My daughter is 15 months old and 19 lbs. Her doctor informed me that she has been progressively losing weight from the 75th percentile as a baby to the 10th percentile now. I am breastfeeding, but not very often. She drinks whole milk and eats "grown-up" food with the rest of the family--although she doesn't consume large amounts. She likes yogurt, fruit, malt-o-meal, oatmeal and foods that don't really have alot of calories. I am giving her a half of a children's chewable multi-vitamin every few days and haven't been overly concerned about her weight until now. She seems healthy to me but I am now worried that there may be some underlying problem. Do you have any suggestions as far as putting pounds on her or comments about what could possibly be going on??? thanks.
Dear Karen -
With regard to your daughter - it is important to distinguish between "losing weight" from "losing percentiles." I am going to assume that your child is actually gaining weight - but dropping in her weight percentile for age. If that, indeed, is the case - she may very well be fine. Many children start out bigger (by percentiles) then they end up. I don't know if this trend reflects improved prenatal care - followed by genetic growth patterns declaring themselves. But it is very common for toddlers to drop slightly in percentile measurements. However - that said - a drop from the 75% to the 10th % needs to be followed to make sure there is no further drop.
Then, as far as your child's nutrition is concerned - know that toddler nutrition is hard to assess, in that many toddlers only consume a few good meals every few days. But, do try to make sure that your daughter isn't using breastmilk and regular milk as snack foods which might sabotage her solid intake. I have had many toddlers who were "poor" eaters because they "grazed" on liquids, decreasing their desire for regular meals. I would suggest talking to your child's doctor about possible calorie supplements, like enhanced toddler drinks or calorie rich snacks, if he/she thought that was advisable. If your doctor is concerned about your child - he might want to do some bloodwork to evaluate your child's serum protein. But if she seems healthy to you, it is most probable that there is nothing wrong.
Also - pediatric nutritionists can be helpful in advising how to provide more calorie dense foods.
In the end - I would encourage you to follow your daughter's weight closely with her doctor - to evaluate any liquid "snacking" - and to keep in mind a consultation with a nutritionist. Try not to worry - as this is not an uncommon finding. Good luck - Dr. EV.
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