HELP! My Child Won't Gain Weight!

It's not a feeding or eating problem...it's a WHOLE body problem. Get her into a brain based intervention and stop force feeding her and begging her. This only creates more resentmant and resistance on the child's part. Her sense have not integrated enough for her to be able to suck, swallow and breathe at the same time so breathing wins out. A speech path can help too. She might be a chest breather, have low muscle tone and not enough strength in her jaw, neck and core. Usually these are the babies that hated tummy time! If you live in Broward or Dade I can tell you where to go.

It sounds like a control issue for her. Maybe. You could put out a bunch of healthy stuff to nibble on and she could graze throughout the day. Only make healthy stuff available. she'll eat when hungry. Apple slices, pecans (easier to chew than some nuts), carrots, TLC crackers, grapes, bananas, etc.

Hi H.,

Instead of specific advice, I thought I would tell you my story and feel free to ask me any specific questions you might have. :)

My daughter was a preemie - born weighting only 1 pound and 2 ounces. Getting her to eat was a struggle from the very first attempt. She was born so early that she had not mastered her sucking reflex. She was in the hospital for 3 months and for that time was fed with a feeding tube. Her doctors wanted to send her home with one permanently inserted - but I refused. I felt she was capable of eating "normally" and they gave me two weeks to prove it. So I quit my job and stayed at the hospital around the clock with a feeding therapist on staff there helping us along. At the end of the two weeks, she was taking a specialty nipple - but it was all very hard and stressful. I would like to be able to tell you that once we came home her eating troubles disappeared, but that is not the case. She is now nearing 5 year old and weighs 30 pounds (on a good day). She is tiny and most people think she is 2 or 3 years old. Although every single day has been a struggle to get her to eat - she is healthy. Malnourishment is not the cause of her small size. We've had test after test and nothing was found to be wrong. There is no reason her doctors can find that should prevent her from sucking/chewing/swallowing/growing normally. And over the years we've had many, many tests. When she was a baby and taking a bottle we fed her the most calorie dense formula we could find and was agreeable to her system - NeoSure (recommended by her doc). She stayed on that until she was 1 year and then we struggled to find our next step in feeding. She was not successful at all once we tried to feed her cereals and baby foods - no combination was right for her. But she would drink and we had switched her to another Similac formula that was meant for older babies (again the most calorie dense). Then she outgrew that one - and still wasn't eating, so we had to make a choice. We had her put into therapy and started feeding her PediaSure. I can tell you that PediaSure kept her alive during that time period. There were days that it was the only thing that got down her throat. She liked the vanilla flavor best, by the way. Her pediatrician said we were only giving her a "glorified milkshake" and chastised us about it, but we had little choice. She wasn't able to chew/swallow any food. Her therapists, who worked with her twice a week, were closer to the situation and saw how urgent it was that we get her to accept some form of nutrition and they were much more supportive. One even told me of disabled patients she had that practically lived off of PediaSure - like my daughter was doing. All the while, she was on a vitamin, but you have to be careful that the vitamin you are giving doesn't have iron because PediaSure, and most other meal replacements for little ones, have plenty. Like you, we weren't making any noticeable improvements in therapy either. I think the initial process did more for my sanity than it did for my daughter's eating skills. Our therapist was an awesome person and completely understood how stressed out Mom's would be by the time they made it there and she was super supportive. It took us two years in therapy, but we finally (and VERY slowly) made some progress and she "graduated". But to be honest, I wasn't ready. I wanted to stay and the therapist kept us on for another few weeks, just to prove to me that my daughter could eat, just very slowly and a bit at a time. I was looking for a "cure" and it didn't happen. Instead the therapist had told me that I had learned more in the last two years than most graduating therapists know and I could handle the rest on my own from home. So, it was more work and I broke down many times thinking I wasn't doing a good enough job for my daughter. What was even more difficult was all the gagging and choking at mealtime. It is torture feeling as if I was putting her through that by feeding her, but also knowing I had to feed her to keep her alive. There were two primal-motherly instincts colliding: prevent baby from harm and feed baby. So, eventually we made it off PediaSure and switched to whole milk and lots of Activa yogurt. (When little ones don't eat well, their digestive system gets bound up and the Activia is a gentle and nutritious way to keep them regular.)So again, now she is nearly 5 and 30 pounds. She can eat, although sometimes has trouble chewing meat. The point is - she can. She is just meant to be a small girl. We have made it through to the other side. The other side is there, H., it just may take several years and lots of frustration and tears to get there. Keep your daughter in therapy (but maybe switch therapists until you find one you like, if you can). It will also be an expensive process - expect that, but it is worth it. Although my daughter is small, her weight is what it should be for her height and she is healthy. And, as parents, we did what we had to to get her there. I'm certain you will do the same and you will all be just fine. :)

Dear H.,

Been there done that! All I wanted for my oldest daughter was to see her hit 20 lbs for her second birthday, and no she didn't do it (she weighed 19 lbs). I went through the doctors, the tests, accusations that I was starving her, etc...

That same child who was petite all the way through high school despite developing an appetite that would put a grown man to shame, had to gain 10 lbs to get into the army!

What worked for me when she was little (kept her healthy, but did not put weight on) was to only put two bites of each food on her plate. When she was not so overwhelmed, and when I stopped making a big deal about what she ate and what she didn't, she started eating more. She never had to finish anything before getting seconds of something else, and all additional servings were two bites each. It was a hassle at first, but it worked, she started eating more. After a few weeks I was able to gradually increase the amount of food on her plate until a few months later she was getting plates like her sisters.

Remember at your childs age, two or three tablespoons is a full meal, and they need several meals and snacks a day.

I will probably get blasted by other moms for this one, but it works with my youngest (now 5, and autistic) when her appetite drops I give her candy. I don't give her pounds of it, but a couple of peanut butter cups or a kit kat. Usually an hour or so later she is hungry because of the sugar spike and drop, and I can get at least part of a meal into her.

Good luck and know that you are not alone, but your child will not starve, and yes, she will come into her own :)

Do you think she will drink formula? They ahve the formula for kids up to 24 months. I know you said you tried shakes, but maybe if its something that is closest to milk that she can drink. I know this is probably a step back, but offer it in a bottle and see if she will drink it while watching TV. Just until she can gain the weight she needs. Just a thought. Hope something works for you.

I'm not sure if this will help you but it's worth a shot. when i was little my parents couldn't get me to eat very much either the most i would eat was vegtables and my parents and the doctor were very concerned with my weight and my height. my ped. refered my parents to all childrens hospital in saint pete where they were able to find a doctor to help me. i had to get a shot every day for about yrs to help me grow after that i finaly started growing and eating more normally. im not saying that thats what your child needs but all childrens hospital caters to kids needs. i think they would be able to help you. in the mean time you could try getting your child to eat shakes they have drinks for toddlers to help them through times like this. hope i helped.

A. C.

I agree with Debbie K. Give the healthiest foods you can find that are the highest in fats like avacados, cheese etc. My 2 year old weighs 23 lbs now and it was a fight to get him that high. I found out he loves burritos and black olives... so thats exactly what he ate nearly every day for a long time!!
Best of luck!
Jen M.
Mom of 3 boys ages 6 yrs, 3.5 yrs, and just turned 2 yrs.

Hi, H.!

My oldest, now a beautiful five-year-old girl, has always been a light eater. She was breastfed until 15 months, and even as a newborn she ate frequently in small amounts. My doctor put us through the wringer about "failure to thrive" when she was about six weeks old, so I changed doctors.

My current doctor (and I am so happy with him!) has two thoughts about weight. One, as long as they maintain their place on the weight curve, they're fine. (In other words, if her weight has always been around the 15th percentile, it's fine for her to stay in the 15th percentile.)His second point is that they form their permanent fat cells early in life, so he'd rather see kids on the thin side than the heavy side.

Just to give you an example, my daughter was 18.5 lbs and 32 inches at 18 months--that's 25th and 70th percentiles. By 24 months she was 22 lbs and 34 inches--57th and 60th percentiles. So you can see that she was tall and skinny, and then totally balanced six months later. And I didn't change a thing! That's just how she grows.

Keep in mind, that was before the World Health Organization came out with the new percentile charts for breastfed babies. They do NOT gain the same way that formula-fed babies do. You might want to look up the WHO charts for breastfed babies on the internet.

As for eating, NOW my daughter will eat 4-5 bites of each thing at a meal, but when she was 18 months, I was happy if she ate three bites of each thing in her. We just kept serving balanced meals (what we eat). She loves fruit and yogurt, bread and pasta, so I made sure she got those. She's learning to like meat and veggies.

I still stress about her getting enough protein, but I try not to show it. She's old enough to know that she has to eat her five bites of everything. My two year old, on the other hand....we serve healthy food and he eats what he chooses. He's not old enough to understand.

No child, given good food to choose from, has ever starved themselves. Try not to pressure her, and make sure you're comfortable with WHY your doctors want her to gain.

Good luck!

I know it's frustrating...I'd keep up with the high calorie supplements. And I wish you the best.

My daughter was 9 lbs at birth and has not grown in weight as doctors would have liked. She is now 3 1/2 years old and 26 lbs. She has been in the 3 percentile since 6mo old but developed fine. We had a home aid come and visit once a month and she assured us that out little girl was completly healthy. As long as her brain is functioning properly and her iron and all that was stable there is nothing to worry about. We try to add calories to things she likes, like adding cheese to her grits. As long as she is healthy you should be happy, children only eat when they are hungry and they won't starve themselves. I hope this helps.

Well, now it's a power struggle, and it's one you can't win. You cannot force her to eat. You know that she is basically ok because she's meeting all of her milestones, so you don't have to really worry, but I understand that the doctors are saying that she needs to gain weight now.
You can either back off and not care what she eats, at least outwardly, and you would get the same results, apparently. Or you can tell her that if she doesn't eat, the doctors will give her a shot (or whatever therapy they say they will do). My advice is let it go. I have two friends with exactly the same issues; they have toddler girls who are skinny and the doctors have called them officially "malnourished" but it's because they don't eat. But their moms are very slender too so it might just be the way they are. If she's meeting her milestones, you probably don't have anything to worry about. I think if you quit fighting she will either eat more or she won't, but you won't be fighting about food and setting her up to use food as a control mechanism forever. That's setting her up for an eating disorder.
At 18 months, she understands asserting herself, but she doesn't understand long-term consequences. Let her get whatever therapy the doctors want her to have, IV treatments or what have you, and tell her that's what they need to do for now until she can eat more. When she can eat more, they can stop. But don't make it a punishment for not eating, just something that needs to happen for now until she's ready to eat more on her own. Good luck.

I have a friend whose daughter was the same...she did not go the route of french fries, etc. even though everyone recommended it. She picked the most fattenign healthy foods she could find, avocado, everyday, homeade cheesecake, adding extra powdered milk to her milk for the calorie boost. I would recommend you go this route. Even with a few bites each time, if she gets the most calories and healthy fats per bite, that is th ebst you can do.

I also believe that kids eat until they're full and it is important for us to let them listen totheir bodies. My son was underweight for years, I was so sick of hearing how skinny he was...but he was reallyonly given healthy foods and is now almost 5 and of average weight. Very healthy, happy and thriving.I do know how hard itis not to worry about your kid eating enough, but in retrospect, all my worrying was for nothing and he was eating the portions he needed.

Good luck to you!

My daughter (now 7) was doing the same thing. I understand your frustration. I hate to say this, but if you've tried everything, then I'm afraid it may be nessasary to give her fast food. I introduced my daughter to McDonalds french fries & chicken nuggets at the same age your daughter is. I didn't have a choice. I did everything you did, i swear! Also, u can get her to drink milk by adding hersheys chocolate syrup in it. These things actually worked for my little one, I hope it will also work for you. Now that shes older, she eats a huge variety of foods. So hang in there mommy! Oh, also between 18-36 mos. babies don't gain weight as rapidly as they did when infants, so if you can get 1 or 2 pounds added..you'll be fine! One more thing..my 4 year old son weighs more than his 7 year old sister! If you were thin growing up, she will probably be the same as you. I was always very thin growing up...people always commented on me being so thin, that I actually developed a complex. Well needless to say, when my thirties hit, I finally gained weight...go figure! Good Luck!

this may seem unrelated but has she ever been checked for a sinus infection. my nephew was always a picky eater and a very skinny fellow. the drs had him on the protein shakes and he only ate chicken and cheese that was it. after 2.5 years and 5 drs one of them FINALLY found out that he had a horrible sinus infection for the past 2.5 years after 10 months of antibiotics it was cleared up and he was a nonstop eater. it is a long shot but something you may want to think about having checked. my son was 10% for weight at his year check up and by 18 months was 75% his waist can still fit into some 6 month sizes and he is almost 2 now. Good luck

Have your tried toddler formula? My daughter hated eatting but would drink a ton of formula. I kept her on it till she decided to eat more.Also early steps program helped me get a feeding therapist and its free. J.

Hello H., I am no expert at this, but I was always told that no child will ever starve herself to death. I know it is frustrating but I know many children especially girls who don't eat much and are perfectly healthy.

My daughter is 21 months and weighs 22 lbs at her heaviest! she is still in 12 month pants.
My girlfriends daughter is 3 years old and weighs only 30 lbs- she eats like a bird, a few bites here and their.

Try not to make a big deal about it because then she will think it's a battle she has to win. Say here is dinner if you aet it great if you don't that's ok too.

I personally give my children nano greens every morning to ensure they are getting the vitamins and nutrients they need. it is a vegetable and fruit supplement that is awesome!!! better than juice plus! my husband and I take it too!

If it makes you feel any better, my 16 month old is barely 18lbs. She likes different foods but is like your little one, just eats a few bites and she's done. She's in 6-9 month clothes still too.
The only way I feel comfortable is just giving her meal replacement shakes throughout the day. At least then she's getting vitamins and nutrients. My girl is also still breastfed so I hope that helps her some too.
Our pediatrician also wants her to gain weight but I'm not overly concerned. I was tiny too!!!
Just keep doing what you're doing and be thankful you are getting your money's worth out of her clothes!!! LOL I know I enjoy that aspect!!

Go to WestonPrice.com- they will tell you about food they recommend- may be a new idea.
Also you can get Health Alert for Dr. Bruce West and get a free consult- he is amazing.
Hard to believe the folks examining her tell YOU to make her gain wt, and that it is important w/o telling you how.
I think the 2 referrals here will sort it out for you. best,k

H.,
When I read your posting yesterday it brought back so many memories. I can relate to your struggles. My son was born an ounce smaller than yours and was nearly 17 pounds when he was 18 months. Although not necessarily connected, he has a heart condition as well which made his not eating even more of a problem. We had to do a feeding tube when he turned 8 months. In my case, I don't buy it that kids won't starve themselves. It was looking like mine was going to. In some ways the tube was good because I knew he was getting proper noutrition but of course it just prolonged our oral issues and made for some logistic ones as well. We went through years of feeding therapy but finally got him off it 2 years 8 months later when he was drinking enough Pediasure to sustain him (supplemented by a few pretzel rods a day.) I encourage you too to try out a different therapist if your current one doesn't seem to be a good fit. The first several we used, though very qualified and nice, weren't the right match for us. Looking back at it one of the "mistakes" I made was just giving him baby food, or food that kids are supposed to like. He didn't really like sweets and had / has huge texture issues with anything pureed. I wish I had tried more savory and salty things earlier on. One clue should have been for me when he had ranch dressing one morning on his waffles. Now at 8 ( a skinny 8, but he made it through!!) he enjoys eating odd things like sushi, satay, anchovies and pickled herring. He hates jelly, hot dogs, chocolate milk, pudding and applesauce.

A couple more things - I made the mistake of not bringing him to the dentist sooner. The pediasure had done a real number on his teeth and he had to have all of his molars capped. Don't make that same mistake I made!

The other thing is I thought about you. I know how stressful this is on you. I can't imagine having that stress and managing a household with three other kids. I typcially held it together well, but sometimes the overwhelming stress would be very difficult. A few years into this I finally went on a small dose of antidepressant and stayed on it for a couple years. It really helped me and took the edge off a little. I wish I had gone on it sooner. Just try to take care of yourself - maybe drugs aren't the answer for you and you can manage a yoga class or even escape with a book a few times a week. Good luck!!!!!!!!!!!!!

Sorry that you have to go through, but have the doctors suggested anything about protien? I know she is very young, but like the ensure drinks with some icecream in it makes a very yummy drink and she will get the protien and vitamins she needs. Have you tried not trying so hard I mean like when you eat something see that she sees you eating and maybe she will try it on her own. Hope it helps I will be praying for you.