My daughter, who is six years old and turning seven this summer, recently went to the pediatrician for her wellness check-up. Other than her seasonal allergies and eczema, she’s usually been pretty healthy and has always been a very good eater.
So maybe that’s why it took me by surprise when the pediatrician noted some concern about how little she had grown over the past year. While I was glad that she had finally made it over 40 pounds, I was a little bit shocked to learn that put her in the 10th percentile for weight and that her height was in the 8th percentile. I checked her weight and height from last year, and she had only gained two pounds and grown only one inch. (Last year she had been in the 16th percentile for both weight and height.)
The pediatrician, who we’ve been seeing since HJ was an infant, suggested we check her thyroid level and do a blood test just in case. This is why I love our pediatrician. He is decisive without being overbearing, and thorough and cautious yet still very reassuring. He also has a great bedside manner with HJ and can make her smile and laugh even when she still gets a little anxious about going to the doctor. This is also why we still drive half an hour to see him even after we moved away!
In any case, it turned out that all her levels were fine. Which basically means that she just needs to get more calories. Our pediatrician suggested high calorie foods such as milkshakes and smoothies, and even adding extra oil when cooking for her. It was funny to hear HJ say that the doctor ordered her to have a milkshake after the visit. 
We actually did go out to get Mexican food right after the appointment, and I was happy to see her eat a lot of guacamole, one of her favorites, and quite a bit of steak from my taco salad.
The thing is HJ used to not be picky at all with food when she was younger. I always attributed it to her being fed lots of different vegetables and spices and flavors when she was in Korea for the first year of life, but she was the type of toddler who would eat salmon, broccoli, bean sprouts, black beans, spinach and any kind of Korean soup. I didn’t really take any of the credit but just thought I had lucked out.
Now she will still eat lots of fruits and vegetables and actually loves salad, but it’s definitely harder to get her to eat enough protein. She has become somewhat of a picky meat eater, only eating steak, really good burgers, and Korean kalbi (marinated short ribs). Either our grocery bill is going to get really expensive or we have to find some other ways to get some protein in her! She will eat eggs, but only the white part, and she unfortunately has decided she doesn’t like beans anymore.
I also wonder if part of the reason she hasn’t gained as much weight is that she just doesn’t eat enough during the school day. She usually eats breakfast at home, but again, mostly just carbs like toast and butter, or waffles, and sometimes she will eat breakfast again at school if she has time. For lunch, she eats in the cafeteria if she likes whatever’s on the menu that day, but that will usually be chicken nuggets, cheese pizza, or breadsticks. Not very nutritious. She actually does sometimes order the salad, but I don’t think it’s very substantial.
Last year, we went through the whole rigmarole of trying to figure out what she would eat if I packed her lunch. Believe me, we tried everything. Rice, Korean bulgogi, and seaweed, soba noodles, potstickers, soup, etc… The problem was she didn’t like any of it because it didn’t taste the same after sitting there for a few hours, even though I tried thermoses and the PlanetBox lunchbox to make it more appealing. And even all the fruit that she enjoyed at home, watermelon, grapes, and blueberries, for example, for some reason she just would not eat when I packed it for her in her lunch.
I asked her teacher if there were other issues going on at lunch, but other than having someone sit next to her encouraging her to eat, I know it’s hard, especially when their lunch period is 20 minutes long and all the kids are rushing through lunch so they can go out and play. I know that eating in the loud and crowded cafeteria doesn’t make it easy for her either with her sensory issues.
So basically I gave in to the fact that she would usually come home from school starving and eat a huge snack, or early dinner, and hopefully be eating enough that way.
But with this new information about how little weight she has gained, I may have to rethink things.
We briefly thought about switching to whole milk, but think that might upset her stomach since she’s not used to it. She’s also not really big into most dairy, such as yogurt or cheese.
And I really hope that we don’t have to go down the route of nutritional supplements like Pediasure, since we have a hard enough time getting her to drink anything that she doesn’t like.
Any suggestions or advice on what’s worked for your kiddos when you’ve needed to increase their calorie intake? I’d love to hear your ideas!
When we first saw pictures of HJ from Korea at the age of about 3 months, we had the opposite problem. I don’t know how much she weighed at the time, but this picture says it all… Korean people really like their babies to be chunky!
pomelo / 5524 posts
Is she ok with peanut butter? That’s a good source of protein in the morning. While you might not be able to pack it in a lunch if your school is peanut free, it’s how I balanced out my carb-full breakfast when I had GD with my son.
And though she doesn’t like a lot of meats, is tofu an option? The good thing about the eggs is that the whites are what are full of protein, so even making her egg whites in the morning is a good source of protein for her.
grapefruit / 4110 posts
My son was failure to thrive and now at 4 has dropped to a lower weight percentile again. He also can’t have soy and doesn’t do much dairy. So what we have done is try to make each bite as calorically dense as possible. We have also started sending a meal replacement drink in for lunch for those extra calories. I hate that it’s a drink but it helps get just those few more calories in.
blogger / pineapple / 12381 posts
Or this could just be her? Not everyone can be in the 50th %ile. (Says the mom of a 30 lb 39 inch 5 year old!)
kiwi / 511 posts
@Mrs.Jacks I
your comment so much. My son’s pedi gave me an eating disorder (ok not quite) but I was so obsessed with food for well over a year. I finally just gave up and said I offer them tons of food and good food and that is it. They eat like little horses some days and other days not. My three year old still gets a “Lion Milk” aka pediasure (vanilla has a lion on it) after dinner almost every day…he finally hit 25 lbs but is still in 24 month/2T clothes. The kid never stops moving and you cannot feed him anything if he is not hungry even cake and ice cream he will stop if he is full. I don’t want to derail that instinct so I pretty much told the pedi after the blood work to shove it. But I said it nicely, I just cannot take the meal/food anxiety any longer. Yes they are in 1 percentile but their curve is their curve and they don’t deviate they are just low and slow oddly enough it looks very similar to my growth chart when I was his age.
Both my 3 and 5 year old are on whole milk, whole milk dairy when I can find it. I stopped whole milk yogurt because that I can only find in Yo-Baby they tell me they are not babies any more, They both love rotissierre chicken and will eat the skin so I give them all the skin they will eat and all the chicken too.
Since we have a nut allergy in the family I am not comfortable giving them commercial ice cream so I make ice cream with whole milk and heavy cream. But it is not an every day thing, I am sorry that was another line I drew I would not give them dessert every single day.
@Mrs.Juice when they were both younger I would add canola oil to everything on their plate and to their milk and to their yogurt. They ate it just fine I thought it was disgusting. They don’t like avocados
but they do really like soynut butter and it is pretty high in protein content as well.
kiwi / 511 posts
I should say that the pedisure does make him feel full so he won’t eat dinner or regular food. That is why I reserve it until the end of the day after dinner. He will drink it even after he tells me he is done with dinner. But some days he doesn’t even drink the whole thing, he is just too full. Other days he will suck it down like he is a starving man, despite having dinner and seconds.
admin / watermelon / 14210 posts
charlie isn’t 40 pounds and he’s 5 1/2, and he only grew one inch over the past year as well. we just put butter in everything because charlie is obsessed with it!
blogger / apricot / 367 posts
@2PeasinaPod: She is not a fan of peanut butter unfortunately
She used to have a nut allergy but grew out of it, which may be why she just doesn’t like it now. But yes she loves tofu so I need to give her more of that! And good pt about the eggwhites!
@brownie: Which meal replacement drink do you do? Does your son like it?
@Mrs. Jacks: my husband always says the same thing
I’m just worried because although she’s always been small, this past year it seems like she’s dropped off her growth curve…
@Mrs. Maven: That’s a great tip about making your own ice cream with the whole milk and cream. I’m sure my daughter would love that but I know what you mean about too much dessert too
It’s hard to find the balance between keeping a healthy diet and getting them enough calories!
pomelo / 5628 posts
My son was born tiny so we have always been consumed with food. Although I don’t think you should ovelu worry, I have a few simple suggestions. 1) do a big snack right after school AND a big dinner (which you prob do). I imagine four meals for my son instead of 3 and it helps me get him hearty meals. 2) add calories into all foods, butter oil, PB in smoothies and also limit empty calories snacks like puff type foods since they are low calorie.
There’s prob no harm in slowly trying fattier milks…if she tolerates it. We do whole milk with added whole milk powder.
blogger / apricot / 367 posts
@Mrs. Bee: Yes HJ loves butter too
My friend just told me to try Kerry Gold irish butter which they sell at costco …
blogger / apricot / 367 posts
@Mrs Green Grass: Thank you for the suggestions! I definitely need to be better about limiting the lower calorie snacks…
apricot / 317 posts
My son is 30 lbs at 4, so he’s finally starting to catch up a little…(he was 18 lbs at 18 months, when he was adopted from Korea). He’s really low on the height, as well, and is usually an inch or two shorter than other kids his age. We also feed him lots of calories…and he is a voracious eater. His thyroid has been checked, too – he’s fine, just small!
pomelo / 5524 posts
@Mrs. Juice: Ah…bummer about the peanut butter. As for the dairy, and possibly switching to whole milk…you could introduce it gradually. Start off with 1/4 whole and the rest what she’s used to and just gradually increase as it seems like she’s tolerating it.
Hummus might also be something that you could try with her since there are so many different flavors you can try.
admin / watermelon / 14210 posts
@Mrs. Jacks: she is the size of Olive at 3 1/2! Olive is 30 pounds and 38 inches.
grapefruit / 4988 posts
@Mrs. Jacks: This is a great comment. Somebody has to be at the lower percentages! I try not to worry about height/weight too much (my LO is in the 10-20% range) because DH and I are both short/small.
admin / watermelon / 14210 posts
@Mrs. Juice: that’s the kind we buy! grass-fed!
grapefruit / 4110 posts
@Mrs. Juice: we do kid essentials because it doesn’t use soy protein and happy times one. We get the chocolate flavor. I have seen him nurse them and down them depending. But even if he only drinks half that is 100 calories more than he used to eat and it is filled with protein and other goodies.
Have you tried sunflower seed butter? It is actually about 10 more calories per tbs than peanut butter.
guest
I make smoothies with whole milk yogurt, avocados, almond butter and whatever fruit/veggies I have on hand. My kids will not touch avocado normally, but it blends in and makes the smoothly really rich and creamy. Stoneyfield farm has a great whole milk vanilla yogurt in large quart size containers.
Also, what about cheese? My kids would eat a million cheese sticks if I let them . They also like quesodillas and I can sneak various meats/beans in that they wouldn’t otherwise eat.
cantaloupe / 6131 posts
Make calorie dense smoothies. Use whole milk plain yogurt, frozen fruit, coconut oil, banana, and even a splash of cream. It will taste like creamy sherbet. You can add spinach and flax and chia seeds too. Or a blob of nut butter.
Coconut oil hides in baked goods and sweets really well, so we fry French toast in it or add it to a lot of sweet recipes. Sweet potato chunks tossed in coconut oil and roasted is so good.
Whole milk is probably going to be easier to digest than lower fat milk because the fat acts as a buffer against the milk proteins that some people have a hard time digesting. Another great thing to use is full fat coconut milk (the kind in the can) or coconut cream. You can make a mild Thai curry sauce or use it in the smoothies.
See if your kid will eat massaged kale salad. You massage oil and avocado and salt and lemon juice into kale leaves and it helps tenderize and wilt the leaves down. It’s basically kale marinated in guacamole and really tasty. I like to heap it on sandwiches and it’s really good with just about any lunch meat.
See if you can make little chicken wings or drumettes using a bulgogi marinade and play up the cute factor – perhaps she will eat more skin and fat that way.
Bake little pancake mini muffins using an egg and oil rich batter and push a small piece of breakfast sausage in the batter in the morning. Have her dip the muffins in a mixture of melted butter and maple syrup. Same concept for corn dog bites – use an egg and oil rich cornbread batter, brush the tops with butter after baking and let her dip into ketchup or mix some mayo into the ketchup for a “pretty pink sauce.” Or creamy honey mustard sauce (ie mayo with Dijon and honey).
blogger / apricot / 367 posts
@gingerbebe: Thank you for all those great suggestions. I bet she would like the kale
@brownie: We haven’t tried the sunflower butter yet but will try it out — had no idea that had more calories than peanut butter!
@Mrs. Green Grass: and @2peasinapod: just came back from the grocery with whole milk. gonna try it out on her!
blogger / pineapple / 12381 posts
@Mrs. Bee: I know she’s such a peanut. But I had constitutional growth delay so I’m not too worried. It actually runs in our family. My grandfather grew a foot at 18 from 5 ft 4 to 6 ft 4!
I think it’s always good to question when someone is drifting off their curve… But sometimes it’s just them