Is he getting enough protein? Out daughter was consistently underweight until about a year, and we think it was because we had read that pieces of meat, even small ones, were a choking hazard for small children so we weren’t feeding her any meat. When we started feeding her meat paste (put the meat through a baby-food grinder) she gained weight rapidly.
If you’re vegetarian, then obviously you’d need to use beans/peas/lentils and similar high-protein vegetable foods – and to look into issues about the required balance of different amino acids, since the balance humans need and the balance available from most vegetable protein sources are not an ideal match. Or if your diet includes dairy products and/or eggs, they’re both great protein sources.
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I just want to share my experience. My pediatrician was concerned about my daughter’s weight gain too. She started out in the 90% for weight and went to 75 to 50 to 25 from 4 – 9 months. She was concerned because her weight seemed to go down when she started solids. Wanted me to feed her more, give her more milk. After I stressed out about it for awhile, my husband convinced me not to be too concerned about it because she was eating well and didn’t seem overly thin and was generally healthy and developing well. We chalked some of it up to the charts they used to compare height, weight, and head circumference. They were created off of kids in the 1950’s in the US (mostly Caucasian). So it doesn’t take into account different ethnicities and a lot of other factors. My husband was a really skinny kid, me not so much. So we chalked it up to heredity and didn’t worry about it too much.
She’ll be 3 years old in June. And she’s skinny as a stick. (She’s got a tall and thin body type) We joke that we can see her ribs. But she eats very well and often. She just has a super high metabolism. And our pediatrician is not concerned about her weight anymore.
And she did sleep 8 hours through the night by the time she was 6 months old, and napped well during the day. So I don’t think the sleep thing has anything to do with her metabolism rate. It was still high.
I hope that encourages you and puts your mind to rest a little bit.
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Our daughter had the same problem – she was consistently underweight (under the 3rd percentile). We went through a series of tests as well and nothing came up. We were suggested a high fat and high calorie. Things like Ritz bits, a lot of butter in food, heavy cream in her milk (this we did after she was a year old). In the end none of this really . We found that when we gave her a high fat diet – shehelped would just eat less of it. She used to love eating steamed vegetables but with a high fat diet she started eating less food and certainly a lot less of healthy foods. We stopped trying after a while.
Now she is 2½ years old – . She has always slept less than thehealthy, active and still skinny average kid her age and has always been more active as well. Also she does eat well – she finishes her meals and snacks at day care and we hear fairly regularly from her teacher that she has an excellent appetite. She just doesn’t seem to put on weight – which will probably be a boon when she grows older!
I know it can be pretty frustrating and stressful – we went through a lot of it when we were trying really hard to fatten her up. So if your son is eating healthy meals, is happy and active I wouldn’t worry too much.
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I talked with a couple of the mom’s in my mom’s group and they suggested looking at the Super Baby Food book for ideas. It has a lot of recipes in their that add additional “good” food to what your son will eat. This way you won’t get as much “filler” food that the per-made food can contain.
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I would feed him more (natural food) protein but check with your doctor first, of course. Baby Cereal doesn’t really have a lot of nutritional/caloric substance (check the label).
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Scheduling feedings is key. Good feeding patterns beget good sleeping patterns. Sleeping promotes growth. So you are on the right track in guessing the sleep is probably contributing to his lack of weight gain, not to mention the consistent activity.
It is important to schedule his feedings so he does get longer sleep times. Why do I know this? I gave birth to twins who are now 15 months. We scheduled these 2 every 2 ½ hours feeding since birth and they slept through the night and had scheduled naps at 2.5 months. Until they were about 4 months they had a bottle, were up for 1 ½ hours, then went to sleep for 1 hour.
I read BabyWise which told me about the scheduled feedings and the sleeping patterns that develop. I couldn’t believe it happened like clockwork. Consider getting your baby on a schedule right away and read BabyWise.
At about 9 months your baby should have 2 naps a day. Ours was 1 at 10:30am and another at 2-3pm for 1 to 2 hours.
I know it works because I had 2 babies on the exact same schedule that changed as they got older but they always were consistently sleeping at the same time.
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I went through this with my son. Visits to the pediatrician and Children’s all determined nothing wrong, just need to bulk him up. At age 6 he’s still only in the 3rd percentile for weight and he didn’t get up there until he was 3.
At 9 months old they had me giving him some heavy calorie food to add the weight. For example, they had me put butter on his vegetables, add carnation instant breakfast drink to his whole milk (I think “pediasure” and “ensure” have a lot of the same content & calories), always put cereal into his formula, and feed him as often as possible, which it sounds like you are already doing. They also had me try to pack on as many calories right before bed as possible. The more calories I managed to get into him, the longer he slept. The lack of calories may be contributing to the lack of sleep.
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We had this exact situation with my son (who is now 2.5 years). He’s just at the right weight – maybe slightly under weight. And, sorry to say – he still doesn’t sleep through the night. He’s up at least once. We just give him a sippy cup of water and that’s enough to tide him over till the morning. What we did was introduce yo baby yogurt (twice a day) – per our dr. recommendation. He loved the yogurt (still does). You can find yo baby yogurt in the organic section of some grocery stores. Others have it right with the regular yogurt. The yo baby yogurt is high in fat (plus gives them extra protein). Make sure you check with your doctor before starting him on yogurt though.
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Pureed avocado
Mashed potatoes with butter or olive oil
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Our daughter didn't seem to be following her curve at that age as well although now at age 2 her pediatrician has decided that's just how she is.
Here are some things we did after consulting with a dietician you might try:
- when you make formula, use 1.5 times the amount of powder in the usual amount of water
- mix flax seed oil into his solids (cereal, yogurt, whatever)
- avocado
He may sleep better if he has more calories in his system...?
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If your baby is “consistently underweight”, unless he has fallen off the percentile chart (unlikely), I don’t see what the problem is. Usually it’s a downward trend that raises flag. Mathematically, someone has to be lower on the percentile list, just as someone needs to fall near the top. There’s nothing inherently unhealthy or preferable about either position.
Here’s a link you might find interesting http://news.bbc.co.uk/2/hi/health/4236229.stm
“Growth tables used to chart a baby's development may be inaccurate, on-going research suggests.
The World Health Organization study found they may over-estimate how quickly babies should put on weight.
The latest WHO study, of 8,440 children from six countries, found that target weights for two and three-year-olds were 15% to 20% too high.
And the charts suggest healthy one-year-old weighs between 22.5lb (10.2kg) and 28.5lb (12.93kg), when in fact the true healthy weight is 21lb (9.53kg) to 26lb (11.79kg), they say.
The researchers say the current overfeeding of babies could explain in part why this generation of adults is the fattest ever.”
You didn’t provide detail, but I’d question the doctor’s bulk—up recommendations a bit further provided as you say, your son is consistently underweight. Maybe seek a second opinion.
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Don’t freak out about it. I was a stick figure basically until I got pregnant at age 29. Seriously, I was 5’7” and 90 pounds in high school (and again in graduate school, but that was stress!) – eating a well-rounded diet, lots of physical activity, just a stick figure. It’s in my genes (I know, I’m lucky). My mother and grandfather are built the same way (and he survived 2 kinds of cancer and lived to age 94 will all his own teeth, so there’s something to that being skinny thing). There’s actually research that shows folks who are way skinny live longer. Doctors are all targeting the mean. You know your kid – offer lots of different foods, and if he’s active, learning, enjoying – don’t sweat it. My best friend’s daughter has been at the 10% percentile since she was born, and she’s now 3 – with no ill effects. It will be fine!
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Hi Brian – While I can’t give too much help on the bulking up front, I highly recommend the following book on sleep. My wife swears by it and it has helped us out a lot. We’ve referred it to a couple of friends who also have had great success implementing some of the ideas.
Dr. Marc Weissbluth "Healthy Sleep Habits, Happy Child”
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Hi there Brian – I’m curious about this b/c I’ve seen a few postings recently about wanting to help babies to gain more weight. My daughter is probably classified as underweight as well – she’s usually in the 10th percentile in weight, but in 50-75% in height at her checkups (she’s 7.5 months). The pediatrician was initially (in the 1st three weeks of her life) concerned, but then relaxed when she saw her own “growth curve” establish. I understand that to be that my daughter is gaining weight steadily at her own rate, though not according to the official infant weight charts. I’m not concerned that she’s underweight, but all these recent questions make me wonder if I should be more concerned?
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My daughter is a pip squeak. Smallest percentile in all of her check ups since birth. She’s only just gained on that and is at 25% at her 9 month visit.
She’s healthy and eats like a line backer most of the time. She’s a happy kid, is hitting all of her milestones.
Why is your dr. saying that he should gain weight? I’m guessing that he may be referencing the percentile chart. Did your wife breastfeed your son? If so, breastfed babies are often smaller and the percentile chart that we all use for a standard is created with formula babies in mind. Our daughter was breastfed exclusively until 7 months then had fomula/pumped milk until 10 months. At 10 months she was at 100% formula.
My daughter is my first born and I’ve pretty much stopped worrying about her size and weight and comparing to other kids. We were considerably worried after she was born because she was so small, had jaundice and was losing weight. We take her to the Dr. for all regular check ups and immunizations so I believe in the medical establishment. But I also believe in believing in what your gut is telling you and second opinions.
I would question needing to add additional weight to your son’s frame unless it truly looked like he was malnourished or if there were obvious health or developmental concerns.
If and your wife are worried about his weight then ask for a second opinion to be sure.
I think that many Americans believe that babies need to be chubby and fat in order to be healthy when little ones like my daughter point to the opposite. My daughter is a svelte and at 15 months only weights 23 lbs or so. The only “chub” that she has is around her thighs.
With obesity on the rise it’s a tough call for the need to feed your son more unless it’s obvious that he wants more. We just go by the push the spoon away indication that our daughter is full. Some days she will want three cheerios, other days she’ll eat a garden burger pattie, 2 tangerines and 3 bowls of yoghurt in one sitting. (seriously!)
By the way, our ped told us that after 12 months you don’t need to give formula, start on milk products and not to worry about other supplements. Maybe once you add milk fats to his diet he’ll begin bulking up a little too. You can’t give him milk now but if he likes avocado that has a lot of fat (good fat) in it.
I think that it sounds like you and your wife are doing everything right. And if your son is thriving that’s all that matters!
You’ll likely be looking up to a 6’5 teen in no time!!
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Butter up the dishes! You might be in a vicious cycle. Tired kids don’t necessarily sleep well. So they wake up tired and are super active and don’t eat well and get more tired and don’t get rested well… You get my drift. Try to pace him a bit and start varying and introducing more solids. Try to catch him getting sleepy before he is overly tired and if you get him to sleep at that critical minute, then he may start napping longer. My daughter, now 2.5, still doesn’t go to sleep easily and gets more and more active if I miss that moment when she is mellow and ‘just ready’ to go to sleep.
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We have been feeding out 7 month old, 7 oz per feeding since he was 4 months old….although he eats every 3-4 hours. Have you tried bigger feedings spaced more apart? Yes, his lack of sleep could cause this as well. We had issues with weight gain for the first 2 months and he was awake a lot more than other babies.
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Could be from being very active. My daughter was like that. Didn’t sleep much, extremely alert and active, and was in the 5th percentile for weight at one year (down from the 80th percentile at birth).
She is a average sized teenager now and I can’t remember exactly when it resolved. I think her weight was normal by 2 or 3 yrs. (after she discovered macaroni & cheese)
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but haveI’m not a doctor had enough experience with all this stuff to at least think that there’s some sort of nutrient absorption problem going on; he may eat all day but if the nutrients aren’t being absorbed properly that can lead to all the symptoms you’re describing – including sleep problems. Keep looking for a doctor that can figure it out!! Best of luck – I totally sympathize – we found gluten intolerance runs in our family…but it took a really long time of active investigation.
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Our daughter was diagnosed with ‘failure to thrive’ and we have battled her lack of weight gain since she was born. She had several other health issues (the biggest of which was congenital heart defects) that contributed to her high metabolism but we were constantly battling the weight gain, non-the-less. Some tricks that we found (with the help of her nutritionists):
• You can actually mix extra formula powder...we mixed her milk using breastmilk (I was pumping all the time) and added the extra formula powder to it. There is a ‘recipe’ to it though that ensures they aren’t getting so much protein that they can’t digest it appropriately, etc. I don’t remember the exact formula but a pediatric nutritionist could definitely give this to you.
• It may be a little soon for Pediasure but we moved to pediasure when our daughter was about 11 months old. This is a meal replacement/supplement that actually provides all of the nutritional needs and is used to feed children that won’t eat by mouth at all (they have to be fed liquids only).
• There’s another powder supplement...I think it’s called Additions and it’s basically a protein supplement. We used to buy it through Option Care (they’re a home health supply company).
• Anyplace you can, add a little bit of melted butter or other high calorie topping for basic calories...to the rice cereal, mashed veggies, etc.. This isn’t ideal for other reasons but is a way to get more calories...
If you are still looking for suggestions, I would highly recommend using a pediatric nutritionist. We’ve used a nutritionist through Children’s hospital and they were great. They can also help determine if maybe your baby is just a small baby or if there’s some other reason for the high metabolism. I hope this helps.
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We had a similar issue with our son – we didn’t want him to just get fat…so we started adding “healthy” fat to his diet – for instance he loved whole wheat bread – so we started giving him that with olive oil – lots of calories but much healthier. We basically found as many ways as possible to add olive oil to his diet – and now he loves olive oil as much as butter – which is good! It is also good on pasta too.
Good luck – our son is now 5 and he is in the 50th %.
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sounds like you have quite the active little guy! My 19-month son was/is also on the slim side and for quite a while was in the 15-20th percent on weight but 80-90% on height. Here are a few thoughts .... First, eating every hour is pretty frequent for a 9-month old. Feedings should be at least 2-3 hours apart by that age, and he is physically able to sleep 8-9 hours w/o a feeding. Maybe he's eating less at each feeding because he's not all that hungry (since there's another feeding right around the corner). His short naps might also be contributing. At that age, babies should be getting 12-14 hours of total sleep per day, sometimes more. If he's really low on the weight charts, there are enriched formulas w/ more calories, but that should only be a short-term solution. I think they're by prescription only (we didn't use them). One idea to eliminate the nighttime feeding is to substitute water for the formula. They get really cranky about that and it takes a few nights, but eventually they realize it's not worth waking up for. I was nervous to cut the nighttime feeding because I didn't want to take those calories out of his day --- but he did just fine, settled himself down after 10 minutes or so (we generally don't go in until 10-15 minutes have passed when he wakes up at night), and generally ate more during the day to wake up from it.
Also, make sure you're using a nipple with a bigger opening; he could probably drink more than 4-5 ounces at a time by now; flow might be an issue. Am assuming he doesn't have any other health issues that prevent him from consuming greater volumes (reflux, etc.).
Good luck to you --- most importantly, if he has enough energy to be an active kid and is overall pretty healthy, don't worry about it too much.
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I am not sure if you should worry about this. What does your pediatrician say? He is too young now, but at 1 year, you can start giving him cheese slices. I liked this idea a lot, because as they grow they can use the low-fat versions. It is a good source of protein, calcium and will help him gain weight. Whole milk is also good (from 1 year).
My kid was in the 20-25 percentile. Now, he is between 50 – 75 percentile. I would attribute it to dairy.
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Have you been giving him any wheat based cereal during this time? It’s a long shot – but if you have – you might want to get him tested for gluten intolerance. That can cause low weight and height. The lack of sleep may be something to be concerned about – it may be a sign of some other sort of allergy or health condition. From what I’ve read babies and small children need at least 12 to 14 hours of sleep a day for good brain and physical development. Not trying to cause alarm – just the 4 hrs. per night part doesn’t sound good.
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Hi Brian, you might try Similac Neosure. We used this with out preemie twins to help them gain weight – it’s a formula w/ a higher calorie content. http://welcomeaddition.com/product9.aspx
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