Failure to Thrive/Poor appetite

Hello,
I am wondering if you have any advice on how to help our child. He has only gained 1/2 lb since October, and eats very small amounts of food at a time. He has an extremely small appetite and is hardly ever hungry. We have done some reading about using Benecalorie and was wondering if that is something you recommend? Also, do you have any experience or advice about using an appetite stimulant such as Periactin? Finally, what advice can you give to help encourage our little one to eat more. When he skips meals we give him fruit smoothies that our concentrated with Carnation Instant Breakfast, powdered milk, half & half, with bananas. However, I feel like his diet is getting more and more limited and he is just "drinking" all his food, which is not ideal. He drinks well from a sippy cup.
Lastly, can you tell us how many calories he should be consuming to help him gain weight? When we added up his calories he is getting 800-900 calories at most.
Thank you,
Struggling Mom

[Renee Radenberg]

For his age he needs 800-1300 calories a day. His weight is below the 5th percentile for his age. It is good you are giving him the ‘smoothies’. Suggest he has them in place of milk at all meals/snacks for additional calories. Is he eating regular finger foods? If he isn’t, then he may need to learn how to chew and swallow. If that is the case, suggest getting him evaluated. The most important is to relax at meals. If he will not eat a certain food or not eat too much, do not make a fuss over it. Let it go and enjoy the meal. Suggest giving him a chewable children’s daily multi-vitamin due to his eating habits. I do not recommend an appetite stimulate for that young age, but you can ask your Doctor about it. Thank you for your question.