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low weight two year old

4184 Views 20 Replies 18 Participants Last post by  MamaFern
I just got back from my son's two year check up and am reminded why I hate going to doctors. My son is 22 1/2 lbs. and 34 1/2" and has always been in the 50%+++ for height but always also in about the 5% for weight. I am small and the doc and midwives have always told me not to worry but all of a sudden the doc is telling me something is wrong and he should weigh more then that and is sending us to all sorts of specialists. I am really feeling frustrated. He eats well, not a lot but he does eat healthy. His iron count has also always been a little anemic which mine also always is. The doc thinks there is a correlation between low iron and low weight gain. He stopped nursing in Oct. but drinks about 20oz. of organic whole milk a day plus fortified soy or rice milk and foods like oatmeal, rice, peanut and almond butter, cheese, pasta, fruits, veggie juices and occassionally peas...... so he eats good food. He also takes a multivitamin with all sorts of greens in it daily. Anyone out there with some supportive ideas or experience?

Jesica in Buffalo, NY
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my friend (and sister MDC mama) has a son the same age as ours who was diagnosed as failure to thrive (FTT) at about one year of age. he now has a nasogastric tube (for about the past month) and is gaining well and growing in height, too. his low muslce tone (hypotonia) has almost disappeared, and he is making huge developmental advances, too. she shared that in retrospect, she always knew the answers she was getting about her concerns with him (very thin, slower in developmental milestones, never eating significant amounts of solid foods, nursing very often) never felt quite right. now his care providers suspect that he must have always had reflux (it started with a vengeance when the tube was put in), but she still suspects something else like food allergies might be going on.

so my question to you is is your child reaching developmental milestones pretty much on time (especially the gross motor ones)? does your child have hypotonia/ low muscle tone? do you have any reasons to suspect that perhaps your child is too thin?

it is probably your child's care provider just trying to be reactive to the low weight thing, but just as adults come in all weights, heights, shapes and sizes, children do, too.

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those are good questions because I think the distinction is important. He is developmentally advanced if anything and I am guessing he uses and knows atleast 300+ words, puts 3-4 words together to form mini sentences, has incredible gross and fine motor skills, can stand on one foot, etc.... I feel like he is amazing in every area and he does have some muscle tone especially on his arms and legs and can pick up and carry things that are heavy for his size. He also is constantly active both verbally and physically and we always joke that he burns off his food faster then he can eat it and the same was true even while he was nursing. I can tell him, "eat five bites and then we will go for a walk" and he will do it. He just seems to be growing up not out. He grew two inches since the fall. Jesica
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Just curious to how this turned out for the op....
I'd tell your ped to stick it. My DD was smaller/shorter/lighter than your DS...actually, she still is at 31 mo. She might have hit 22lbs. by now.

She's had some speech issues, and we recently diagnosed food allergies. But since we took care of the allergies and took her to a chiropractor, her nasal congestion/fluid in the ears has cleared up and her speech is really improving.

The ENT we got referred to wanted to take out her tonsils and adenoids and put tubes in her ears. No, thank you.
Go with your feeling about your ds and his growth/development. I dislike doctors and avoid them at all cost. My dd barely made it into the chart recently, at 33 months, being now in about the 5% for height and maybe 2% for weight.... but up until now she was never even on the chart, falling below the lowest numbers... we worried when she was younger, but she is just petite, and eats well, and is very active and talks non-stop. She has no developmental problems, and as far as I can tell, she is actually more advanced than a lot of kids her age. So unless you really think he seems unhealthy, ignore the doctor's "smarts" and go with your own wisdom.
its hard to have a skinny kid in a world full of chubby ones! but rest assured that if he is happy and energetic and eats something every day then he is most likely fine. i have a 3.5 year old who weighs 25 pounds.. maybe. he was 16lbs at a year 20lbs at 2.. my almost 6 month old weighs more than he did at a year. i nursed him till he was past 2 and he has only just started to show a real interest in food...but he has always been happy, energetic and healthy in every other way. keep in mind that kids so young and small dont need a huge amount of food..

if you are worried about iron you can always try giving him something like floradix/floravit.. they make one for kids too.. i mix a small shot of floravit with juice and my extremely picky kid loves it. i take it as well.

sometimes its frustrating getting kids to try new things and just when you find something they love they dont like it anymore...

my son will almost always eat..(high fat and healthy ideas from a mom who knows all about a skinny kid) we always eat organic eggs and try to eat all organic dairy.

chicpeas and other beans
sweet red peppers
fried eggs (with the yolk mushed but not scrambled..)
toast with nut butter or butter and nutritional yeast
grated cheese (but not slices) we call it cheese confetti
whole pitted olives
whole milk with a bit of maple syrup aded & warmed up(sometimes i expres some BM and add that too)
organic turkey sasuages or tofu dogs cut up and dipped in ketchup
home made baked potato fries
smoothies with full fat yogurt (balkan style), berries, bannana..ect (we often add a scoop of hemp protein powder as well)
balkan yogurt with maple syrup or jam
frozen smoothiesicles
homemade muffins/breads/cookies ..carrot, zuchinni, poppyseed ect
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I had the same concerns w/ ds last check-up. I too became worried but wrote here and had many postitive comments come back. As long as your dc is progressing mentally and seems happy and is thriving, I would say not to worry! I have put all of my worries behind me and concentrate on feeding ds a healthy diet. He is so happy and extreamly ACTIVE! No wonder he is skinny. Also, I know they are re-doing the growth chart for breastfed babies b/c the old one was 20 yrs.old and the majority of babes were formula fed I guess when they made that chart. So, with the new chart, babes who were low on the scale will suddenly be higher up. Did that make sense? Gosh, I'm tired....
He stopped nursing in Oct. but drinks about 20oz. of organic whole milk a day plus fortified soy or rice milk and foods like oatmeal, rice, peanut and almond butter, cheese, pasta, fruits, veggie juices and occassionally peas......
Way way way too much dairy so no surprise re anemia (significant correlation between too much (non-breast) dairy and anemia in small children).

He should be getting no more than 16 oz of cow's milk per day OR other dairy equivalent. So eating 20 oz of milk, plus cheese is too much. I would cut out one cup of milk and give water instead. He will eat more if you do, guaranteed.
DS was at his 2 year check up a month ago. He is 40% for height (despite a seriously height challenged father!, I am 5'8"), 15% for head circumference, and somewhere below the 5% for weight. The doc said it was okay since otherwise he is fine. He's actually a little monkey, the way he climbs on everything. He is a little speech delayed, but also normal: father French, mother German, surroundings English. This is more frustrating than a problem (not knowing what he wants when he hits the fridge).

So, the question is: Is DC happy? Engaging? Playing? I try to feed him high caloric foods but what can I do? He loves tomatoes...
Jessica, if your child is acting normally, has enough energy to play... then I'd say he's fine. But, of course, that's only my opinion. What you are feeding him is packed with nutrition and protein, so I can't see where the doctor is going bonkers.

I do agree with the dairy possibly causing anemia in young children. it interferes with iron absorption. I would also recommend using blackstrap molasses to increase iron levels. It tastes... well, interesting, to say the least. lol

the previous posters also had lots of good things to say.

Take good care of yourself...


dd is also small. i read that even mild anemia can interfere with appetite and weight gain. so i offered her blackstrap molasses and she LOVES it! no kidding, she eats it straight off the spoon.
then washes it down w/ a sip of OJ to help the iron absorb.

our ped quit looking at the charts after 12 mo. she offered to chart her still, but told us that she is obviously growing, learning, and full of energy.

she actually said "Have you seen this kid stop moving since you've been here? If I moved that much I'd be skinny too!"
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My dd was diagnosed failure to thrive at about a year old. She was 15LB 15oz at a year and about 21 at 2 years. She's fine now, still tall and skinny and looking back I was the same way when I was little.(Only wish I was still like that
) After a full year of seeing a specialist at Children's Memorial they finally told me that even though she has low weight she is still getting TALLER! That's key there because if your son was not getting enough calories he wouldn't have grown those two inches since Fall. I don't think it would hurt to maybe explore this issue a little further just be wary of the invasive procedures for now but talk to a nutritionist maybe. They can calculate how many calories he's getting and if he's getting enough variety etc. I agree about the dairy though. Cut back to 16 oz of whole milk and see if you can replace it with another high calorie/fat food like a nut butter or something so he's not losing those calories, but minus that liquid he may replace it with more food and get that iron he needs. Good luck mama and go with your gut.
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My nephew is in the bottom 5% at his 3 year check up & the dr told sil to let him eat whatever he wants to fatten him up. I thought this sounded stupid as my sil started buying him McDonalds hashbrowns every day. Isn't this a bad fat???
I am going through the same thing. My doc asked me to come in this month, because dd had dropped off the charts in weight. I don't have any advice, obviously, but it was helpful to read what others said. Sounds like there are quite a few kids out there who are off the charts. Good luck.
My daughter is off the chats, too. But she was a reflux baby, and still may be one. She was 16 pds at the 12 month check-up, lost weight, and then regained it when we went back to treating her for reflux. Her doc decided to wait to see how she's doing at the 18 month check-up to decide and send her to specialists. If she's not doing better, I'm not to concerned about the doctor's taking a look at her. If there's something wrong, I want them to catch it. And low iron levels can affect brain development, so if that's a problem, I want to know.

thank you everyone for all of the helpful advice and now many months since the original post he is almost 25 lbs. We changed pediatricians and found an amazing doc. who has been very supportive and not so concerned. She sees that I am small and that my son is very healthy and developmentally doing amazing. He has also started, probably about a month or so after I posted, eating so much and practically anything we put in front of him. I think he just wasn't so interested in food until after he turned two. I did cut back his milk per all of your suggestions and that seemed to really help. Jesica
That's wonderful. Keep up the good parenting!

We have much the same story here. My little boy (and I do mean little) fell off the charts at nine months. The ped ordered all these tests to rule out possible problems (thyroid, metabolism, etc.). The diagnosis: Skinny parents. Strange they didn't notice that going in, but whatever.

He's three now and happy and healthy as ever. Still a skinny little guy, but tall. As someone else said, he's putting all his calories into growing up, not out. And, of course, into developing that gigantic brain of his.
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I know this is an older post but just felt I could add my 2 cents. My daughter is 2 1/2 and weighs 25 lbs. Both her father and I are petite, she is also active, eats a lot of great food,etc. but it has been the only issue at her checkups since infancy...she is is also usually in the 5th percentile.

At the last checkup we agreed to come into the clinic once a month for six months to get a weight and height on her. This allows us to create a sample of her own long as she is growing over that period there shouldn't be a problem. This may be an option before pursuing a "specialist" to identify if indeed there is a problem.

Thanks for the info on anemia and growth. I assumed there was a connection there. However, we do not eat much meat (only fish)...I'm curious about checking her iron levels to see if anemia is an issue.

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I know the OP's situation is resolved, but I wanted to chime in anyway. :)

My 16-month-old has always been in the 90th %ile for height, but since her nine-month WBC I've watched her weight drop from the 75th %ile to the 60th, 40th, 25th. You can see her ribs and count every one of her vertebrae when she's undressed. She is active, energetic, hitting milestones, etc., but I worry that she's too skinny.

At the 12-month WBC, her doctor said, "Toddlers don't starve to death, but we have no idea why not." He said that he considers it normal to drop off in percentile on the weight chart at this age, and that as long as she isn't actually losing weight he won't worry. But I wonder how much of a percentile drop is okay.

Thanks for the list of high-fat/high-energy foods, MamaFern. Does anyone limit fat and cholesterol for their toddler, or do you figure that as long as you're not feeding junk food, high-fat foods are okay? I'm thinking of eggs and cheese in particular. My daughter would happily eat two or more eggs every single day, but I've kind of been thinking, "four eggs a week is enough." But maybe she's too young to worry about it?

Anyone have good recipies for carrot, banana, or zucchini muffins? I hadn't thought of them, but they sound like a great idea.
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