Not able to help child gain weight

Hello:

My wife and I have been attempting to help our 3 years 3 month old boy gain weight since we started noticing he was continually going further and further down the weight charts from a very early age; in fact, he did not gain a single pound from 6 months to 9 months old because he had major reflux and digestive issues.  Since he could not digest solid foods, we had him on pediasure and boost for over a year and half and he reached 30 lbs, but we recently took him off of the drinks since he was able to start digesting solid foods and the drinks were making him ill--he was vomiting at least once a day.  After taking him off of pedisure/boost he dropped down to 26 lbs which was his weight at 2 years old.  He has managed to gain 2 pounds over the last 3 months.  We have talked with nutritionist after nutritionist and they can only help us with "losing weight" not "gaining weight"; further, our insurance company cannot provide any suggestions or help either unless it is "losing weight".  

He is very active and is intellectually in line with his peer group with advancements in his fine motor skills.  Doctor’s have recommended conducting upper and lower GI test; however, our concern, as well as the doctor's, is that our child would have to be "put under" and there is chance of him not waking up.  He can not eat normal quantities of food at a time, so he eats small portions through out the day--almost immediately he starts running around and burning off any caloric intake that he make have just received.  Further, any type of medicines taken orally often do not stay down and further exacerbate the challenges he already has in recovering from common illnesses.   Right now he has a BMI of 13.0. We are very frustrated, concerned, and only want to help our child. Any help would be greatly appreciated.

[Renee Radenberg]

His weight is approximately between the 10-5th percentile and his height is on the 50th percentile for his age. If he can tolerate yogurt, suggest giving him yogurt smoothies (yogurt, and frozen or fresh fruit blended) or store brought. If he tolerates ice cream add that to the smoothie for additional calories. Here are some additional tips for extra calories/protein: If he likes pasta, then add meat or cream sauces to the pasta instead of plain tomato sauce or plain pasta. Add dry milk to oatmeal, mashed potatoes, gravies, creamed vegetables, and creamed soups (add additional meats to soups). Use all fat dairy products (if tolerated). Some suggestions that may help with for his digestive issues: Eat 5-6 small meals a day, wait ½ to 1 hour before lying down,   and raise the head of his bed or crib to a 45 degree angle. Hoped this helped you.