failure to thrive?? no wt gain???

[mO'S mom]

HI all my DS now 2 yrs is very allergic to multiple foods including but not limited to dairy, soy, nuts et al. to top it all he is a very picky eater. we are strict vegetarians. i dont know if anyone has observed this with allergic kids or not but my DS is off the charts in wt and ht. he is 2 and barely weighs 19 lbs, his ht is around 28 inches. the sad part is he still fits into size 9-12 months for clothes. i feel really sad when i look at him and i dont know what my options are for such a child. why cant he have a normal childhood

[happyblessedmama]

is your son under some kind of medical care or nutritional evaluation? My youngest DD is 13 months, 18 lbs and 27 inches and we just got the ball rolling looking for allergies to try to find out why she's "so small"... though there's a good chance it's just familial traits. In your situation, I would work with a nutritionist to work out a diet that would maximize calories for your son and make sure he's getting what he needs...

[karin95]

That's very small, but as the pp said, look at your familial history. If your family is generally on the small side, then maybe he's just a little bit smaller than average. If your family is average or large, then it's a bigger problem - YK?

I'd definitely get with a nutritionist/dietician. You don't have to do everything they say, but it would be helpful to find out exactly how many calories/fats/proteins/etc. your son shoudl be getting on a daily basis. Then you can look at the foods he will eat and figure out how much of each thing will get him to those minimums.

also, look into introducing new foods that are nutrient-dense. In our household, we're working with milk, soy, egg, nut allergies, and are vegetarian, so the only protein we can eat (besides the small amounts of protein in grains and veggies) is nutritional yeast. Nutritional yeast is actually VERY protein-dense. An adult needs about 1/3 of a cup per day to get all the protein they need. It's easy to slip into things - mix with a grain with some oil for a "cheesy" type of casserole. Mix with oil and water for a pasta sauce. Even mix into mashed potatoes. Always with oil, because that adds fats!

My son is 15 months old and is about 19 lbs and is skinny, so I know how you feel. He won't eat very much solids, but he's also still mostly breastfeeding, so we're not too worried. We aren't strict vegetarian, though, so we're actually going to try him on chicken today. If he could eat beans, we woudln't introduce meat, but he can't, and his iron is low, so chicken it is. Hopefully he'll like it.
We're big fans of doing what works and what's needed, so it doesn't bother me to have to give him chicken for a while. If he ends up being able to eat some beans, or outgrowing some of his allergies, then we'll stop the chicken. it's certainly better than having to start giving him Elecare or Neocate or whatever, imo!

Oh, and if you do bring your son to a doctor/nutritionist/etc., be ready for them to freak out on you because your son is "so small". Be aware that some doctors, in some places, have been known to get the "authorities" involved if a child isn't gaining properly and they think it's the parents' fault (for "withholding meat" or whatever). So tread lightly.

[kjbrown92]

I have two kids with multiple intolerances, and I have to say that meat has been their saving grace. One is 75th percentile and the other is 50th percentile, and the doctors are always amazed that they're doing so well healthwise considering their food restrictions.

Here's some of what my kids eat (one of them is 3 yo and picky and can't do soy, dairy, egg, all fruits except in banana, all veggies except spinach, onion, carrot, celery, asparagus, sweet potato, fennel, corn):

carrot sticks dipped in mashed avocado
baked salmon with sautreed spinach
tunafish
banana
coconut milk yogurt (either in smoothies with banana and carrot juice or to dip bananas in) - probiotic powder added besides
asparagus dipped in gravy
chicken, gravy, and rice
chicken broth (homemade for gut healing)
salmon cakes
mini meatball (ground turkey) soup in chicken broth
rice noodles in chicken broth

What are you doing for protein if you don't do meat and he can't do soy? Does he eat alot of beans? Quinoa is also protein. And fats are essential. We use coconut oil in cooking. And I use coconut milk alot (in rice pudding and tapioca pudding and in cinnamon rolls). Maybe work to make new foods, and yes, at the picky stage, he will refuse a lot of it. But it's always gratifying when they like something. Can you make what you have in new ways? Like if he does eggs, can you do poached, fried, scrambled, omelets, hard boiled? If he doesn't like veggies, have you tried making different things to dip it in?

[sbgrace]

Have you looked at his nutrition intake? The most common dietary factor in failure to thrive is deficient protein intake. Are you sure he is getting the amount of protein he needs particularly--that is hard (doable, we did it) without dairy and soy but take out all animal products and nuts and add in a picky eater. Very difficult I would think. What is his protein source? Make sure he is getting a minimum of 16 grams of protein per day. Catch up growth needs more. The actual calories may be low too depending on the nutrient density of what he is eating (fats, etc.). Smoothies saved us there but my smoothies had protein as well as carbs/fats. I know it is hard. My son really struggles/struggled. And what makes me sad is I think had we figured things out when he was younger he might have been able to make up some of the ground he lost.

Other possibilities: He's possibly low in zinc. Dietary fiber/phytates in beans/seeds/grains inhibit zinc absorption. And you don't have any of the animal product zinc sources. Optizinc is a good supplement...just break it in fourths and either crush or have him chew it. I recommend this one because it isn't affected by grains/phytates. Both my boys get it at the RDA levels. I would also wonder about iron. Do you give vitamin C with meals? That would help iron absorption. Iron is also impaired by phytates as well as other things in our diets. If his ferritin is low ferrous bis-glycinate with some vitamin C would be good for vegetarians as it also isn't affected by phytates and similar things in grains. You can get either of those levels tested and I would--test ferritin for iron as well as CBC and zinc. Or I would test ferritin and just supplement zinc. Zinc is good for him whether he's deficient or not. Either one can affect his appetite as well as growth. The nutritional yeast a pp mentioned would also have b12 I think so that would be a nice addition if you aren't already doing it.

Given his extensive allergies I would wonder about eosinophilic disorder or celiac. Look at symptoms and see if either fit him.

[karin95]

Oh, and another thing I forgot - have you tried hemp milk with your son? We can't do soy or cow/goat's milk, and all rice milk is x-contam with soy, so hemp milk (from Hemp Bliss) is the only safe "milk" for us. It's very high in protein and good fats (omegas!), iron, and basically a great food. It's quite expensive (but isn't everything when you're dealing with allergies?) so you might not be able to feed him a lot everyday, but it's good to look into. We mix it with some carrot/apple juice to make the iron more absorbable, but it's be great in smoothies or mixed with a little cocoa powder or another juice. We use it in baking, too.

personally, I've lost some weight (not a good thing, I'm skinny to start) being on this TED and b'feeding, and I did a week of drinking 1 carton of chocolate hemp milk every day (I hate the plain stuff) and I gained back some of what I lost (it's very hard for me to gain weight) and felt much better by the end of the week. Now, that'd be $35/week if I did that everyday, so I'm not continuing that, but just to show you that it can help a lot. Even 1 glass into your son per day would be great for him!

[mO'S mom]

Thanx guys... all this was very helpful. he does have calcium, zinc and multi vit supplement. not on iron yet. yes his protein intake is very less. his only form of proteins is 2 types of legumes as he is allergic to a lot of legumes too. we r vegetarians as in nothing with a face so no chicken, fish, no red or white meat. i will certainly look more into the nutritional yeast and hemp milk and try the other recipes u guys mentioned. thanks a ton. i'm just confused why my paed is not taking this seriously. we r an average size family, both my husband and me were healthy chubby babies. i have called up early intervention services for help with a nutritionist. i dont know where to turn to for an expert. this blog certainly helps.

[mO'S mom]

oh and one more thing... what would be a good place to find hemp milk? and the nutritional yeast u mentioned? i live in NJ

[alysmommy2004]

Originally Posted by mO'S mom

oh and one more thing... what would be a good place to find hemp milk? and the nutritional yeast u mentioned? i live in NJ

You should be able to find both a health foods store or Whole Foods, if you have one. I shop at a southern chain similar to WF and they keep the nutritional yeast between the spices and flours. Hemp milk is with soy and rice milk on the shelf.

[karin95]

Originally Posted by mO'S mom

oh and one more thing... what would be a good place to find hemp milk? and the nutritional yeast u mentioned? i live in NJ

It depends what your son's allergies are and how sensitive he is to cross-contaimination.
The yeast we get is from VeganEssentials.com and is Red Star brand. We called the company, and the 6 and 10 pound pails are totally safe from x-contam. They couldn't guarantee the small shaker can was safe because it's packaged at a different plant.

I don't know where to find Hemp Bliss in your area, but you can buy it online at their website. You can probably contact them and find a retailer near you. Their protein powder might be a good option for your son, as well, if he'll drink smoothies. Or you could mix it in a grain or hot cereal or whatever he'll eat.

I'm surprised your doc isn't taking his growth seriously. Do you know what his growth *curve* looks like? If he has a normal growth curve, then maybe there's not much to worry about, but if he's stagnating, then I'd say it's time to find a new doctor. It could be his diet, it could be some metabolic problem, it could be a lot of things.

Again, be wary of docs because they are very likely to call CPS on you because you won't feed him meat. Definitely get more protein (hemp, etc.) into him and bring the nutritional information of the "weird" foods you give him to the doctor/nutritionist so they understand that you're giving him a balanced diet, even if it's weird.