Ask the Expert – Toddler Not Gaining Weight

by TwinToddlersDad on May 25, 2010

in Ask The Expert

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

It is natural for parents to be concerned about slow weight gain in their children when they see the weight percentile number on the growth charts. They try to then force feed their child in the hope that he will gain more weight. In this article, registered dietitian Teresa Wagner explains why this approach may not work in the long run. Instead, she suggests you try to implement the notion of division of responsibility in feeding.

Teresa Wagner, MS, RD, LD

  • BS, Dietetics from Texas Christian University
  • MS, Nutrition from Texas Women’s University
  • Certified in childhood and adolescent weight management
  • Director Dairy Max Program
  • 10 years teaching experience at community college and university level
  • Blogger at the Dairy Report
  • Twitter: @TravelingRD

Question:I am worried that my 4 year old is not gaining enough weight although he is growing tall. What should I be feeding him so he can put on some weight?

Answer:

As a registered dietitian who worked for almost 10 years with pediatric clients, I have met many parents who are concerned with their children’s either abundance of or lack of weight gain. Weight status is a result of many factors including but not limited to heredity, metabolism, growth, environment and activity level.

Healthy children are born with an innate ability to regulate their own food intake due to hormones in the body that control the rise and fall of blood glucose levels and appetite. When left to one’s own devices, children will naturally eat when they are hungry and stop when they are full. Take for example, my own daughter who has surpassed me in height at the age of 14. When she was a child, she hovered around the 25th% for weight vs. height and was so tiny that you could have wrapped your fingers around her legs. However, when she was eating, she might stop in the middle of a bowl of ice cream, a baggie of grapes or a slice of pizza and be done. Once she went through puberty, she blossomed out into a curvy teen, now hovering around the 50th% of weight for height and still enjoys the foods she eats but innately monitors her own appetite.

The main concepts we should be concentrating on as parents to teach our children involving eating are balance, variety and moderation. Enjoying a variety of nutrient rich foods that will maximize the nutrients we obtain while moderating our calories and balancing those calories with appropriate physical activity or active play. When I taught college, the first statement I would make to my students was that if they learned nothing in my class but the definition and application of the three words balance, variety and moderation, I would be happy.

As a young dietitian, I learned all of my basic information on child feeding and actually worked for years in eating therapy for children who were born without the innate ability to either eat by mouth or sense hunger, fullness and satiety. The guru of child feeding in my book has always been Ellyn Satter.

Ellyn’s division of responsibility in eating tells us that parents are responsible for serving nutritious foods in a positive and supportive atmosphere while the child is responsible for how much and whether or not they will eat. In doing so on both parts, the child can develop successful skills in balance, variety and moderation and carry forth these skills into adulthood in developing a healthy lifestyle that includes physical activity, adequate sleep and weight maintenance. Teaching these concepts at a young age decreases your child’s risk of developing chronic disease as an adult. By becoming overly concerned or forceful with children’s eating and weight, we disrupt this natural balance by creating a negative atmosphere or forcing unneeded calories and our child may lose  that inborn ability, as many of us have, to balance their own weight and monitor their own food intake. In the mean time, they will grow normally based on their own unique make-up of weight status factors. Thus, Ellyn says don’t try to control the amount of food or calories that your child eats; that is the child’s job.

Instead:

  • Maintain a division of responsibility in feeding; you providing/child monitoring.
  • Do family-friendly feeding and maintain a supportive atmosphere.
  • Offer nutrient rich snacks between meals and encourage active play.
  • Let your child grow up to get the strong, healthy body that is right for them.

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Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

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  • http://www.growingraw.com GrowingRaw

    Having been there done that (the worrying bit I mean) I know that it’s hard to truly stop worrying until your child starts growing again. But having been through it once while my daughter was a toddler I don’t worry about it at all with my son. She ate heaps one day, close to zero the next…. he does the same and it all evens out. I do make sure I offer the dish I want them to eat most separately first (i.e. the veggies) and let them look at that for 5 minutes or so before I serve up the rest of the meal.

  • http://www.growingraw.com GrowingRaw

    Having been there done that (the worrying bit I mean) I know that it’s hard to truly stop worrying until your child starts growing again. But having been through it once while my daughter was a toddler I don’t worry about it at all with my son. She ate heaps one day, close to zero the next…. he does the same and it all evens out. I do make sure I offer the dish I want them to eat most separately first (i.e. the veggies) and let them look at that for 5 minutes or so before I serve up the rest of the meal.

  • Karenshaw

    hi my 18 month old daughter hs only put 4lb on in  8 months should i be worried

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