2-year-old difficulty gaining weight

A PSP member writes: "Our daughter is just over two years old and has had issues gaining weight for the last six months. She has always been around 5th percentile in weight but since her 1.5 year check up it has been off the chart, as in her weight is too low to determine the percentile..."

toddler

They go on to describe: "And we knew it was attributed to her not being able to consume much at a time (though we tried to give multiple snacks per day). Our pediatrician also thinks it’s due to her low consumption in cow’s milk. Besides poor weight gain, our daughter is healthy and has hit all milestones and doesn’t seem to exhibit any developmental problems. Ever since the beginning of January, she started to eat more, and drink a little more milk. I can finally feel that she is actually eating as opposed to just nibbling. She also started the preschool in January and the teachers said that she is eating well (I had spoken to them about the eating and weight gaining issues).
Now I weighed her, and she has lost some weight...
Now I am very concerned about what is causing this difficulty in gaining weight. As our pediatrician said, it really shouldn’t be that hard for a child to gain weight. I know many picky eating children but they somehow gain weight. I also know plenty of toddlers who don’t like cows milk but they somehow gain weight. But not our daughter.
I don’t know any children with such issues so I’m feeling quite alone in this. We have our daughter’s two year appointment with the pediatrician tomorrow and we will discuss it further.
But I also wanted to know if there are any parents out there whose children had problems gaining weight even with normal consumption of food? Anything I could do to change this? This has been such a stress for me for the past six months and I thought I am finally seeing the light at the end of the tunnel after seeing her eat more now... is there any types of sickness I should be aware of that is related to poor weight gain? Perhaps celiac disease even though no family members from both sides have it? Any advise or thoughts would be greatly appreciated.

 

Here are PSP member replies*:

 

"I am so sorry to hear this has been a stressful situation for you.
I don't have any advice for weight gain in toddlers. But I wanted to let you know that you are not alone. I have fraternal twin girls who will be 3 next week. They have almost always been on the low percentile. Last visit they were -1%. I have one twin that eats really well and all the time and while the other one hardly eats at all.  They both have the exact weight which is amazing.  I just wanted to share this with you to let you know that a big part of weight gain seems to be preprogrammed or genetic.  I don't worry about their weight as long as they are active and happy in their daily activities.  
I hope the appointment goes well and you get good guidance from your doctor. "

 

"We have had the same problem. Our son is under weight and height. Last week We went to his 2 year’s appointment and the pediatrician told us that he has his own curve of growth (that is something good), but she ask us to visit the gastroenterologist just to confirm that everything is ok. Does your pediatrician has told you something about visit a to the gastroenterologist?
My son loves the breakfast and the morning snacks but he is not good with lunch. And dinner depend on his mood.
We have always think that his under weight is normal because I am petite. My son act normally and he seems happy. So I don’t think we should worried."

 

"I'm so sorry for this issue and for your stress and fear (?). My son stopped growing around 12 months. The doctors didn't notice but I did. Eventually we figured out it was his adenoids - so large that he had trouble chewing and swallowing. A feeding therapist suggested that we get it checked out; we'd had no idea. While I have no idea if this is relevant for you, I wanted to share it. Through that process and our concern about what was going on, we'd initially gone to an endocrinologist and gastroenterologist. We still see the Endo every six months to make sure growth is on track and there's not something else going on. I'm happy to make recommendations if any of that seems appropriate for you.
My son is 3.5 now. He had his adenoids out a little over a year ago. It's been a big help. Still, I remain stressed at times about growth and am finally able to feel less worried all the time."

 

"My daughter has Graves’ disease and she is very thin, eats very well and does not put in weight. I would get a full thyroid panel done just to be safe. it is rare in children, but does happen. most dr’s don’t even consider it.  my daughter went undiagnosed for two years.
good luck!"

 

"My daughter was always at the low end of the scale for weight, still is. But her growth was always steady so the doctor was ok with it. But she did have a smaller appetite than her peers and ate small portions more frequently.
One thing I did was to learn to maximize the calories in everything she did eat. And to really think about her snacks carefully to not waste calories.
Once a day I put yogurt or ovaltine in her milk or gave her a yogurt drink/kefir instead. If I made pancakes I always added yogurt or bananas or apple sauce. Lots of pasta, rice and oatmeal. Snacks were cheese sticks, cereal bars, nut butters, avocado, hummus, fig newtons, mini muffins. I cooked everything in butter.  I was also careful to not let her snack within 90 minutes of a meal to make sure she ate her meal.
Eventually as her appetite grew I tapered off these things but it helped when she was little."

 

"Hi! I don’t have this experience personally but I’m an occupational therapist at a school. We have a lot of children with poor weight gain— I’d advise the families to try one or all of these options:
- 2nd opinion from another pediatrician
- endocrinologist referral
- GI referral
- nutrionist referral."

 

"Is she exhibiting other symptoms in addition to the weight loss, like: very thirsty, frequent urination, exhausted even after she's slept?
If so, perhaps have her blood sugar tested to rule out type 1 diabetes. A quick finger stick test and/or maybe a hemoglobin A1C.
I hope it's not T1D or anything else serious. Sending positive vibes your way!"

 

"My pediatrician told me that kids really don't change percentiles much from age 6 months to 24 months and after that you often see changes up and down.  did you ask your doctor about this?  were they concerned?  
i suspect if you see failure to gain weight starting around now, it'll be more instructive than the past 6 months when kids mostly lock into a percentile.

 

My little brother was always very small and eventually my parents and pediatrician recognized he had a growth hormone deficiency when he was around 10. He started doing injections of growth hormone and started growing. Not sure if that can be an issue for younger kids too."

 

"I think your thought about something like celiac is a good one. If you truly feel she is eating enough and still isn’t growing, maybe it’s an issue of her gut not absorbing the calories / nutrients correctly and there are several GI type issues that could cause that. Some parents in my allergy mom Facebook group dealt with stuff like that."

 

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