all he ate out of his lunch.

He loves fruit and drinks plenty of water. His dad is the same BTW, I think there’s about 5 different foods his dad would actually eat.

I know what people are going to say… but this food issue isn’t related to autism, and that’s never been a concern. He’s going beyond developmental expectations for his age. I haven’t been concerned about his eating because his weight matches his height, he doesn’t look skinny, just small. He lets me know when he’s hungry, what he wants to eat. He looks forward to food, he tries new things all the time. He took a bite of a carrot a few days ago which was progress.

Absolutely not neglect, they are being given and offered a variety of nutritious food. I'd also suggest asking the HV for tips.

I personally had to be really harsh with my now 4yo and just stopped offering sugary snacks for a while until she ate an actual meal, even if it was a small portion (let's pretend it wasn't chicken nuggets cous cous and peas) but it seemed to do the trick. Now she has them as treats but it's all a balance.

My phone is playing up but yes I am exhausted. He hasn’t gone to bed before 11pm for over a year now. He just fell asleep 5 minutes ago. He lays there in bed playing pretend games, he just has so much energy. Only recently stopped having a set nap although he does often fall asleep in the car still!

Haven’t seen a health visitor for 2 years, mine retired, they kept making appointments for a new one and never turned up.

My daughter didn't eat much either at that age. But I did not offer her things like lollies or biscuits because if she wasn't eating much I did want what she was eating to have some nutrition in it! She is an enthusiastic and adventurous eater now in her teens.

I don't think this is a ridiculously small amount of food but it isn't very healthy so I would work on that before worrying about quantities if I were you.

You're right that calorific food is good - I would be encouraging milk (full fat) which is full of other good stuff. I've been to a dietician for DS and they weren't particularly worried about milk filling them up, just said to serve it with food rather than before as we don't get satiated that quickly really.

That said, I absolutely hear you that you are offering a huge variety and feel that any food is better than no food, but custard, an ice lolly and biscuits? I would cut back on the snack foods that you have available in the house. Wholewheat toast, more fruit, some veg or cheese or milk would be better.

Oh and no, you're not neglectful!

Is he following the line on the chart?
So he should be still growing along the line
Maybe he is just small
If he full of energy then doesnt sound too concerning tho coeliac can manifest as poor growth
Keep a food diary for a werk begore goingvto gp and alsking for dietiian referral to review intake
Get him measured at gp then again in three months and six months to see if he is growing or not

Is there anything nutritious that he will eat? I know you are concerned about his weight but personally I wouldn't offer my son biscuits, lollies and custard if he had left every other healthy component of his meal. Might be a bit old fashioned but I think they need some motivation to try new things to expand on what they will eat. Taking away his veg and replacing it with custard sounds quite counter productive to me.

That said though, no you don't sound at all neglectful, but maybe you should ask your GP for some help with this.

He ate fruit, toast and milk today. I also offered him cheese and veg, which he didn’t eat. All listed in my original post. The snacks (mini pot of custard, practically water ice lolly on a boiling day, and 2 biscuits) are so he doesn’t starve.

I lost his red book but I’ve been trying to work it out this evening from weights I’d written down. He’s gone from 75th centile to below 9th for weight. For height he is far below the minimum height for the chart, completely off the scale. Although it’s probably only 2-4cm off.

wish I never mentioned what he eats as people are now obsessing over it. I repeat, for the 3rd time, I am not concerned about his weight or eating, I mentioned it to show in comparison to his height. I’m only concerned about his height

Yes take him to get checked out he does sound tiny but also food helps him grow so if he is not taking in enough there won't be enough nutrition for that I was also give him milk an hour after each meal and no liquid around 45 mins before meal as he my be filling up on liquids before food, being in 12 to 18 months trousers is working when he is over double that age

His weight is higher than his height centile wise so that proves he’s not under eating. Children self regulate, it’s better to look at a toddlers intake over the course of a week than a day, so the posters who are saying it’s not a lot of food might be a bit off.

if you are concerned with his intake you should ask for a referral to a paed dietitian, GPs and HVs from my experience are awful at eating advice.

where you do definitely need to press forward is with his height, he’s off the Bottom of the charts which warrants a referral to a paediatric endocrinologist. You’re mid parental height is around the 25th centile (so your mph range is 2-75th) your son falls outside of that so it warrants further investigation

how heavy was he at birth ?

My asd/adhd son has always ate tiny amounts. But he's so tall, just super skinny. Not underweight though, apparently. I was told lots of people with asd/adhd don't feel hunger. He literally could go all day without eating anything.

Course you are not neglectful!

You say you are only worried about his height, but surely if he isn't getting the right amount of nutrition and calories his growth will slow, in the same way overweight children who consume too much are often tall. Height, weight, food intake are all inherently linked.
Yes you need to see a doctor, if this is more than short term behaviour, the lack of sleep would worry me too and I say that with a child who barely slept through the night until 2.5.
If he doesn't want dinner would he eat plain but filling things, Weetabix, porridge, scrambled egg? DS has tonsillitis at the moment and complains that things taste funny (I get it I've been there), he usually has a healthy appetite and isn't fussy so we don't go down the route of offering alternatives (completely understand why there is a need to with some children). Tonight he barely touched his dinner, usually one of his favourites but said after he was still hungry but his mouth tastes funny, so I offered Weetabix or Porridge, he had porridge and went to bed happily and I feel better knowing he's eaten.

Have you looked on the nhs site? On the nhs bmi checker you can change it to a child, enter height and weight and dob and it will give you the centile and tell ypu of he is under weight.

I would definitely speak to gp, I was concerned about my son, took several years to get gp to listen to my concerns.

I am v concerned about my DD for similar reasons to yours, she is gradually falling down her red book charts and is now underweight and looking to be about your height as an adult despite me being about 5'5 and DH being 6'3. However prepare yourself for nobody to be arsed. She's seen 2 GPs and a HV and none of them will do anything at all so far, so I am getting her referred privately to a paediatrician as fortunately one of her DGPs has kindly offered to fund it.

Hey @SecondhandTable how old and how tall is your daughter? What centile does that put her on? I’ve got a feeling your mph is around the 75th centile so you’re range will be quite a high range from around the 25th to 98, do work it out for sure though. If your daughter is over 2 and below 25th then you qualify for a referral to endocrinology based on height. Don’t let them fob you off. If needs be take the nice guidelines to the GP and demand it. I’ve been disappointed by paeds in this area too, height seems to be viewed as merely a vanity thing

You're right not to take random advice off here about nutrition!

Definitely worth seeking medical advice. And no I don't think it's a problem that you haven't before. Possibly if he'd had HV check ups it would have been flagged a bit earlier, but seeking help/advice now is fine.

What children eat affects their height.