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 the doctors but don't worry too much. When my eldest was about 4 he hardly ate, he'd eat what he liked which wasn't much and drink a lot of milk. I took him to the doctors they said he was a normal weight but on the lower end, said to let him have milk as it was calories for him and that it was healthier for him to be like this than being overweight.

And he's normal now with food, he actually went through a chubby stage, then his height shot up and he's more balanced out now.

Always worth a chat with a Gp.

As you say you're both short so he may be short.

When I was worried about my small, wiry, non eating food fussy and very energetic child Gp pointed out that he must be ok if he has energy. I queried iron as he didn't sleep easily (he did do 10 hours though) and Gp said again, loads of energy but just give an iron vit as it's very common among young children (ds was also iugr.)

He will be eating enough for him especially if energetic.

It's also calories over a week so he may have a pig out day?

It's worth asking Gp though just incase there's a "malabsorption issue" - quoting a friend who's son was really tiny, as they looked at things like coeliacs etc. but they decided he was just genetically small (also had short relatives.)

You need to speak to your GP. His diet is pretty terrible, although I get that he is a very fussy eater. You should only be offering fruit and natural yogurt for pudding, not sugary processed food when his diet is already so bad.

another thing that can affect growth in children is underactive thyroid but I suspect he wouldn't be as active - symptoms can be different in children but very slow growth and short stature are symptoms. It affects metabolism.

Babies get a test at birth though so it would be v rare that he's developed it later.

Bloody hell
thats bad op

Not much and what there is, shite

yep, you need professional support with this but what you do have in your favour is insight - and that’s a massive positive

I wouldn't offer the potato waffles if there are healthy options provided. Encourage him to eat that first.

Will he eat custard with chopped banana or something in it so you can at least get some fruit in there at the same time?

I don't know how he's not starving on what he's eating. My 9 month old eats much more than that in a day. She'll have a good three quarters of a slice of toast.

Food suggestions: cubes of cheese, bowls of chopped veg (carrots, peppers, cucumber, tomato, avocado) put out without comment a bit before a meal time to snack on, perhaps if watching tv or similar. Smoothies made with yoghurt, yoghurt and honey, bowl of porridge or weetabix before bed, homemade flapjacks (less sugar and can put in some fruit) and a big glass of milk.

I would definitely see Dr, but in the meantime if they will drink more milk I would let them have it. Better to have milk than nothing.

also seems like very little sleep. I think most growing is when asleep?

This. It's definitely not neglect, but take him to the doctor just in case there's some underlying problem. If there is, then he'll get the help he needs ASAP; if there isn't then you'll have or your own mind at rest.

It’s not neglect OP but given he’s off the chart I’d ask for a paediatric referral and review.
He does sound diddy- my one year old was 27lb on her first birthday! She was 99th centile though (has grown into her rolls since!)
I do agree that if his appetite is small make sure everything you offer is healthy but high calorie options too (eg full fat natural yogurt with honey instead of biscuits) otherwise he’s getting little nutrients.

Sorry OP but that example of food is abysmal, no protein whatsoever, no vegetables (fruit is far from being as good as vegetables) and hardly any calcium.The carbs are also all processed food. It’s absolutely shit.

If you can’t make him eat anything else but carbs at least let him stuff himself with milk, that’s the only protein he is having!

You don’t need doctors’ advice to make things better, just ensure he has his 5 a day (and that most of them are vegs not fruit) , 2 servings of protein a day and, if you want a taller kid, plenty of dairy.

If he is used to this diet he will likely refuse to eat other things but just remember, if you keep filling him with carbs he is never going to be willing to eat new things. You need to introduce him to new flavours slowly but not to slowly to cause malnutrition.

Full fat plain natural yoghurt is a great dessert for children. I would not be offering custard pots and things like that.

"as at least it’s something savoury."

Sorry OP but a potato waffle is just carbs/sugar too.

I would be very concerned about his height. I'd also be looking to get milk in him as much as possible (whole 'big' milk by arla if affordable).

I'd also be asking the GP to rule out Coeliac. Even if no other symptoms poor height growth and poor sleep can be big flags in kids his age.

Take him to the doctors. I'm surprised nobody ever picked up on this before if he's slipped off the bottom of the chart. My eldest had growth hormone deficiency and had slipped off the bottom of the charts by 12 months despite being larger than average at birth. I suppose that is less likely if he's still on the charts for weight, but it does need to be investigated. He looked like a baby/toddler at 4.

My son also ate far less than other children and it was simply because he didn't need the extra energy as he wasn't growing. The consultant told me that the first thing we'd notice was an increase in appetite and we really did. His food intake at least doubled.

I'm not sure I would worry. DD is also 3.5, quite a bit taller than your son at 96cm but only 29lb and in 2-3 clothes mostly still, though some items 18-24 months. You are short and your DH isn't overly tall for a man so it makes sense that he may be more on the petite end of the scale.

Yes maybe talk to a gp, but I wouldn't be panicking.

My friend had a similar issue. One thing that really helped was involving her daughter in food prep/ cooking/ baking. She was much more interested in eating food that she had helped to prepare. Her daughter was later diagnosed with coeliac disease which also helped to explain why she was so tiny.
Hope you get some support OP.

Hi OP. Definitely take him to the GP for a review. I have a 1.5 yr old a d nearly 4 Yr old. They eat very similar amounts though my 4 yr old snacks more. The you gest is definitely fussier. I offer small amounts of varied things. I also make up snack pots that they love going to get from the fridge. I pretty much allow them to have snack pots whenever because they're not big and I know what's in them. Example: 1. veggie pot (carrot batons, peppers slices and quartered tomatoes) 1 carrot and 1 pepper and a handful of tomatoes would make up 4/6 snack pots. 2. Fruit pot (grapes cut length ways twice, watermelon and raisins) again a handful of grass and half a watermelon go a very long way).

For breakfast they have a few different things. We always start with fruit. So youngest has banana and oldest has sliced apples. Then they will have toast or cereal. On a weekend day they might have a treat like a breakfast bar but this isn't every day or even every weekend.

For lunch they will have a sandwich, or like cold picky things such as a slice of cheese, ham, veg and a couple of breadwitcks with pickle or something. Like a kids ploughman's.

For dinner they will eat meals that I make myself. Meatballs and pasta, roast dinner. Sausage and mash. My youngest has a thing about texture he won't eat a roast dinner unless blended so I still do that. They both have desserts of yogurt or whatever else I have to hand- yes they do eat crisp and chocolate everything in moderation. They both have milk morning and evening.

Honestly some days I could pull my hair out trying to persuade them to eat. I bought them nice plates and table and chair to sit at etc. So you're not on your own. But I think on the days they do eat properly they eat well which puts my mind at rest a bit. Anyway hope the above gave some ideas. And I think it would be neglectful to ignore your concerns. But you've picked up on something and are actively seeking advice and that's a good thing x

We have similar problems with our 2 year old son. He is 87cm and approximately 11 kg. His low appetite is a side effect from medicine for a medical condition so we see a dietician through the hospital. They have told us calories are the most important thing and not to worry about healthy eating at all at this point. Healthy food sometimes fills them up and has less calories, so should be avoided if a child needs to gain weight. We have been told to do things like add ice cream to milk to make it higher in calories. So if your son is not getting enough calories the food you are feeding is probably better than healthier food.

Of course if your son is tracking his percentile line, he might be ok, but I would definitely start tracking weight and height if you’re not and would probably go see a doctor.

This link has some useful suggestions for boosting weight: www.uhcw.nhs.uk/download/clientfiles/files/Patient%20Information%20Leaflets/Clinical%20Support%20Services/Dietetics/119085_Paediatrics_-How_to_gain_weight_in_children(697)_-_June_2019.pdf

I would say thay if either of mine elf most their lunch and only ate the waffles before clearing it away I would be clear that unless they eat the cucumber etc there's nothing serious. If they still didn't eat it they would not get a ice lolly or custard or any snacks In-between. I don't know if that's right or wrong or too harsh. But I'm not having them eating rubbish and not the stuff I actually spend time preparing. The rubbish stuff is a treat not a given- if that makes sense.

My now 4 yo ds is a good eater but like your ds was in 18-24 month trousers so we had him checked at the doctors when he was 3.5. He had low iron, now takes 1 Iron gummy a day and within a couple of weeks he wasn't fitting in 18 - 24 months anymore. He had a repeat blood test and his iron has improved so they aren't concerned anymore and we've noticed such a difference to him so it may be worth asking for a blood test

Same. I know in theory you should let them choose everything but there comes a point when they work out that they can skip most of their dinner and hold out for the delicious ice cream etc. for pudding.

Why is he getting jammy dodgers and twister without eating more balanced food first? Those will give him a short term energy rush but protein and carbs would last longer. Does he still drink milk?

Sleep. Sleep creates the growth hormone. You need to improve his sleep ASAP.
Protein for muscles and calcium for bones. You shouldn't be giving in to him when he asks for seconds in desert. He's obviously addicted to sugar so you need to break the cycle.

He does sound very small, so yes I'd be worried in your shoes. I saw a nutritionist with my DS as he had chronic toddler diarrhea, and it was really useful to chat things through with her.

His diet isn't great as you know but I sympathise, fussy eaters are a nightmare. My DCs take a vitamin gummy bear. My DD eats dry cereal every morning and cheesy pasta every night. Nothing else. All other meals go untouched. At least she's eating something. 😏

Those refined sugary treats should be well..treats!
Height is affected massively by what children eat. You need to give him only good foods until he stops refusing them. He will eventually eat. Then reintroduce treats