My Kid does not want to eat!

Posted by Patrick on August 02, 1999 at 03:05:23
I have a 19 months old child and she is not really fond of eating. She just weighs 9.7 kg and is underweight according to her pedia.
She has just been confined and the doctors says its lactose intolerance. She now even weighs .7 kg less!!
Her doctors gave her "Pediasure" and I would want some referral for some other milk (chocolate flavored..she does not want white colored drink)of same kind.
What must be wrong with her and what could you advice on what kind of foods shall Iwe give her?
thanks and Godspeed!
Posted by HVM M.D. - EV on August 17, 1999 at 09:22:45
Dear Patrick -
    I am sorry I have not responded to your question sooner - but I have been away on my summer vacation.
    With regard to your daughter's weight - know that children come in all different shapes and sizes.  For some 18-19 month old females, a weight of 9.7 kg, 'tho small, may be normal.  This weight represents the 5th -10th percentile - which is well within normal limits.  NOW - the question I would ask you and your child's doctor is - Has your child grown at a normal rate, meaning has she always been small?  If so - then I would be inclined not to worry about her weight.  If she has definitely lost weight, particularly over the long term, then that needs attention.
    Also - know that in the context of normal behavior and normal eating habits that toddlers are often not interested in eating.  Many of my toddler patients only eat 4-5 good meals a WEEK.  They seem to graze more than eat.  Others drink too many fluids - and these can interfere with solid food.  So, I would ask you to make sure your daughter doesn't drink a lot of juice or other fluid - and recommend a wean from the bottle if she still takes one. Also - make sure she isn't drinking from a bottle during the night.  Not only will that sabotage her appetite - but that can lead to dental cavities.  
   Now - with regard to diet options:  If your daughter is truly lactose intolerant - I would advise you to speak to a pediatric nutritionist about diet options.  You can flavor supplemental drinks - offer soy products - use the lactose free products - offer calcium supplemented drinks, as well.  With regard to the Pediasure - it is a good supplemental formula - but I think it, too, may contain milk products (including lactose) - so you might want to discuss that with your child's doctor.
   So - in summary - if your child is healthy and has always been small - I would not worry too much.  If she is truly lactose intolerant - I would advise a consultation with a nutritionist, if available, or your doctor to look at your child's diet and offer suggestions.  If there is definite weight loss - like over months- then I would recommend a reevaluation with your child's doctor to make sure there is truly nothing serious going on.
   Finally - with regard to your child not being fond of eating, I would suggest offering reasonable food choices for 3 meals and 2-3 snacks a day - but not to chase her with foods and not to worry if she doesn't eat well on a consistent basis.
   I hope this helps.  Don't hesitate to share your concerns with your child's doctor - because he/she is there to help you and to make sure your child is well.     Good luck  -   Dr. EV.

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