How do we get our toddler to gain weight?
Our toddler isn't gaining weight, and our doctor told us to fix it. We stopped breastfeeding and she gained a kilo in just two weeks, but since then (soon two months) she hasn't gained anything again, possibly even lost a bit.
The weather is fantastic and she is running around like crazy both inside and outside, which I'm sure isn't helping, but we need to get her to eat more, but she isn't really that interested (except in baby formula milk, which she loves, and gets during the night, the recommended 500-800ml).
Everything else seems fine.
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Loads of good answers on here. Just wanted to add one thing that we were given in advice when our son was this age and we were all keen to see more weight gain. Make sure you don't use whole grain foods all the time. we were surprised because we had assumed they were healthier but too much fiber can be a problem for small systems. we went back to white bread etc (along with the supplements etc that people are talking about here) and saw an improvement.
that said, he's now 5 and healthy but still small and still not interested in food. At this age the fear is obesity so no one tells us to 'fix it' any more!
My husband had a similar growth profile (my mother in law kept his charts) and he says that the important thing is to remain calm. Once your child realises its an issue you will have struggles for life (we struggle with this aspect too despite our best efforts to avoid)
remember, you can offer the best but you can't make them eat it
I noticed in one of the responses that you said you quit offering snacks. Here is a sample of our meal schedule for our 15 month old twins. We seldom offer snacks but stagger meals and milk. By staggering them we get more high calorie/protein milk in them on a regular basis.
7:30 AM 8oz of milk with liquid vitamins (Poly-Vi-Sol) added in
8:30 AM Breakfast (Whole milk plain Yogurt with fruit puree, protein such as eggs or ham, fruit, carb such as peanut butter toast)
10:30 AM 8 oz of milk offered
[11-1 Nap time]
1:30 Lunch (Avocado with banana, protein, veggie, carb, fruit for dessert)
3:30 8 oz milk offered
5:30 Supper (Protein, veggies, carb, fruit for dessert)
7:00 8 oz milk offered
[8:00 bed time]
We offer 8 oz of milk each time but other than in the morning it is seldom that the full glass gets drank. Water is always available in the play area to be drank when thirsty.
I Googled "high calorie foods for toddlers" and got some great hits that had some good ideas on foods to offer. We make sure to always offer a wide variety of foods at each meal.
Our biggest trick is just what you said in a comment, we offer the meal and then after it is gone we offer fruit to get a few extra calories in. Freeze dried blueberries are a favorite.
Our eldest daughter was told the same thing (gain weight!) at the 12, 15, 18, 21, and 24 month appts- (we actually went every month because she was not on the weight charts, <1%).
We found Pediasure was an excellent addition to her diet. It contains 9 grams of fat per serving as well as fiber & protein. PediaSure also has lots of vitamins and minerals. It does not contain dairy or wheat.
We replaced all whole milk with Pediasure for 6 months, & then continued with mostly Pediasure. She is now well into the 40% for her age (3.5 years). After the age of 3, we cut back on the Pediasure, just 1 bottle and we switched to the lower fat version (Side Kicks).
The best success we have had is in giving her one thing at a time.
Ie, instead of giving her potatoes and meat, we give her potatoes. When that got boring, we try a bit of boiled carrot. And when she doesn't want that we give her some meat. And when finally she wants no food at all, we give her a bit of yogurt as dessert.
This has kick-started the weight-gain again and she took an a lot the last month.
I noticed that someone suggested offering lots of fruits. Fruits are not good for weight gain. My son is very underweight and we found we were feeding him too many fruits and he was not gaining well at all. We thought it as healthy for him, and it is in moderation, but not to pack on the pounds like he needed. Our pediatrician recommended carnation instant breakfast, cheese and butter (real butter) on everything possible. We tried Pediasure, but he doesn't like the taste and its pretty expensive. I've seen some people try adding cream instead of milk in mashed potatoes and I'm going to try that one next. Hope this helps!
It is also the same concern I have with my 22 month old son. When he turned one, he is not gaining that much weight. As we all know, as this age, they like to run around and explore things. They are very busy with a lot of things which burn up their calories, easily. What I did is that I devise a meal plan to ensure that he can get the right amount of nutrients at the right time, and I make sure that this scheduled is followed. Like I give him a bottle of milk, as soon as he wake up. When we take our breakfast, he also join us. He even has his own specially made chair, so he can join in the dining table. In this way, he is all the more encourage to eat because he can see us dining with him, as well. I also purchased some baby food stuffs, so if he feels like eating, he can just pinpoint it. My mom also bought him some chocolates, (I give it in moderation), for energy boosting. It is also important that your child gets enough sleep and rest, so he can re-charge. Anyhow, just continue keeping track of your baby's weight, so you would know the progress.
Sometimes this is just the kid in general, my oldest tended to be on the taller/thinner side although he had a good appetite growing up. He was breast-fed until almost 1.5 years, my 14 month old still gets a little although he is a pudgy and has a great appetite. What we tried to do was give something else after our son decided he was not going to eat more of one thing, that way we kept him eating. I have noticed that when the kids are VERY active, their appetites sometimes go down even when expending lots of calories, and other times they are more hungry when not doing much.
A few times our old pediatrician told us to work on the eating and weight gain, sometimes we succeeded and other times we did not. We just dealt with it.
The way I look at it, if the kid is still growing, eating a wide variety of foods, then things are fine and every child being different will grow and eat in different ways. You seem to be doing the right things.
Our toddler's appetite seems to vary in large swings from month to month, but when she's in a phase where she seems to be eating too little we've noticed that different eating positions can affect how much she eats. Sometimes she will only focus and eat much if she's in her high chair w/tray; sometimes she hates the high chair and will eat more feeding herself finger food on a blanket on the floor, sometimes she best likes to sit in my lap and have me feed her facing away, sometimes she is most interested in trying to feed herself with a toy fork; and if all else fails we'll sometimes put on a video for her and feed her while she's watching, as she's somewhat distracted and will eat without scrutinizing it.
So, maybe try mixing up the feeding style?
Busy toddlers burn lots of calories. A child that is not gaining weight steadily can be in danger of not meeting their nutritional needs. This is the reason for your physician's concern.
Getting your little one to eat more is likely to be very difficult. Therefore, making each mouthful have the greatest caloric impact is the most likely to add those needed ounces.
Here are some strategies for adding calories.
Add 1 or 2 tablespoons of nonfat dry milk powder to casseroles, muffins, cooked cereal, pancakes, puddings, mashed potatoes scrambled eggs, meatloaf, whole milk, milkshakes, yogurt, and even her formula.
Add a powdered breakfast drink (such as Instant Breakfast®) to:milk, milkshakes, smoothies, or ice cream.
Add extra margarine or butter to: cooked cereal, rice, pasta dishes, sandwiches, potatoes, and vegetables.
Add cheese to: casseroles, meatloaf, crackers, sandwiches, hamburgers, soups, mashed potatoes, and vegetables.
Spread cream cheese or peanut butter (watch for allergies) on: crackers, muffins, fruit slices, pancakes, graham crackers, and pretzels.
Include supplements, such as:Boost® Pediasure®, Carnation Instant Sport shakes® & Breakfast®, and Yo-J®.
For extra protein, offer more of these foods: eggs, milk, cheese, peanut butter, cottage cheese, puddings, legumes, ricotta cheese, meats, & yogurt.
These strategies are recommended by dieticians. You may even want to ask your physician for a referral for a dietary consult with a dietician that can help you with a very specific plan for your child.
Toddlers do need snacks between meals, their stomachs aren't big like adults. But, maximize every calorie by being selective about only offering healthy foods with lots of vitamins, healthy fats, dense nutrients, etc. Make sure she is not filling up on goldfish crackers and the like, more cheese, fresh fruit, add butter to everything you can to get more fats that babies need, etc. And you may have to remind your child it would be a good time to snack by preparing a healthy snack and offering it at a time spaced apart from meals.
At 14 months I would still expect a significant portion of her calories to come from breastmilk or formula. Although it is generally regarded as acceptable to allow a 14 month old to drink whole milk, if you are needing to "fatten her up" I would stick to using the formula, which is better for them nutrition-wise. Often it is easier to get more calories in through adding liquid calories (just like it is for adults, eg: drinking soda, coffee, etc doesn't always seem hard on a "full" stomach), so perhaps consult your pediatrician about whether upping her allowance of formula per day would be ok.
I would add proteins (meat, beans) and more frequent meals (may be with healthy snacks in between if it does not spoil her appetite) to the answers since you mention that she is not picky just does not eat much in one sitting.
But if you daughter eats balanced diet and enough calories(and kids don't need that much) and does not have any known health issues, I would ask your pediatrician why her weight gain is a concern to her. If there are some underlying issues, stuffing the child is not going to help while creating potential problems in the future. Healthy children will not starve themselves and eat as much as needed. If the weight gain remains a concern may be your doctor could run tests to check for things associated with this problem.
It sounds like your pediatrician may not be specific enough to be particularly helpful. I'd suggest:
Making a food diary. List the food, portion size, and time of day. Perhaps you think your child is eating more than she actually is. (It's a pain in the rear at first but you get used to it; my parents had to do this for me because of allergies and it becomes second nature pretty fast.)
Taking a long, close look at family history--on your side and her mother's. Were all the babies lean/skinny/tall/underweight/small-framed on one side of the family? My baby's a peanut but on my husband's side, many of his female relatives have a small frame, so we're not too concerned.
Making a consultation appointment to sit down and discuss just this topic. Bring a notebook with questions pre-written down, and take copious notes.
If the pediatrician isn't being specific/helpful enough, look for another pediatrician.
Getting a referral to a pediatric nutritionist. Preferably someone who can get your baby on prescription supplements if necessary (e.g. a nutritionist who works with a doctor, or one who is legally licensed to prescribe)
I know how concerning it is when your child seems on the low end of the bell curve, weight-wise. Fortunately, right now our ped isn't concerned (she said SOMEONE's gotta be on the skinny end of that curve!) but I've been cheering every bit of weight gain I can get. My baby looks healthy and is very active, but I think it's just normal parenting paranoia to be a little concerned in the back of your mind. I wish you the best of luck and hope you can get some solutions soon!
Have you tried ...?
tons of fruits (if she's not interested in regular food, at least sweet fruits might catch her interest?)
fruits with full-fat/whole-fat yoghurt (gotta get those calories somehow...), consider natural (=unflavored) yoghurt to avoid sugars and whatever else they put in regular food.
asking the paediatrician for more useful advice than "fix it".
if she won't accept anything else than formula, get the richest sort you can find (for older children?) and serve during the day too (not ideal, but better than losing weight!)
Is her weight out of proportion to her height, like she is malnourished? Or is she in good proportion but in a low "percentile" or just stalled for a little bit? The former is a much more serious problem, but a lot of doctors freak out about the latter just as much.
Children gain weight the same way adults do, with foods very dense in calories such as high carbs. Make sure she is getting vitamins in, but make a lot bigger proportion of her diet in higher calorie foods than you would consider healthy for yourself as an adult.
Also review some of the threads on picky eaters. If kids know they will get their favorite foods if they hold out long enough, they will go hungry so they can get more of their favorite. It can be very difficult to do, esspecially with a child that needs to gain weight, but if you limit her portions on her favorites, she will eventually get hungry enough that she has no choice but to expand her diet during the day. It's a short-term trade off for a long-term gain.
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