When to be alarmed about underweight child?

[Anonymous]

I worked with a kid in elementary school who had this issue. He never wanted to eat lunch because of his meds. I asked him what his favorite foods were and bought them, one was chocolate pudding, another was cheese crackers, and around 2-3 o'clock he was always hungry and we gave him the snacks. Check to see if your child eats at school, make sure they get foods they like to eat for school meals, and ask the teacher if they can offer snacks when the child is hungry. It will at least help a little.

[Anonymous]

Anonymous wrote:If they are healthy and active I wouldn’t worry too much.
I wouldnt resort to lucky charms and Reese’s pieces just to get food in, that’s crazy.

If by “crazy,” you mean “recommended by experts as a way to manage a crazy situation,” then you are correct.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If they are healthy and active I wouldn’t worry too much.
I wouldnt resort to lucky charms and Reese’s pieces just to get food in, that’s crazy.

So says someone who has never experienced kids who refuse to eat. And, no, some kids will NOT eat when they're hungry.

DP. OP's DC is growing taller, which is a good sign. In her shoes, I would try to increases calories and call the pediatrician to ask about the concerns. But I have also done extensive research about when to be alarmed about an underweight child. OP needs to do her own research, not ask DCUM. We can give her advice about increasing calories. Her doctor can say when to be worried.

You mean by allowing her kid to eat Lucky Charm's and Reese's? Anyone who has been in OP's shoes understands the challenge of getting calories into a kid and shouldn't be judged (or called crazy) by doing the best they can. It's a perfect example of the judgment PPs have described.

[Anonymous]

Anonymous wrote:I'm assuming you mean 10th percentile on the growth charts, not BMI...

My kid was <5% his whole life and we/ped had no concerns - until anxiety spiked in 6th grade and he actually lost a small amount of weight. Ped said then that it wasn't a serious issue yet but that if we couldn't turn it around in 6 months it would be more concerning. TBH that was scary for me. I met with a wonderful nutritionist and we got him back on his growth curve by the fall. (All in concert with therapy/treatment for the anxiety, too, of course.)

Her advice to us in a nutshell - all calories are good calories for this case, don't be afraid of liquid supplements or sugar if that's all he'll eat, add a multivitamin+iron for micronutrients. It is HARD to let go when the only thing your kid will eat is Lucky Charms with whole milk or Reeses cups, but when it came down to that or nothing, we took it. And lots of Ensure Plus / Boost Plus / Protein shakes.

It's still hard, his diet hasn't gotten significantly better / is still a work in progress, but he's gaining weight at a normal pace now and I'm learning to deal with the side eye I get from other parents who don't know the history there.

Good luck <3

You assume wrong.

They said BMI because they meant BMI.

[Anonymous]

Refined coconut oil melted in the microwave is a tasteless, imperceptible way to mix hundreds of extra calories into anything that isn't dry and crunchy. Avoid the unrefined/raw kind, as it tastes like coconut. Add it to milk, juice, pudding, smoothies, etc.

[Anonymous]

I’d suggest getting another opinion in addition to on your pediatrician. They can miss a lot of things because they are more generalists. I’d recommend meeting with a nutritionist to make sure he’s eating enough calories and getting ideas on how to get them in. I don’t want to speculate but could also be some type of eating disorder. Might as well rule it out….

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm assuming you mean 10th percentile on the growth charts, not BMI...

My kid was <5% his whole life and we/ped had no concerns - until anxiety spiked in 6th grade and he actually lost a small amount of weight. Ped said then that it wasn't a serious issue yet but that if we couldn't turn it around in 6 months it would be more concerning. TBH that was scary for me. I met with a wonderful nutritionist and we got him back on his growth curve by the fall. (All in concert with therapy/treatment for the anxiety, too, of course.)

Her advice to us in a nutshell - all calories are good calories for this case, don't be afraid of liquid supplements or sugar if that's all he'll eat, add a multivitamin+iron for micronutrients. It is HARD to let go when the only thing your kid will eat is Lucky Charms with whole milk or Reeses cups, but when it came down to that or nothing, we took it. And lots of Ensure Plus / Boost Plus / Protein shakes.

It's still hard, his diet hasn't gotten significantly better / is still a work in progress, but he's gaining weight at a normal pace now and I'm learning to deal with the side eye I get from other parents who don't know the history there.

Good luck <3

You assume wrong.

They said BMI because they meant BMI.

eyeroll sorry I misread but it doesn't negate the rest of what I said. I just did the math on my kid and he went from a BMI of 15.1/9th percentile to 14.6/3rd percentile, in 4.5 months. So yeah *I* (Lucky Charms mom) would find a BMI of 12.5 very concerning.

[Anonymous]

Anonymous wrote:My child was put on cyproheptadine/periactin to stimulate appetite, and it helped her put on some weight. That said, she’s 5’4” and weighs 90 lbs. she’s always been very skinny and is 2nd% for bmi. Our pediatrician recommended all of the things already mentioned.

Cyproheptadine saved my child's life.

[Anonymous]

Anonymous wrote:

Anonymous wrote:If they are healthy and active I wouldn’t worry too much.
I wouldnt resort to lucky charms and Reese’s pieces just to get food in, that’s crazy.

If by “crazy,” you mean “recommended by experts as a way to manage a crazy situation,” then you are correct.

Not the person you are responding to, but when my son was overweight I heard this advice and ignored it. I have since gotten opinions on the other health issues involved and mentioned this advice and much more esteemed doctors agree with my take and the person above-junk food is really bad medicine. It's one thing to do nutrition shakes to get the weight gain going and some nutrients, but you are much better off long term adding more olive oil, finding the safest shake you can, making smoothies that have a base like avocado and that sort of thing. When I took the original advice of getting weight any way you can even with cookies and cake, my kid was so ill. When I went with my gut (pun intended) later backed up by other doctors and dieticians, the weight gain was slower, but the health gains were faster and greater. Food for thought.

[Anonymous]

Sorry underweight not overweight

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If they are healthy and active I wouldn’t worry too much.
I wouldnt resort to lucky charms and Reese’s pieces just to get food in, that’s crazy.

If by “crazy,” you mean “recommended by experts as a way to manage a crazy situation,” then you are correct.

Not the person you are responding to, but when my son was overweight I heard this advice and ignored it. I have since gotten opinions on the other health issues involved and mentioned this advice and much more esteemed doctors agree with my take and the person above-junk food is really bad medicine. It's one thing to do nutrition shakes to get the weight gain going and some nutrients, but you are much better off long term adding more olive oil, finding the safest shake you can, making smoothies that have a base like avocado and that sort of thing. When I took the original advice of getting weight any way you can even with cookies and cake, my kid was so ill. When I went with my gut (pun intended) later backed up by other doctors and dieticians, the weight gain was slower, but the health gains were faster and greater. Food for thought.

I’m totally with you that if it doesn’t pass the logic test, don’t do it. I understand some parents have no choice and that’s fine too.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If they are healthy and active I wouldn’t worry too much.
I wouldnt resort to lucky charms and Reese’s pieces just to get food in, that’s crazy.

If by “crazy,” you mean “recommended by experts as a way to manage a crazy situation,” then you are correct.

Not the person you are responding to, but when my son was overweight I heard this advice and ignored it. I have since gotten opinions on the other health issues involved and mentioned this advice and much more esteemed doctors agree with my take and the person above-junk food is really bad medicine. It's one thing to do nutrition shakes to get the weight gain going and some nutrients, but you are much better off long term adding more olive oil, finding the safest shake you can, making smoothies that have a base like avocado and that sort of thing. When I took the original advice of getting weight any way you can even with cookies and cake, my kid was so ill. When I went with my gut (pun intended) later backed up by other doctors and dieticians, the weight gain was slower, but the health gains were faster and greater. Food for thought.

This depends so much on how bad the situation is.

Some people have the time to take your approach, others who have kids below the 1percentile BMI need to take more drastic measures NOW. Then maybe once the situation stabilizes they can consider your approach.

People on here with kids like yours who have 5 percentile BMI do not understand the urgency. You are in an entirely different situation and trying to compare apples and oranges.

[Anonymous]

I would be more concerned with my child’s apparently declining physical health than their lack of ability to comply with the rather arbitrary structures and rules at school. In other words, I would be SERIOUSLY questioning whether their stimulant is causing more harm than good.

[Anonymous]

When my petite and slender kid was 10 she was 46 inches tall and weighed 44 pounds. I used the CDC child BMI calculator and found that for her to have a BMI of around 12.5 she would need to weigh 37-38 pounds. For a 48 inch tall girl that would be a weight of 42 pounds and puts a child in under the 1% for weight but average-ish for height. I can see why you are worried.

If the child isn't on medications during weekends and school holidays, could you do really high calorie foods then?

Could you switch medications? Your child's psychiatrist or whomever is managing meds should be able to offer an alternative.

[Anonymous]

Anonymous wrote:I would be more concerned with my child’s apparently declining physical health than their lack of ability to comply with the rather arbitrary structures and rules at school. In other words, I would be SERIOUSLY questioning whether their stimulant is causing more harm than good.

+1

It seems clear that the stimulant medication is contraindicated for this child. There are alternatives, some of which may be as effective, some of which may be almost as effective.