6 small meals vs. 3 big meals & 2 yr old weight gain

[echoecho1528]

My DD has had difficulty gaining weight since she was about 9 mo or so. She started out at about 30 %ile and is now (at 27 mo) just below the 3rd %ile in weight. So, we've been to quite a few doctors appointments - regular ped every 2 months for weight check, GI, nutritionists, etc, and nothing has been of any help.
She was fed on demand pretty much all of her life and continues to really just eat all day. I try to make everything that goes in her mouth really count for calories/fats/vitamins/minerals, but she pretty much eats 6 small meals a day.
So, the most current recommendation from her GI is that it is counter productive for her to be eating all day long because "6 small meals a day is what you do if you are dieting." I'm assuming she means that it ups your metabolism and her theory is that that is why DD doesn't gain weight despite (nearly) adequate calorie intake, lots of fats, proteins, etc. The GI is recommending having her eat 3 big meals and only one nutritious snack per day.
I am unsure about her recommendation because the whole reason DD eats all day long is that she won't eat much at one time, and hasn't ever.
I'm wondering if anyone has any insight on this doctor's recommendations and/or can offer any advice.
TIA!

[Alyantavid]

If she naturally eats 6 smaller meals, it'll be hard for her to eat 3 big meals. I'm a small meal eater and I get hungry much more often than meal times. My kids have always eaten on demand and I have tiny skinny little boy and one chunky big boy. They eat basically the same things and amounts. So I'd have a hard time forcing that kind of schedule on my kids.

Is she seeing all these docs because of your concerns or her ped's? Even if she falls on the growth charts, as long as she is consistently growing and is healthy, she's probably fine. Some kids are smaller. My oldest has always been thin, but he's growing and is healthy and happy and I'm not worried at all. My youngest has always been bigger. Same parents, same genes, just different body shapes. And they're completely fine.

I think as along as your feeding her healthy foods with plenty of fat for her growing body, I'd leave it alone. But that's totally my opinion.

[echoecho1528]

Thank you for your opinion!
She does have other health concerns including an intolerance to wheat/gluten, brittle hair & nails, bruising easily, and rapidly decaying teeth. I think that she has malabsorption issues because of food intolerances that I have not been able to pin-point, but the doctors don't even consider this as a possibility
It is nice to hear your personal experience of having one skinny kid and one chunky one each being fed the same way.

Originally Posted by Alyantavid

If she naturally eats 6 smaller meals, it'll be hard for her to eat 3 big meals. I'm a small meal eater and I get hungry much more often than meal times. My kids have always eaten on demand and I have tiny skinny little boy and one chunky big boy. They eat basically the same things and amounts. So I'd have a hard time forcing that kind of schedule on my kids.

Is she seeing all these docs because of your concerns or her ped's? Even if she falls on the growth charts, as long as she is consistently growing and is healthy, she's probably fine. Some kids are smaller. My oldest has always been thin, but he's growing and is healthy and happy and I'm not worried at all. My youngest has always been bigger. Same parents, same genes, just different body shapes. And they're completely fine.

I think as along as your feeding her healthy foods with plenty of fat for her growing body, I'd leave it alone. But that's totally my opinion.

[sbgrace]

I was told lots of small meals/snacks. My son also doesn't take much in at one time. His twin is more naturally a three meals a day kid and eats much, much more each meal. It's really built in I think but, generally, many kids eat frequently to keep energy up. They burn it fast.

In your daughters case--has she been worked up for malabsorption? What tests? I was told that sometimes the stool tests aren't accurate for that and kids benefit from enzymes like they use for Cystic Fibrosis because their malabsorption problems are similar. There are also CF cases that don't involve lungs but rather just digestion.

I've got a tiny (he's failure to thrive right now) child as well.

[karika]

I believe we are meant to eat like grazers. We were a nomadic people not that long ago evolutionary wise and our bodies are still expecting that for health. I eat when I am hungry. I raise my children the same way. Sometimes it is a steamed veggie, then 30 min or an hour later, a pancake... Your daughter could benefit from a different type of doctor perhaps. If she is intolerant to wheat, are you on a gluten free diet? Gluten is what wheat intolerant people are sensitive to and gluten is in many things. The brittle nails may be a lack of good fats like olive oil, coconut oil and the like (I am not a health professional or nutritionist, but that is what it says to me). Weak teeth can be fluorosis. Is she getting fluoride from somewhere? If it is in your water supply, stop using it. Move if possible. I would also recommend removing dairy and soy, going on a GFCFSF diet. Can you see a natural doctor in your area that specializes in pinpointing intolerances as well as whole body treatments? Her weight may be just fine for her, or it can be a symptom of her food intolerances. I think the easy bruising is related to a need for more nutrition (or supplements). A search yielded this info "deficiencies of vitamins B12, C, or K, or folic acid" Does she eat meat? It would seem meat and eggs are good sources of B12. As long as she is still nursing, I wouldn't worry too much about the charts. But I would go GFCFSF as soon as possible to help her with her nutrition.

[echoecho1528]

Originally Posted by sbgrace

In your daughters case--has she been worked up for malabsorption? What tests? I was told that sometimes the stool tests aren't accurate for that and kids benefit from enzymes like they use for Cystic Fibrosis because their malabsorption problems are similar. There are also CF cases that don't involve lungs but rather just digestion.

She has had stool tests done and a bunch of blood tests, but I don't know off hand what exactly. Her GI wants to do an endoscopy and that scares me. I'm not sure if this is indicative at all of not being CF, but her poop (size, shape, consistency) is all good - foul smelling, but not greasy or anything. She has suffered from constipation pretty consistently since about 3 mo old. What is the test called that they run for CF?

[echoecho1528]

Originally Posted by karika

I believe we are meant to eat like grazers. We were a nomadic people not that long ago evolutionary wise and our bodies are still expecting that for health. I eat when I am hungry. I raise my children the same way. Sometimes it is a steamed veggie, then 30 min or an hour later, a pancake... Your daughter could benefit from a different type of doctor perhaps. If she is intolerant to wheat, are you on a gluten free diet? Gluten is what wheat intolerant people are sensitive to and gluten is in many things. The brittle nails may be a lack of good fats like olive oil, coconut oil and the like (I am not a health professional or nutritionist, but that is what it says to me). Weak teeth can be fluorosis. Is she getting fluoride from somewhere? If it is in your water supply, stop using it. Move if possible. I would also recommend removing dairy and soy, going on a GFCFSF diet. Can you see a natural doctor in your area that specializes in pinpointing intolerances as well as whole body treatments? Her weight may be just fine for her, or it can be a symptom of her food intolerances. I think the easy bruising is related to a need for more nutrition (or supplements). A search yielded this info "deficiencies of vitamins B12, C, or K, or folic acid" Does she eat meat? It would seem meat and eggs are good sources of B12. As long as she is still nursing, I wouldn't worry too much about the charts. But I would go GFCFSF as soon as possible to help her with her nutrition.

To answer your many questions:

- We are on a GF diet.
- She doesn't get fluoridated water. (but we just started to try a fluoride toothpaste to help with her teeth... is that bad?)
- We've removed dairy before, but not soy. I'm hesitant to do that because I have had a really hard time emotionally with limiting food for both of us (lame reason, I know, but I have a hard time with food). This is the next thing on my list of things to do, though.
- We can go to a natural doctor. I'm hoping my flexible spending account will cover charges, but I will have to check into that.
- We cook nearly everything she eats in either coconut or olive oil. She eats nut butters from a spoon daily. All of this tells me there is a problem with absorption because she is taking it in, but it isn't going to all of her cells.
- Eggs and meat are the easiest things to get her to eat. She has at least one serving of meat per day and usually 2-3 eggs fried in coconut oil.
- Her current supplements are
- Multi-vitamin
- Cell Salts for teeth (calc phos, calc fluor, silica)
- Liquid Mag
- Liquid Zinc (only when sick - like she is currently)
- Iron + vit C
- Vit D (2000 iu/day)
- Fermented CLO & High Vitamin Butter Oil (for Vits K & D)
- She just started Calcium
- And, I am taking pretty good doses of B vits, magnesium, & P5P because we both have metals issues.

This is a flippin' maze that I struggle with daily. I just want my baby to thrive

[kjbrown92]

Originally Posted by echoecho1528

Thank you for your opinion!
She does have other health concerns including an intolerance to wheat/gluten, brittle hair & nails, bruising easily, and rapidly decaying teeth. I think that she has malabsorption issues because of food intolerances that I have not been able to pin-point, but the doctors don't even consider this as a possibility
It is nice to hear your personal experience of having one skinny kid and one chunky one each being fed the same way.

Does she have other symptoms that are more easy to track than weight? Like sleep issues? or rashes? Where you could do a food journal and see cause and effect (weight is just a hard one to track).

The Genova stool test helped us. It's like an $800 test or something but we used the PayAssured plan so it was only $150. It told us that DS didn't have the right good bacteria, and some bad bacteria, and he needed enzymes to help him digest food. Since then he's been pooping every day, instead of every 3-4 days, and he's been gaining weight steadily. We know his food intolerances though (between elimination diet and ALCAT blood testing).

It is true that they say that 3 meals will make you gain weight faster than 6 mini-meals, but in this case, it sounds like something else is going on, not just the meal thing.

[echoecho1528]

Thank you, Kathy, for validating my concerns that her issues extend beyond how much and when she eats.
If I step back and look at the whole picture, everything has really started falling in to place recently. Her biggest symptom was sleep and that all changed within the last 6-8 weeks in which we started all of the supplements, and concluded a gluten trial. She has been pooping every day, eating more, and sleeping a ton better. I originally saw a hault in her tooth decay, bit that seems to have started again.
I think the magnesium is really helping her sleep, but could that be masking the effects of another food intolerance? Now that her sleep is so much better I'm not sure what to look for as for a reaction. As you said, growth is so hard to monitor. Although she did gain a pound in the last month after 6 months of no change. Perhaps things are actually better, but she just needs more time?
Then again, having to be on so many supps to counteract the effects of food intolerances is not good for the long run.

[sbgrace]

I'd second the genova stool test (or metametrix comprehensive is actually my favorite because they use DNA technology).

Have you actually sat down and tracked her intake?
Was her calorie intake good? Protein?

If she's taking in enough calories/protein and not growing I'd be wanting to find the underlying issue.
The CF screen is a sweat test. She's unlikely to have CF. But she may still have malabsorption.

[kjbrown92]

I used www.fitday.com to track calories and ratios of fat, protein, etc. to figure out nutritional data.

What kind of supps is she on? besides the magnesium?

[leafwood]

go w/ the genova stool sample. very helpful for us w/ ds. we also ruled out CF w/ the sweat test and he did have an endoscopy w/ a biopsy (which was fine). i also second the idea of tracking calories and if she is on dairy you can add organic heavy cream to a shake for her to sip during the day.

as for intake, calories are calories (which is what our nutritionist says). your idea about malabsorption may be worth following up on as far as more challenges for food intolerance.

[echoecho1528]

Kathy, this is what she is taking currently:
- Multi-vitamin
- Cell Salts for teeth (calc phos, calc fluor, silica)
- Liquid Mag
- Liquid Zinc (only when sick - like she is currently)
- Iron + vit C
- Vit D (2000 iu/day)
- Fermented CLO & High Vitamin Butter Oil (for Vits K & D)
- She just started Calcium
- And, I am taking pretty good doses of B vits, magnesium, & P5P because we both have metals issues.

I will be back with more after DD is asleep

[echoecho1528]

Originally Posted by sbgrace

I'd second the genova stool test (or metametrix comprehensive is actually my favorite because they use DNA technology).

Have you actually sat down and tracked her intake?
Was her calorie intake good? Protein?

If she's taking in enough calories/protein and not growing I'd be wanting to find the underlying issue.
The CF screen is a sweat test. She's unlikely to have CF. But she may still have malabsorption.

I have tracked her intake in the past and I just looked through the log for the first week of may. She averaged about between 1050-1200 calories and between 20-30 grams of protein. This particular week was a really good week for her intake. Right now she is teething and has a stuffed nose which is effecting her input greatly.
But, the major point to take into consideration is that she just started eating adequately in the last 6-8 weeks or so and she IS growing. She was 21#7oz in December, the same in February, 21#9oz in april, and then finally made some progress weighing 22#7oz in may. We are going that she continues to gain now that she is eating more, but I am also hoping to see positive changes in her hair and teeth. Just seeing her hair grow and become shiny would make me feel a lot better.

[echoecho1528]

Originally Posted by kjbrown92

I used www.fitday.com to track calories and ratios of fat, protein, etc. to figure out nutritional data.

What kind of supps is she on? besides the magnesium?

I went on the site you provided and it wouldn't let me enter dd's information. Would this inhibit the calculations?

[kjbrown92]

Originally Posted by echoecho1528

Kathy, this is what she is taking currently:
- Multi-vitamin
- Cell Salts for teeth (calc phos, calc fluor, silica)
- Liquid Mag
- Liquid Zinc (only when sick - like she is currently)
- Iron + vit C
- Vit D (2000 iu/day)
- Fermented CLO & High Vitamin Butter Oil (for Vits K & D)
- She just started Calcium
- And, I am taking pretty good doses of B vits, magnesium, & P5P because we both have metals issues.

I will be back with more after DD is asleep

You're only gluten free? Nothing else? I'm just wondering because a lot of supplements have things added to them (especially corn, soy, and dairy; the other 3 of the top 4 intolerances besides gluten). I wouldn't think those were necessarily hiding intolerances. If you were doing reflux medicine or gripe water or something, it might be hiding it, but I wouldn't think those would.

Originally Posted by echoecho1528

I went on the site you provided and it wouldn't let me enter dd's information. Would this inhibit the calculations?

Hmmm... I entered Fitday through Facebook. I wonder if that makes a difference. I did it for a couple weeks just to see the range. Are you tracking fat as well as protein? Are you choosing fattier meats if meats are easy to get into her? Avocado? coconut milk? all those nice high fat things?

Have you tried to get her to eat more by making things fun? My DD2 will eat pineapple rings faster if they've got a cherry (not maraschino, a real cherry) in the middle for an eye. Or making the carrot sticks into letters. Or making a letter or a smiley face in a pancake. Just regular kid stuff.