Tuesday, August 7, 2012

Guest Post: A Tiny Toddler

The following is a guest post from a reader, who asked not to be identified. Hearing other mothers' stories will open up discussion on topics I may not have any personal experience with and provide a different perspective on parenting. I'm excited to present this first in a series of guest posts, in which this mother talks about her difficulty in getting her daughter to gain weight and grow according to the doctors' expectations. At what point do we go with our gut instinct over what the doctors think? How many tests, specialists, and evaluations do we put our children through before we decide on our own that maybe there's really nothing specifically wrong? And how do you convince a two-year-old to eat when she doesn't feel like it? We'd love to hear your comments!


I should begin this post with some vital stats- I am barely 5 feet tall and was 20 years old before I hit 100 lbs. My daughter was born 5 lbs 3 oz full term but two weeks early.  At 6 months she was a healthy 11 lbs having doubled her weight as expected.  At 12 months she was just under 14 lbs and at 24 months just under 20 lbs. Twenty pounds is the average weight for a 1 year old . Between ages 1 and 2 my daughter has had 3 visits with a nutritionist, 3 visits with a gastroenterologist, numerous visits to the pediatrician, blood testing for every known allergy and carries a “failure to thrive” diagnosis on her medical record. Between ages 1 and 2 my daughter has also developed an impressive vocabulary, shockingly accurate memory, all of the age-appropriate gross and fine motor skills, “friendships” with her toddler classmates, and a thriving personality.  In that same year, our lives have turned into an endless feeding chore- finding food with the highest possible fat content, finding the best toys/stories/tricks to get food into her and most often finding the energy and patience within ourselves to get through one mealtime after the next.

A few months ago, after yet another period of no weight gain, I decided to do an experiment. I was pretty convinced that her lack of weight gain was due to insufficient intake of calories- there didn’t appear to be anything medically wrong- she just ate very small amounts of food and was much more interested in doing everything else under the sun other than eating.  On any given day she probably burns all of the calories she takes in, if not more. Or whatever is left over for growth translates into height increases and brain development- both parameters for which she is on the charts and growing on the curve. So we found a solution that held her attention and physically kept her seated long enough to shovel large quantities of high fat food into her that required as little chewing as possible: we let her have an iPad.  She watched and played and, blissfully unaware that she was “eating”, swallowed anything on a spoon we put in her mouth. The results were striking- she put on just over 1 lb in 1 month.  QED. But not wanting to make a habit out of it and having proven satisfactorily to myself that this was unlikely to be a medically-based problem, I went back to more “normal” meals. Weight gain over the next 6 weeks- 5 oz.

And so it is that I find myself in my current predicament- do I give in to her current medical providers' requests and put her through specialist visits and further testing? Do I trust my instinct that she is fine, try to cultivate a liking for food in her in a relaxed non-forceful environment (someone please describe what that is because I certainly don’t know!)? Do I find an alternate medical provider who might think more along those lines? Or do I simply go back to the iPad-fuelled feeding frenzy and get her “on the charts”? Do I, as many of my colleagues have suggested, not give a second thought to “Westernized” weight standards? In a society so plagued by obesity the concept of focusing on weight gain is hard to explain. Case in point- the insurance company’s repeated denial of our nutritionist visit claims because they would only be approved if the patients’s BMI is greater that 35. i.e. if you are obese we support your treatment, but if you are underweight we don’t recognize that as a medical problem. Is it time then that I stopped considering this a problem too? 


  1. Great post!! I have so been there!! we fought for the first 12 months to get our son off of failure to thrive. we had him drinking 2 ounces of cream with every bottle of milk, mixed butter in all of his foods, and he is still underweight. I do have to say that our difference is that our son has CP, so his muscles are burning about twice the calories that a normal child does, which also means he eats ALL THE TIME, so when i finally, on my own after arguing for over a year, pulled up the growth charts for a child with CP he was right on target. My point is that the doctors don't always know everything, but they sure think they do. Trust your instincts. if she has energy, is happy, and she is meeting the other milestones, then maybe she will just be a tiny child. I think in this society we place so much weight on weight that what we are doing is creating a generation of weight conscious kids. My friend's 8 year old counts calories, is that REALLY what we want?

  2. To me, it seems that the question of is she thriving from a size perspective is considerably less important than is she thriving from a health perspective. Obviously, they are related in certain ways, but it seems to me that calories aren't as important as other nutrients and her level of energy. Plus she may simply be genetically small, since you are small. Have you talked to your mom about how you ate as a child? The other issue is what kind of eating habits do you want her to develop. The habit of mindless eating while absorbed in other things is one that could easily lead her to obesity. Obviously, you need to find ways to keep her engaged with her food, and you want her to eat extra snacks if you want to try to meet the growth chart. Have you tried making bentos, or using some of the principals? I've read that it encourages kids to eat more. http://www.hellobee.com/2012/03/07/four-great-reasons-to-pack-bento-box-lunches-for-your-toddler/ and http://www.hellobee.com/2011/09/15/bentolicious/ There are some neat how-tos on that site; here's one on how to make a fun plate: http://www.hellobee.com/2012/05/31/fancy-lunch-plate-sunshine-and-squirrel/