PediaSure and declining growth charts

[CGsMom]

Quick stats: DD born at 27 weeks, weighing 2 lbs, 2 ounces and is now 18 months actual and weighs 18.5 pounds.

I am almost laughing at myself because not long ago I posted on another thread about how my doctor didn't want us worrying about our DD's weight because she was developing fine.  Well, her 18 month appointment didn't go the same way.  Her little growth chart is no longer growing and while our doctor isn't overly concerned about her not being "on the charts" she does want us to give DD two 8oz bottles of PediaSure a day for the next two months.  We also have to go back at 20 months, instead of 24, to check her weight.

So we have been at it for about a week and I am getting very frustrated.  If I actually get two full bottles in her a day, she doesn't really eat anything else.  On days that she actually eats a good breakfast, she won't finish two full bottles.  I also find myself constantly pushing her cup in her face trying to get her to take more and I hesitate to give her water!  That really bothers me.  If the doctor doesn't see a marked improvement by 20 months, we will have to get back in the weight watch circus and I really don't want that.  I had enough of that during the 11 weeks we were in the NICU.

I don't know if I am just venting or looking for words of wisdom.

[pigirl]

First of all, oy.  I'm sorry you're in this situation.  My 2 year old son seems to barely eat, too, and it can be really difficult.

That said, can you call your doctor and check in about how it's going with the PediaSure?  Maybe the 18 month weigh-in just caught DD at a funny time between growth spurts.  It sounds like DD knows when she's hungry and how much she wants to eat, and I can understand how you wouldn't want to mess with that.  If what the doctor suggested doesn't seem to be working, esp. if you have a good relationship with this doctor, she may be able to give you some revised suggestions.  And personally, in the bulking up category, we've had some luck offfering ice cream or a milkshake after dinner.  I know it may not be the healthiest option, but my son will almost always eat it, and it helps get the weight on.  And really, what's the difference between a milkshake and a vitamin, and a bottle of PediaSure?  Besides the fact that a milkshake actually tastes good....

[Bokonon]

Has your daughter grown height-wise?  Is she meeting milestones and otherwise healthy?

Most kids don't gain much weight between 12 and 18 months.  My daughter gained maybe 1 lb. in that time, and dropped percentiles.  She was a 34 weeker with IUGR, and gained beautifully for the first 6 months, and was toward the top of the charts.  Since then, she has dropped percentiles - gaining height and head circumference, meeting milestones, and is very healthy.  She is on the charts for weight at 2 years, but towards the bottom of the chart.  She's just tall and slender.

If you are unhappy with the doctor's recommendation, I would honestly recommend finding another pediatrician, perhaps one who is more familiar with preemie development if your current one isn't, or seeing a nutritionist.  I don't see much value in force-feeding a toddler PediaSure just to meet a number on a scale.  There are healthier ways to increase calories that don't include a ton of sugar, which can cause further issues down the road.

Just my $.02.  :)

[CGsMom]

Thanks ladies.  She is developing fine in height and her head is huge 75-90th% actual!  Our pediatrician is actually a neonatologist with a high risk clinic and rounded on DD when we were in the NICU as did all of her partners, so I know they have quite a bit of preemie experience.  Pigirl, she does love milkshakes so I may try to find a vitamin supplement that she will take and try giving her a shake maybe for an afternoon snack.  I felt like I had a big win this week when I was able to get her to eat eggs.  Bokonon, I worry a lot about being so focused on fattening her up that we are starting bad habits and filling her full of bad stuff, unfortunately most of the healthy stuff just doesn't have enough fat or calories.

I will definitely call and report in on how it is going with the supplements.  You are right about probably having alternative suggestions.  I keep telling myself that it isn't my doing and she is getting what she needs, but I can't help feeling like a bit of a failure sometimes. Thanks for the support.

[pigirl]

One other thought:  I've heard of drs recommending adding a tablespoon of flax or olive oil to a cup of milk, to boost its calorie/fat content.  That may be worth asking about too.  And I know it can be considered a choking hazard, but our doc suggested that we give our son a couple spoonfuls of peanut butter before bedtime, and that works well for us.  He made it from around the 3rd, to just over the 10th percentile in weight between his 18 month and 2 year check-ups.  Good luck! 

[karne]

Will your dd eat avacado? There are good fats/calories there.  My kiddo hated pediasure.  We drink full fat raw milk which has a cream layer on top-maybe not an option for you, but it was a good one for us.  Good ice cream, full fat, is great.  I would make smoothies with ice cram and bananas, or sometimes use full fat yogurt instead.  Scrambled eggs cooked with butter and cheese are easy to feed a toddler as well.

I would not worry about bad eating habits.  If you child needs the weight, they need the weight.  Kids also need good fat for optimum brain development.

[Ky-Momma]

We've had the same issue, and we put olive oil or butter on all of DD and DS's food to gain calories without all the sugar, and the oils don't fill them up like the pediasure did. I don't know if you BF or pump, but if you do, we would let the milk settle then scoop the fat off the top and give that with their food. I suppose you could do the same with un-homogenized cow's milk...

[CGsMom]

Thanks for all of the suggestions ladies.  I have spoken with our doctor and she agrees that it sounds like we need to be a little more creative in getting additional calories in to DD diet.  The last few days have been easier, we are still giving her Pediasure (because we have it) but aren't trying to push two bottles of it a day.  She finishes one with no problems or interruptions to her normal eating habits, so for now, I am going to try to stick with one a day and use some of your suggestions to increase her fat and calorie intake.

[momof2boys83]

My 35 weeker is on Pediasure now just to keep his appetite up.  He is a very active child but seems to rarely want to stop to eat so Pediasure was the only way I could think to help him.  He is underweight now, but not dangerously so....just at the bottom of the chart.  He rose quite a bit once I started him on the Pediasure again.  The trick to that is only one a day should be plenty and give it to him after a meal...but it has to be cold.  He doesn't like them warm at all.  When I do that and make sure there is at least 2-3 hours before his next meal he usually eats good all day and we have no issues.  But, different things work for different children so it is basically a trial and error thing.  Just remember that Pediasure can make them feel full when they really aren't.  That is the one drawback I have with it.  Hopefully this helps!

P.S. Forgot to mention my 35 weeker is now 3yrs 7mos old :)

[mom2tig99Nroo03]

another pediasure using mama here as well- though i'm not real happy about it, as the ingredients aren't what i think of as healthfood for my kiddos.....