My DD is 26 months old. She is extremely bright (e.g. uses complex sentences over 12 words long, has a huge spoken vocabulary - more like a 3 year old), is generally well ahead on all her milestones, is extremely active, and happy.
My concern is her weight. If there were no such things as scales, I probably wouldn't worry at all, but she's been 21 pounds for almost 10 months now. Sometimes 21.0 pounds, sometimes up to 21.8 pounds...but always 21 pounds (she is 34 inches tall, and her height is increasing well. Her head circumference is something like the 60th % and is increasing "normally").
She eats a good variety of foods - beans, whole grains, veggies, nut/seed butters, eggs, fruit (though she's not too into fruit), fish, and the occasional sugary dessert.. I try to include calorie dense foods like avocados and nut butters with every meal. She won't drink anything but breastmilk and water. We saw an OT for awhile when she was about 19 months old because she would not swallow any solid foods (and so was still almost still exclusively breastfed). She'd chew and chew and chew and keep putting food in her mouth and then spit it all out. The OT didn't help much, but I think naturally over the last 7 months she's gotten so much better at swallowing and now only nurses 3 times/24 hours. Her solid food intake is now dramatically higher, but still no weight gain.
Our pediatician is concerned, but not overly concerned. I think she's laying off a bit because she knows I have a BS in nutrition and generally know what I'm talking about when it comes to food. I think she'd be happy if we weaned entirely because she things DD is holding out for breastmilk - and maybe she is, I don't know. She suggested Pediasure, but I told her I don't think DD would drink it (like I said, she refuses anything for drinking except water and breastmilk), and I don't like the ingredients. If she'd drink calorie rich beverages, I'd make my own (and I've tried and continue to try, but DD won't drink them). Our next appt is in August and I'm not sure what she'll say if she is still 21 pounds. At her last appt she had actually lost 2 oz from the previous appt 3 months previously.
I'll add that I am short 5'1" and 110 lbs (normal, healthy for my height), but DH is very, very thin as well as short. 5'6" and only around 115 pounds - he can put on another 5 or so if he weight training. He's always been thin, and my MIL tells me that he was only 16 lbs at 1 year old.
so when you say she refuses other drinks- what have you tried specifically? does she refuse cow's milk? what about fruit smoothies that you could add things to? what about yogurt? also what about addidng butter to some things- to the things that would actually taste good with butter?
if there were no scales, you would not be worried.
your DH is very very thin.
she does eat, right? even if it's not a lot, she does eat?
i would not worry about it anymore. and i would downplay the issue with the ped., so they quit worrying about it too.
Snapdragon - cow's milk and yogurt (even the really sugary stuff) are both a no-go. I continue to offer them to her though...
My husband and I drink fruit smoothies every morning for breakfast and have for 8 years, usually chock full of good stuff. She is offered a cupful every morning. Her friends come over to the house and enjoy them....I can never get her to take more than a few sips. She doesn't HATE them, but isn't enthusiastic enough to drink more. Believe me, I would LOVE to be able to add calorie dense stuff to the smoothies for her...it seems like such and easy thing to do. I even made popsicles out of them and she took one lick and was done.
She likes veggies a lot...even dark green leafy vegetables. I'm ecstatic about that, but they are low calorie. Whenever I put something fatty like butter on them she tells me they are "yucky."
She does like nut and seed butters and to a lesser extent, avocado, so I try to include them with every meal.
And yes, she does eat. In small quantities, but a really good variety of healthy food (not so fond of most fruit for some reason). If she was gaining weight "normally" I wouldn't worry about a thing, and actually be happy that she likes healthy foods. I've been mostly letting her listen to her own hunger/satiety cues, which I think is important.
Thanks for your comment ElliesMomma - that is so the approach I would love to take. But there is always this nagging in the back of my mind. Why isn't she putting on weight? I mean childhood by it's very nature is about growth.
We had a very similar experience with Ds1, who is now about 5.5 yo and Ds2 is following a somewhat similar path.
Honestly, I would not worry. Here is how/why our ped presented her lack of concern. It is very common for toddlers to NOT have any growth spurts between ages 1 and 2, then have them again ages 2-3, 3-4, etc.
Also, according to our ped., genetics start to take over between 9 and 12 mo so that you see kids with smaller parents slow down in their rate of growth. Now I am not particularly small, but Dh is on the shorter side for a man and, more importantly, was very small all through his childhood until puberty.
Ds1 was about 21lbs at 1 yo
22lbs at 2 yo (this was not a full 1lb gain in that year, I just don't recall the oz).
24lbs at 3 yo (ended near 26)
27lbs at 4 yo; 31lbs at 4.5
33lbs at 5yo (though he is now 38lbs at 5.5)
He was also an extrememly verbal child an not very physical. We nursed to nearly 3yo as he had/has trouble with lactose so cow's milk was out and I didn't want to over use soy, though he did eat other processed dairy (cheese, yogurt). He did not eat any meat and or eggs (allergy) until over 3yo so his diet was largely soy, fruit, veggies, grains and beans. We followed his cues and let him eat as needed. He has always been a very slow eater with a low appetite, he would not eat if not hungry (ie if not hungry, he wouldn't even want ice cream, cake, etc). We did start at 2 yo a high fat snack at bed time (grahm crackers with peanut butter and let him add a topping (cheerios, cranberries and, rarely, chocolate chips).
This last growth spurt has been a really big one (5lbs in less than 6 mo)! but he has not had any real diet changes. We did occasional extra weight checks for Ds1 (like at 6 mo instead of every 12 mo) but no one suggested we needed to do anything special/extra to help him gain weight. No one suggested weaning. When we tried higher calorie stuff, he would just eat less because he would be full faster, kwim?
Ds2 was about 21lbs+ at 10 mo, lost weight due to illness, peaked at 23lbs around 14mo and is still down at 22lbs 4oz at 17mo. He has had many more health issues so he gets weighed a lot with various specialists and has had more difficulty with food. Even though he is still at a weight loss right now, no one has expressed any concern and I don't expect them to at his next appointment, though we'll see.
So, I guess I am saying that I wouldn't put too much stock in expecting to see a weight gain at the next appointment. The last 2 oz loss could be explained by a large BM or a little dehydration before weigh-in. Look at the real growth milestones: speech, movement, etc. and use those to guide your concern.
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