When to be alarmed about underweight child?

[Anonymous]

My kid went on stimulants at 5 and immediately dropped 10lbs (within 3 months). It got the point I was scared looking at his bones poking out and the pediatrician/specialist agreed and put him in Cyproheptadine as others have said. My son also has severe food allergies so feeding him peanut butter sandwiches among other things are not options for us. The cyproheptadine has brought him up to a reasonable weight and we still do all the things to give him as many calories as possible. Basically whatever he wants to eat, we let him eat even if it means extra sugar and sweets. Don’t get me wrong, I still serve him vegetables and fruit because I want him to understand that is part of a balanced meal, but I also give as many extra calories in as many ways I can.

[Anonymous]

I can’t speak to the stimulants. I come from a line of abnormally skinny people with very healthy appetites. No matter how many calories are consumed the BMI is low. I was recently diagnosed with a malabsorption disorder. I can’t digest fats and years of high fat consumption damaged my pancreas. My pancreas also cannot properly digest sugar.

Based on personal experience, I recommend poking into malabsorption issues. Or possible endocrine issues.

Best wishes. My 10 y.o. has. BMI of 13.4 and I’m meeting with gastroenterologists, endocrinologists, and geneticists looking for the answer.

[Anonymous]

Can DC go on a medication vacation over summer?

[Anonymous]

Anonymous wrote:I can’t speak to the stimulants. I come from a line of abnormally skinny people with very healthy appetites. No matter how many calories are consumed the BMI is low. I was recently diagnosed with a malabsorption disorder. I can’t digest fats and years of high fat consumption damaged my pancreas. My pancreas also cannot properly digest sugar.

Based on personal experience, I recommend poking into malabsorption issues. Or possible endocrine issues.

Best wishes. My 10 y.o. has. BMI of 13.4 and I’m meeting with gastroenterologists, endocrinologists, and geneticists looking for the answer.

You make a good point. There could be another issue at play in addition to the appetite suppression from the stimulants. I have a relative who was always incredibly skinny, until she was tested for celiac disease and eliminated gluten from her diet. Now she’s a perfectly healthy, normal weight. It’s like her body wasn’t really absorbing nutrients when she ate gluten.

[Anonymous]

I think you are right to be concerned. My child has a history of ARFID though they are doing better now and their psychiatrist has said no stimulants even though Dc is currently at a healthy weight. I highly encourage you to take your child to a psychiatrist to see if there are other options (even pairing with a no stimulant to cut the dose may be an option). Our pediatrician who I respect a lot with treat “straight forward “ kids for their ADHD but said he believes kids with a history of feeding issues need more care than they can provide. In the meantime I agree calories are king. Best of luck

[Anonymous]

Anonymous wrote:

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.

+1

[Anonymous]

Anonymous wrote:

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

I'm not the OP but thank you for this. My son drinks pediasure every single day and I know I get a lot of side eye from other parents but he is literally in the 1% and it's the only way I have some assurance that he's getting nutrients and calories in.

We're in the same boat. We always felt alone and frustrated until we found a nutritionist who said don't focus on how you think others are judging focus on getting calories into your son. If he'll eat it, give it.

We got the same advice. As a parent with severe food aversions and FTT, we based our life schedule on getting calories in. It was really tough. But if you haven’t already done this, try adjusting your schedule to feed around the times them meds reduce appetite and hunger.

[Anonymous]

Milk and peanut butter

[Anonymous]

Op here. Thanks for all the suggestions.

We have done almost everything mentioned here (DC eats whenever they are hungry, we do shakes - either pediasure or homemade - to supplement when DC doesn’t eat enough, we do occasional medication breaks, have tried non-stimulants, try to push high calorie foods). DC still barely gaining weight - they just aren’t very hungry even before they take medication in the morning and BMI keeps dropping as they gain height but not weight.

It was helpful to hear from everyone because it did make me feel that we should probably see a specialist and get a second opinion. I made an appointment at CNMC to see a GI doctor for underweight kids.