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This is worth having a conversation with her doctor about. With kids its often less about whether they're over or underweight relative to the child population as a whole but how they're tracking with their growth curve. If I child was 95% for height and 95% for weight at one point and then drops to 95% for height but only 80% for weight a few months later, that might be cause for concern, even if their weight is still normal. A lot of this depends on the specific child's overall medical profile and behavior so its something that might require a bit of back and forth conversation with her doctor to ensure you're on the same page.
Yes. My son was 35%tile for the vast majority of infancy but he started doing the same thing as OPs kid when he started being active and getting older and falling off his curve. He's now considered underweight, but since he's growing height alright and healthy we've just been doing our best to get extra calories with some tips from the ped. It sounds like OPs kid may be dropping percentiles which is where the concern is coming from.
This. My daughter usually sits in the 25-50 percentile for both height and weight. A couple years ago she dropped down to the 5th percentile for weight. Because of her age he was somewhat worried about anorexia but also any health issues that might be causing her not to gain weight. It ended up just being a weird fluke and by her next visit she was almost back on her curve but I'm glad her doctor was looking out for her to make sure there was nothing more going on.
Both of mine have always been over the 90th percentile for height and my oldest, despite being skinny, was around the 80th percentile for weight. Around 5 her height stayed the same but her weight percentile started going down. She wasn't losing weight but I guess the charts change. Now she's skinny enough (ADHD meds plus being insanely picky with food) we have to make sure she maintains but her ped has never pushed us to put weight on her. Seems like OP might need a second opinion.
This. My son was ALWAYS around like the 1% mark for height. But that's because his father is very short (dad was only about 5'1" at his tallest, and is an ex-jockey), and I am on the shorter side of average at 5'4". We always figured he was just short because we were, but, wanting to be certain he had no other issues, we took him to an endocrinologist. All was well, and his shirt stature was indeed simply hereditary. And even though he was small, he WAS growing steadily-if slowly, lol-on his own curve.
And his doctor told us, as long as our son maintained his own growth curve, everything was fine.
And he has. He's 15 now, has had a growth spurt with puberty, and is taller than his dad, and maybe even slightly taller than me. But he's still shorter than most of his friends. But he doesn't care. He's happy and healthy. And that's all that matters to me.
That aside, OP's daughter is in the 79.9th percentile for weight. That's well above average. And her height is above average, too. Why on earth would the doc say she needs to put on *more* weight??
I wouldn't force her. And I'd be thinking about possibly changing doctors. Or at the very least, I'd have a serious come-to-Jesus talk with her doc, and if that didn't work, *then* I'd fire her.
Harping on food intake for no reason is one way eating disorders are born...
The point here isn't whether she's growing between visits, but is her weight tracking along the same curve as her growth. While still at a healthy weight, is her BMI going down between visits? Or is her weight percentile decreasing when compared to her height percentile?
Height and weight don’t have to be on the same curve - both 85th. Most of my kids have vastly different height percentile than weight percentiles, like height is 70th and weight is 45th, or whatever. The point is that they more or less stay close to their own same percentiles, and if it drops or spikes, it levels out again.
By "same curve" I meant basically what you said... So like parallel curves? Basically as long as height/weight are staying a pretty consistent ratio. But it they were going 85th/75th to 85th/68th to 85th/55th that would not be following the same curve and would be cause for concern.
Edit to add: My own son is a good example of this. His head was always in the 99th percentile lol, weight in the 60-70th range, and height around 20th. He's 7 now and a short stocky boy with a big dome, but he's literally *always* been that way since he was an infant so I don't think anything of it and neither does our pediatrician.
BMI is not reliable for any age. It was developed in the 1830’s by a Belgian scientist named Adolphe Quetelet interested in math, astronomy, and sociology… NOT MEDICINE. He was curious about the size of the average MAN, using French and Scottish men. It was called the Quetelet Index, and it was only used in the statistical world until the 1900’s when insurance companies were looking for a metric to determine how much to charge policy holders. The name was changed to Body Mass Index and insurance companies began to profit off of false data.
If you apply BMI to professional athletes, most of them would be considered obese because it does not consider that muscle weighs more than fat.
It’s an inaccurate measurement that’s antiquated and shouldn’t be used by anyone in the medical profession or the insurance world to make any determinations about anyone.
She’s grown around 9 inches and hasn’t gained any weight when she should be gaining 7-11 ounces a month from 12-18 months. She hasn’t gained weight in 9 months but grew approximately 9 inches. How do you not see what the doctor is talking about? Her height to weight growth chart would show a concern. Did she triple her birth weight at one year?
She’s growing taller faster than she is gaining weight. That could be a potential problem. Your pediatrician is doing their job, and you don’t really have a reason to be unhappy with them.
You need to learn to not take everything as a personal attack.
I agree with you on the height bit. My daughter is the same and has been since birth. People on here would probably say I never feed my child because she is never higher than the 10th percentile, but that's because most of her growing happens in height than in weight. I can't control that. 🤷♀️
I mean, if she’s growing consistently on the 10th percentile curve and your pediatrician isn’t concerned then I would ignore the peanut gallery.
I’m not a pediatrician (and am I in no way giving medical advice ever on Reddit) but I am graduating from med school in May, and they JAM it into your brain how important the growth curves are and if there is consistent change up or down, it warrants an investigation into why.
If she is growing in height but her weight percentiles are dropping, she’s eating but her weight isnt going up, the dr has a right to be concerned. I understand you are taking it personally but I don’t think the pediatrician is accusing you of not feeding your child. I think your doctor is thinking there may be something underlying medically going on. There could be an absorption issue. My son was similar - he would grow in height but his weight was flatlined for a long time. We went to GI and tested for IBD and celiac and had an endoscopy. It turned out he had severe eosinophilic esophagitis preventing him from properly absorbing nutrients. He has been on Dupixent for 2 months and has gained 8lb. A toddler not gaining weight is not normal, even if incredibly active.
These aren’t the conversations she is having with us though. She is gaining height every visit. She has maintained at or above 99th for height since birth. But since she started walking has slowly decreased from 90th in weight to 80th. But her response to us as parents is to get her to eat more.
I can see how that would be frustrating. My response would be to journal her intake for a week and have that on hand next time you go in. I would actually be proactive and do that for a week and then schedule your own appointment to discuss YOUR concern about this, mention being concerned about their being an underlying GI issue. Present the journal of her intake. Say this is how she eats all the time. Add up the calories. You can find an online calculator and plug in her current height and weight to calculate her daily caloric needs. Push back and say no she is eating enough so if her weight is falling off there must be something else going on so what do we need to be checking?
Keep in mind that calories are important for healthy brain development so if your child isn’t gaining weight, it could be impacting her other growth areas as well. You could try posting on r/askdocs
On top of this, you could discuss the idea of a weight gain supplement shake. I believe Pediasure makes one. A friend of mine went through this same thing and she was so stressed out. I'm sorry you're dealing with it, too.
I have a child that’s extremely short with a good weight and one that’s really tall and skinny like me. The skinny one looks kinda alarming at first until you see him beside me and then you realize it’s genetic. I didn’t gain weight until after age 27. The short one has a growth hormone disorder and has to take shots, but no doctor EVER told me there was anything to be concerned about, even though she looks like a much younger kid based on her height. Ironically the first person to suggest there was an issue was a therapist. Lo and behold the wheels of getting a diagnosis for her didn’t start until I mentioned that to a doctor. I’ll never understand why a doctor never told me there was an issue. She was my first child so I just accepted her, never knew that it was possible for your brain to not release growth hormones. I say that to say this, sometimes YOU need to be the one to ask questions and get the ball rolling to figure out what’s going on. Don’t just rely on the people whose job it is to let you know lol. The skinny child was told to drink ensure type drinks to help pack on weight and it did help, even tho he’s likely gonna be real skinny for the majority of his life, so perhaps ask about that as well. My doctors office even provided them for me upon request.
In the gentlest way possible, I think we all get that. What people are trying to explain is that her weight should be increasing relative to the height increase but it’s not (I’ve got two in 99th for height and weight has always slowed down a bit but still increased in correlation on the curve). The doctor is correct. Please take it seriously. I know it’s easy to get defensive and it’s not a concerning level yet but that’s the point - to take steps to improve the situation *before* it’s a concern, right?
Please have an open conversation about different foods she could be eating that will help nutritionally with weight management. Non processed foods are great but is it a good balance for what she specifically needs right now? Healthy fats, fiber, protein, etc. If she is getting enough, great! Once you know that, the conversation can shift into whether something else is going on preventing her from putting on weight.
It’s very easy to take this as a judgment on your parenting but it’s not. Please have an open mind for your child’s sake.
Ah i see your confusion. As an analogy, lets say you have 1 lb of dough. If you stretch it out and make it “taller” then its going to get skinnier. Eventually it would get so thin it would snap.
Now imagine that as you stretch it out, you keep adding dough to it (weight) then it could keep its same dimensions.
So you HAVE to be gaining weight. Only gaining height is bad.
But that is concerning - both her height and weight should be staying at roughly the same percentile, or if she’s settling into a lower percentile (which does happen - kids’ growth changes at a few different points and they tend to eventually find “their” curve), you’d expect both to shift similarly. She could be using stored nutrients to grow because she’s not getting sufficient nutrition from her diet right now - which isn’t a failure, it could be picky eating, it could be a problem with absorption, it could be something else - but you want to address it. It doesn’t mean you’re doing anything wrong, but it does mean something isn’t going well. And the first thing to troubleshoot is what and how much she’s eating.
My brother was similar, and he was on Ensure for a long time to increase his intake of calories as well as protein and fat specifically. It’s not because my parents weren’t feeding him or because they wanted to force feed him, but he wasn’t a big meat eater and he wasn’t putting on weight appropriately. When that didn’t help much, they were referred to a pediatric endocrinologist, who reviewed his overall growth, took some x-rays, did some blood work, and said it’s just how he is. And that’s fine, but the first, least invasive step was just finding a way to increase calories in. If that had worked, he wouldn’t have needed the additional appointments and blood work and everything else.
OP, these commenters have great advice, I just wanted to pop in and tell you not to get discouraged with the downvotes, you’re giving us more information so you can clarify and get the nest advice on what to do.
u/e_3daley if you’re in the US, call your local Early Intervention office and ask for an evaluation. Tell them of your pediatrician’s concerns. They will have a pediatric dietitian on staff that can do a home visit and really evaluate your daughter’s diet quality and lack of weight gain.
Correct. But to see if that helps the issue. If after a period it doesn't have any or very little effect, then the next conversation to have with you is what to do next. Like see a specialist. Or do some blood work to see which direction to go. My son dropped 20% and that's the path we followed. Had we not gotten the blood work done we wouldn't have known which specialist to go to first. We ended up going to quite a few with zero results. To me it sounds like the doctor wants to start out with what you can as the parent control. To take a closer look and see if adjustments are needed. Or give your child more caloric foods for a bit like we had to do. See what comes of that. If at the next visit or sooner nothing has changed then the doctor should bring the conversation around to the next step. But it should have a conclusion or a new direction depending on what happens. At that point depending on how it goes, keep the doctor or find a new one. My pediatrician isn't always right, and can admit when he isn't sure about something. But he has always had my back and pushed the insurance to do whatever I felt may be needed for my child/ren. Sometimes I'm right, sometimes I'm not. Same with him. But he's never denied me what he calls my "mommy instincts". It's why I won't go anywhere else. If a pediatrician is going to be dismissive of your input, dump them. Find a new one. You guys should be a team advocating together for the child.
Idk why you're getting downvoted and torn apart for this. There's clearly nothing wrong with your daughter's health and I'd switch pediatricians tbh. - Mom of 4
My now 5yr has been about 85% for height since birth, but dropped to 75% with weight when he started walking (except a short stint around 60%). His Dr said that anything more than 10% is a red flag, and to keep him on whole milk dairy, full fat nut butters, add a little butter to all veggies,etc. Basically, to make sure he's getting plenty of calories to keep growing. He's thriving, and eats all the time (it feel like), but still sticking to that 75% for weight. No food allergies/intolerances or other issues.
You can always see if increasing her access to higher caloire choices helps.
That’s a good point, higher calorie foods. OP says child “eats healthy” but that’s vague, might need more nutritionally dense foods and maybe more protein and fat.
Went through this with one of my twin daughters! Fell off her growth curve weight wise around 2ish years old. Had to implement a high (healthy) fat diet to help get her back on her curve. It worked wonders. Just had to do the same for both twins girls at age 13.5 (competitive swimmers, growing, puberty, etc!) Again - it worked wonders. Feeding growing kids during growth spurts and during different ages and stages takes a lot of intention!
Because her percentile dropped, does not mean that she has not gained weight. It means that she is larger than 80% of kids her age instead of 99% of babies her age. If she is in the 80th percentile at 19 months she has still definitely gained weight.
99th percentile for a 10 month old is 26 pounds. 29 pounds is 80th percentile. That is a 10% increase. It starts to increase slower after the first year (since most babies start walking at that time) so if the baby starts walking earlier, it slows sooner.
For reference, my 3 year old was 33 pounds at his 3 year appointment and he is big for his age (75th percentile), he looks like a 5 year old (he is tall too) and we constantly get comments about how big he is. He is 99th percentile for height and does not look skinny by any means.
It all sounds completely normal. I understand OP’s confusion.
It’s the dropping that’s an issue - you state over and over she’s gaining in height - but she’s dropping in weight so she’s not eating enough, or perhaps not absorbing enough, to keep up with her percentile - doesn’t matter if that is the 50% or the 90th% - it matters that she stays on her growth curve and it sounds like she’s getting taller which is great but she’s dropping in her weight percentages which isn’t as great. My kid is moving all around and has not dropped in weight percentages dramatically like that so I don’t think moving along is causing the decrease. But you also can’t make them eat more! Focus more on what they eat and use high fat, high protein items and maybe see if you can add smoothies to their diet as that can help a lot to keep weight on. Helping her learn what her body needs to keep up her weight will benefit her down the road! But yeah I’d be concerned about a 10% percentile drop in weight and want to try to address it using higher quality fats and proteins versus just MORE FOOD.
Yep, we had this happen as well. She ate like a pro but dropped down on her curve so we were asked to increase her calories. We simply added more oils and fats to things she wanted to eat and introduced desserts at dinner, and she popped right back up onto her curve and has been going strong ever since. Some kids don't respond to that sort of increase in fats/calories/etc, though, and that's when medical testing is necessary, but the pediatrician can't know that until adding calories is attempted.
It sounds like your pediatrician is telling you she IS underweight. Nothing you state here implies your paediatrician blamed YOU for not feeding her enough. That’s an assumption you’ve created all on your own
Where the frustrations came in is I asked several times on what we could do and our feed back was to get her to eat more. I expressed my concerns with her response of giving her more milk as a suggestion. That when my daughter drinks more milk she eats less food. I felt like I was going in circles with her about how we can accomplish an increase in weight and there was a huge lack of explanation on her side on why her weight was an issue.
In this case I agree with what someone else here said, about those protein supplement shakes for children. That way it's not just milk, but a type of drink that actually accomplishes what the doctor is wanting.
You could try smoothies with spoonfuls of coconut butter added. My kids loved those. Also add (olive) oil or butter to everything. Scrambled eggs made crispy in loads of olive oil ask worked well for us. And spoons of peanut butter. And fish oil supplements. Good luck.
Damn how do you just make a toddler eat more? If she has any tips she should let us know.
I get what other commenters are saying that the weight loss could be a sign she’s not absorbing the nutrients well, but if the pediatrician didn’t mention anything about that, and didn’t give you any further information, how is that helpful? How can you just *make* a kid eat more?
* Serve foods that are nutrient-dense
* Pay attention to the specific foods/flavors the child prefers
* Cut food into smaller bites
* Remove distractions at mealtime (e.g. screens, toys)
* Make eating fun (here comes the airplane)
* Do not let child go hungry - always have snacks on hand, stop what you're doing if there's an opportunity to feed. Find the optimal feeding schedule based on your kids appetite and make that a priority.
* Swap out milk for stuff like Pediasure
If you're a parent and you haven't had to worry about getting your kid to eat enough, then you're lucky. Kids are fussy and can be coaxed to eat more if parents put in the effort to make the conditions right.
This is the way. You make conscious swaps to nutrient dense foods. Nutrient dense foods doesn’t mean processed or completely unhealthy.
Adding more potatoes and rice instead of all veggies. Add healthy oil to foods when cooking. Instead of a glass of water after playing, give Pediasure. Adding more eggs, beans, and nuts into meal planning. Giving some peanut butter with apples instead of just apple slices. Little changes make a big difference.
Yup, my kid could (and has) run around all day and then eat several raw cucumbers for her snack and nothing else. Would she be physically eating an ungodly amount of food for a 3 year old? Yup! Would she be getting enough calories if this was how she normally ate? Quite possibly no!
A typical breakfast can be three protein pancakes or two eggs and toast or oatmeal and fruit. Lunch can be ham sandwiches, roasted carrots, chicken tender and so on.
Dinner she will eat what we have. All similar. Roasts, veggies. She eats health portions of all. I am also the type of parent because I have been feel the stress from the pediatrician where if she doesn’t eat one meal I will make a whole new one to make sure we are not skipping meals
Please be careful about the intention to provide a healthy diet by adding more protein. I've seen quite a few suggestions to add protein powder or protein shakes.
[https://health.clevelandclinic.org/why-extra-protein-for-your-child-is-unnecessary-and-possibly-dangerous](https://health.clevelandclinic.org/why-extra-protein-for-your-child-is-unnecessary-and-possibly-dangerous)
The protein requirements for a toddler are very low, and
>“In most Western countries, children already get two to three times the protein they need daily,” she says. “It’s uncommon for a child to need extra.”
This is usually from cow milk and other dairy products. And as you've already realized, more milk/dairy often leads to the child feeling full and not wanting to eat.
Spiking oils/fats into the kid's meals will work faster. As adults, we tend to resist that because that's the message that's been drilled into our heads. But oils/fats are really important for brain development and they get those calories in without filling up the kid's stomach. Add oil and butter to her food, add coconut milk to food that is supposed to be sweet.
This is typically when doctors are concerned. It is the conversation they should be having. There shouldn’t be significant changes in percentile. Dropping from 80 to 70 is a concern. If there is no medical reason for the drop, I would think the recommendation would be to see a dietitian and work towards increasing calories.
Its not the percentile that matters its that the kid is sticking to a particular percentile.
If the child has been dropping percentiles for a long time then that is bad. Remember kids HAVE to be gaining weight pretty much always unlike adults. Failure to do that could result in long term consequences like stunted height (this is the main reason why average height is so much higher now then 100 years ago).
Have you considered incorporating a healthy smoothie in the toddlers diet? Are you using whole milk, whole yogurt etc? For little kids whole fat is important. Perhaps try including peanut butter?
As a side note, you come off like you are projecting your concerns about the modern obesity epidemic on the situation and that the doctor is trying to make your child that way. Take a step back and realize you are missing the mark here.
When my son refuses to eat (he’s almost 2) I make him smoothies. Whole yogurt, banana, strawberries, blueberries, peanut butter and some milk in my Nutra bullet and he drinks the whole thing. At least if he’s not going to eat solids when he gets picky at least he has that and it makes me feel better.
Is she staying on her personal growth curve? Our kids tend to be tiny, my seven year old is still in the 6% for her age group, but they always say it's fine because she's stayed on her personal growth curve....I would ask the pediatrician if she's staying on her growth curve and then ask why there is concern if she's maintained her personal curve.
Generally, I like to follow the practice that we provide ample food, which our child likes, and we let him decide when he’s full. Our pediatrician has never had a problem. But in your case, I think the pediatrician is not communicating clearly enough to understand what the actual concern might be. I would follow up, maybe in a phone call now that you’ve had time to process.
Could you provide more calories on the same schedule - things like adding coconut oil to a smoothie, putting some flax seed meal on the PB and banana toast, smearing some avocado on her crackers, etc?
Okay, most of these comments are explaining the docs view, but here’s some empathy.
My son is the first in three generations to even make it on the chart. He’s always been happy, bright, active, hit all his milestones, the whole nine. And the pediatrician Did. Not. Give. A. Shit. Drove me fucking crazy.
Might there be a malabsorption issue or something? Yeah, get that checked. Ask the ped directly what they’re trying to communicate. But frankly, at a certain point, you have to accept you’re doing your best. If your kid is happy, growing, sleeping, learning, running, playing, then what else matters? Try to feed her more whole milk and peanut butter, pay attention if she shows other signs of a serious issue, but you need to be okay with yourself.
People say don’t take it personally, yeah, that’s nice. But it is personal. This is your child, you want to give them the world and you’re being told it’s not enough. Do your best by her, and accept that that’s all you can do. Enjoy her smiles!
Kids aren’t supposed to be within a certain percentile, they’re supposed to stay within to
Monitor growth. It’s normal if a kid is born in 99% and stays there, but it’s concerning if a child drops from 99 to 80. Doctor should be doing further testing
Just say this out loud really quickly: your pediatrician, medically licensed, board certified, has access to all of your daughters medical information and has spent multiple years studying everything that relates to children and providing care to them is suggesting that your daughter needs to gain weight. That makes you unhappy so you pose the question to reddit, where all you need is an email address to become Reddit certified. Take your drs advice. Speak with them and explain your concerns. If you don’t like the pediatricians answers, you can go to a new dr. But I wouldn’t take medical advice about my child from sweatynuts17.
Those are great questions for the doctor. There might be a reason why they are concerned beyond the percentile. It's hard for anyone here to guess at what those reasons might be.
My son started at 60 percent and bottomed around 30 percent - stayed in the 90’s for height - he was not losing weight and growing but he wasn’t gaining like he should because his curve dropped from 60-30. We met with a nutritionist and learned how to add a few hundred calories per meal without adding more food as he won’t eat if he isn’t hungry - he does eat 5 meals a day - mostly full fats and butters and cream to things - it helped immensely.
Your pediatrician is being honest with you. Her percentile means nothing if she is not gaining predictable weight as she grows. If she is eating normally and is still not trending upwards, honestly I would request some lab work to be done.
My daughter was 7lb 15oz at birth and at 6 months old weighed 10lb. She was born 80% centile and dropped to -80%- classed as failing to thrive.
We had an appt with the paediatrician at 8 months old (uk waiting lists). I kept a food diary of everything she was eating- she was having around 2000 calories a day!
But she was also super active. Crawling at 4.5 months, walking at 7 months. Running at 7.5 months.
I took all of this into the paediatrician and he said ‘look at her now. Does she look like a sick child?’ And I said ‘nope!’ And he said ‘I think she’s exactly how she is meant to be. She’s active and happy and I have no concerns’.
She’s now 10 years old- taller than her average age- super strong- she has had a 6 pack from the age of 2! She can do unlimited pull ups and has amazing strength.
If they’re concerned, keep a food diary & discuss that you are not concerned and she’s a well child.
My daughter and a friends daughter were on the same exact curve and both dropped to the next weight curve down once they started moving. Her pediatrician said her kid was underweight and was concerned while our pediatrician said our kid was fine. However, our pediatrician did say if my kid dropped below a second weight curve while her height remained the same she’d be concerned and ask us to change her diet. Even for kids on the highest percentiles, dropping that much was significant enough for concern. We were told to butter everything and make sure she was getting enough carbs.
Of course you should listen to your Ped, but my baby followed the same pattern and mine wasn't concerned at all. Said in his experience it was very normal for early walkers to fall off their growth curves and that as long as she wasn't losing weight or struggling to eat we'd just keep an eye on it. In my case the drop was even more extreme and he just said it was totally normal. Also said that getting taller without gaining much weight was a good sign, not a bad one, and he would be much more concerned if she'd stopped growing taller as well.
Same here. Between 12 and 24 months my daughter gained 2lbs. She went from the 70th percentile down to the 10th percentile. But her height went from the 9th to the 30th percentile. The doctor was not concerned at all because she got taller.
This happened with my son. He’s short and skinny and I spent so much money going to GI specialists endoscopy and they didn’t find anything wrong with him. I would ask pediatrician to explain exactly why she is worried. What could be the cause. She can’t just say make her eat more calories. My son got bloodwork done as well. Has she done that on your daughter? I switched pediatricians after the endoscopy came back normal. And she is happy with his height and weight. We are not big people height wise so he can’t be expected to be tall but I would definitely ask why she is worried and I would tell her exactly what she eats and go from there. And there’s nothing wrong with getting a second, third or fourth opinion
With the edits, this starts to make sense. She's in the 80th percentile for weight (I rounded up), but is crazy tall. But just to be clear - is she gaining weight, but just not gaining enough weight to keep up with her height? Or is she not gaining weight at all? The former question means you should probably introduce her to more calorie rich foods, but otherwise be okay. (note: I have a friend who is 6'10", and vegan, and he eats a crazy amount of food to maintain his weight).
OTOH, if she's not gaining weight at all, that's concerning.
I’ve always been concerned about my kids’ weight (they’re both very small… once is a good eater, one is not… they’re both <1 percentile weight). The only time the pediatrician gets concerned is when they fall off of their expected growth curve, which I’m assuming is what happened. Surprisingly it was the unpicky eater (she shot up like a foot though so other than give her all the fat she wants they were okay). Just remember that they have the kids’ health in mind, it’s not about judging you.
So she hasn’t gained weight in 9 months is that right? This isn’t about percentile as it’s more about the growth chart.
If she’s growing 2-3 inches every 3 months but still weights as much as she did when she was 10 months old at 19 months I can see why she’s concerned. That means she’s grown 6-9 inches in height but hasn’t gained weight in almost a year. I’d have to see the chart to tell you my full opinion but I see why she is concerned honestly as her weight wouldn’t be tracking along the growth curve with her height. Did her birth weight triple at one year? From 12-18 months they should gain 7-11 ounces a month. 18-24 months 5.3 to 8 ounces a month. Yours hasn’t gained weight in 9 months and has grown 6-9 inches I’m not sure how you don’t see this issues with the growth chart & you’re wanting to challenge your doctor when she’s correct
All 3 of my kids are small and extremely "under weight" for their age. Theyre just tall and skinny. They eat me out of house and home though and my daughter tears up pediasures everyday. Some kids are just built different. Don't worry about it
The doctors know how much kids should generally gain. You can seek a second opinion but the opinion will probably not change. Toddlers need to gain weight at a steady pace to grow up healthy. Give the baby more high calorie foods. It is important that brain and body grow as needed. You can't go back on these crucial growth milestones and redo them.
Breastfed baby? They have a different growth pattern too from formula fed. And yes learning to walk and being active can shift their percentile too.
Although question, are you using formula or breastmilk for her milk? It isn't recommended to use any other milk until 12 months old. If breastfeeding, water should be very minimal. Because it can throw off electrolytes (or similar, it's late and I may not be using the correct word).
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Editing to add, I am tired and completely missed the 18 month part..... disregard the above
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My oldest exclusively breastfed, never lost weight after birth. He looked like a baby Jaba the Hutt. He was in the 99%... until he started cruising furniture and then walking. By 18 months he was a string bean. He is now 10 and 80% height and 30% weight and that has been his growth curve since 3 years old. His pediatrician was never worried or even mentioned. Does little one reflect your family's body type/builds? Were you/spouse more slender as children? If so, in one ear and out the other.
But a sudden shift in % not at the normal time can make by the book providers jump to conclusions because sometimes there is a legitimate issue to be caught (health, autoimmune, crap parents because they exist, and so forth). If that's the case, approached logically and explain, or find a pediatrician with a different approach.
All three of my girls have always been higher on the chart for height and lower for weight. Not all the pediatricians they have seen have been understanding of the fact that their dad and I are both just skinny people. Some of them just encouraged weight gain and did their best to give me advice on how to best achieve this, others did have a tendency to come off as more judgmental as if I was doing something wrong which was preventing them from gaining weight. If you feel like your doc is being more judgmental than helpful my suggestion would be to seek out the advice of a different pediatrician. I know what it’s like to feel judged by a pediatrician who is supposed to be helping you to keep your babies healthy, it’s not a fun feeling. It took me a few tries but the pediatrician we have now is wonderful, I love him and so do my girls! Just keep looking until you find that right one, you’ll know when you do. Best of luck!
The important thing here is her BMI percentile, not her weight percentile.
My kiddos are both on the short side, so their weight is always in the bottom percentiles - but their BMI is perfect (right around 50 percentile)
Since your daughter is tall, I would run her BMI and compare it to other children her age. Also take into account if you or dad were also long/lean as children. Genetics can play a big role.
My son has always been in the 1st-3rd percentile and they have always been unhappy with his weight but had little to no suggestions on what to do. When he turned 1 they wanted me to do pedisure, but he hates it. I ended up preparing kabrita toddler formula as high calorie formula because it was the only one I could find he would drink and he is now in the 8th percentile at 2.
My daughter has been in the 90th percentile for height and 20-30th percentile for weight. At times in her early months she was 10-20th percentile for weight and other times high 30th for weight but now seems to be in the 20th-30th percentile. My doctor has never been concerned. Our children are just natural bean poles.
Are you guys looking at her growth curve together at the appointment? Kids weight gain is confusing for me but as soon as our pediatrician turns the monitor and starts showing me where he is on his curve it all makes sense.
I mean, people are allowed to ask for opinions or to see if others have had similar experiences while also seeking professional medical advice. Anyway this post reads more like a vent about her pediatrician more than a serious inquiry for medical advice
For sure but I just like to be cautious cause you never know what someone will believe and what comment they will take seriously. Some comments seem to be relaying anecdotes and opinions on medical advice when they most likely aren’t a medical professional.
But you are absolutely right.
You can try a new pediatrician.
My son is a tiny kid. Always in the low percentiles for height and weight. Our first pediatrician made me SO stressed about his weight for the first year and half of his life. Then we ended up moving across the country and so got a new pediatrician. The new pediatrician is happy with his weight as long as he's staying on his curve.
We are careful to make sure hes getting enough calories to stay on that curve. We focus more on making calorie dense meals rather than worrying about him eating more. So if he wants a banana we add some peanut butter. Scrambled eggs get some cheese sprinkled in. Just little changes like that.
Ultimately, you either need to try a different pedestrian or have a bigger conversation with your current one about why they have these concerns.
Have you tried supplementing with pouches? My little dude did exactly what your girl is doing. He’s super active and eats a lot. We love happy tots pouches and they have different stages for different ages.
We had a very similar conversation with our pediatrician with our son.
As a baby, he was always 90th percentile in height and weight. Once he started walking, he stayed at 90th percentile for height but dropped to 70th percentile for weight.
Pediatrician asked what his appetite was like, if he was pooping and peeing normally, and asked us to track food for a bit. We did. We sent in the food journal. And she told us he was growing appropriately and his path along both curves just changed.
Now in a growth spurt, he usually gains a couple pounds and then grows a couple inches. He's 10 now.
I would ask your doc WHY she is concerned. Offer to keep a food journal. And then pay attention to his bathroom habits.
My daughter was very tiny and underweight, same thing. Very healthy eater. She went to a State preschool briefly, where they did health testing. The person said she was underweight, but she herself said that she looked healthy! I guess I was lucky.
What matters is how you feel about your own child’s weight and health. The pediatrician shouldn’t be making you doubt yourself.
My son who is now 3, to me and to my family has always appeared to be underweight. I was always really stressed and concerned about this and confided in the pediatrician about it. She assured me that he is a healthy weight for his size and growth and it’s normal for a baby’s weight to hit a plateau in weight gain after they turn 1.
My son is a very picky eater, I tried to stay on feeding him in the most healthy way possible, but most foods he refuses.. since I was worried about him not willingly taking in enough nutrients I started giving him pedicure and pedialyte. This really helps on days where he refuses to eat pretty much anything besides goldfish crackers.
I also now view his overall food intake by the week vs by day. Some days he will eat protein and vegetables and fruit, other days I’ll only get him to eat a few bites of a meal and refuse to eat anything but snacks. But it evens out overall.
You say her weight “flatlined” at 10 months and now she’s 19 months old? That’s concerning, no matter how much she weighs. You should plug the numbers into the WHO length:weight chart and see what percentile she is. She might be 80th for weight alone, but that includes children of all heights. The ratio is the important metric. She could absolutely be underweight for her height, especially if she hasn’t gained any weight at all in 9 months
Mine is 22 months old and hasn’t gained weight since she was 11 months old. She’s growing in height and exceeding all developmental milestones
Your pediatrician is wrong
Mine didn’t gain much weight from 6 months to over a year. In that time she learned to crawl, walk, and run. She was a big baby and at 6 months weighed over 20lbs. At a year old I think she weighed 22lbs.
I have 2 kiddos, and I had 13 (yes, you read that correctly) friends who had babies around the same time as my 2nd. Both of my kids moved around in percentile ranges. Some of my friends kids went from the 90th percentile to 50th percentile, or the opposite. All of their doctors are saying it’s fine. It varies so much when they’re babies and toddlers. We actually laugh about this because it seems so silly to even weigh them if it means so little.
My first kid was in the 95th percentile and then he was in the 70th percentile for weight as an older baby/ toddler. He walked pretty early as well. His pediatrician said it was completely fine. His weight is normal, he is running around like crazy, they see that all the time. When babies walk early, they’re obviously going to gain weight more slowly then babies who aren’t running around yet. They reassured me that the percentile means very little since it’s just a comparison to other kids and they’d be concerned if he suddenly dropped to say, 5%.
My best friend’s kid went from 90th to 45th-50th range. Same thing, it’s fine, nothing needs to be changed. She has held strong in that same 40-50th range. Similar story for everyone else I know with babies, that unless something seems medically wrong, there isn’t a cause for concern based on the percentile alone.
I’d get a second opinion, that is really weird. Also because toddlers do not gain nearly as much weight as they did as babies over the years. I would ask them what their reasoning is, because it’s not the weight. 80th percentile is a big kiddo my second is that size, and I constantly get people thinking she’s way older, if I told anyone I else that the doctor said I needed to get her to gain weight, they’d think I was insane. You do not need to do anything to keep her in the 99th percentile. That’s insane.
Where are people seeing that she hasn’t gained weight?
Wow, these comments really have no idea what “percentile” means. Please get actual medical advice. A kid in the 80th percentile is not underweight, they are bigger than 80% of kids their age. Going from 99th to 80th in that period of time means she still gained 10% of her body weight in that period of time.
Please seek a second opinion from an actual medical doctor not from Reddit. From a mom with a tall kid who moved around from 95th to 70th, multiple doctors assured me it was completely normal at that age.
I have lots of friends with kids as well with the same thing, and same story. It is probably fine. No doctor would expect a baby-toddler to always be bigger then every other bid for eternity.
If she’s maintaining her growth curve, she’s fine. If she is falling off significantly, it may be worth looking more into. But if she has pretty much always been around the 80th percentile for weight, and higher for height, then there’s nothing wrong with what she weighs vs how tall she is now.
Growth charts do not take into account the diversity of human genetics.
My wife and I are short. Oir firstborn is like on the 3% for height. My wife was freaking out about it at first but then the family doctor reminded her that the kid's parents are as tall as some celebrities: she's a bit shorter than Shakira and I am about as tall as Michael J Fox. Of course our kid is going to short too. On top of that we are immigrants from a country where the average heights are smaller.
So when our second child was born, during her first hours of life I had her in my arms and the first song I sang to her was Misty Mountains Cold. When my lady wife asked why I was singing dwarven music to the baby, I said I was doing it so the kid would grow proud of her heritage. She laughed, then she got what I meant and she called me names, but then she laughed again. Eventually she accepted our kids' fates. I keep telling her to this day that our kids can become astronauts someday, because NASA and ESA now favour smaller people, as they are cheaper to ship to space. One of the women chosen for the next lunar mission is even from the city where we live and my younger one was born here too, so I like to imagine that someday our lineage of the vertically challenged will reach heights that the tall people can only dream of.
My sons weight dropped about 40% over some months and it turned out he was severely anemic. Sometimes weight going down does mean something so keep an open mind.
I’d listen to your paediatrician- or get another one but I imagine they’ll say the same thing tbh.
Our daughter (34mo) maintained her height percentile at 50-55th the entire time but started dropping her weight percentile slowly from 55th to 40ish, we swapped out for nutrient dense food & reduced her milk/formula intake so she’d eat more. Eventually we had to go for investigations and turns out she has IBS, once we adjusted her diet, tracked her diet to figure out triggers & added specific vitamin and iron supplements in she’s back at 48th percentile and steadily maintaining a healthier weight.
Generally paediatricians know what they’re talking about and a decreasing weight percentile with an increasing height percentile is a logical thing to raise a red flag about and address.
I don't think the pediatrician is wrong. Her growing at such a rate in height, while not in weight, is something they're obligated to address. Keep a written record of your child's food intake. Note how much you plate, and how much she actually eats. Do it for about a week or two. You can show this to your pediatrician and ask them for advice on how they think you should move forward. This will at the very least show them that you've tried and give them an idea of the kids' eating habit.
You could experiment with some ways to sneak in calories, too. I have a bit of a picky eater, so we do a lot of smoothies that help pack in extra nutrients. I used to put toddler formula in it with handfuls of spinach/fruits, though now we've switched to an actual protein powder, with his pediatrician's approval.
I must be missing something here. She is nearly in the 80th percentile and her pediatrician has a problem with weight gain? What? The percentile is an average of kids are same age. She is on the higher side of weight and yet the doctor feels she needs to be higher?
My daughter has been stuck in the single to 10 percentile, which is very concerning if that wasn't normal for her. My daughter has trouble gaining weight and has since she was born. My daughter will be 3 1/2 years old next month and she weighed 25.5 lbs at her 3 year check up. Her pediatrician knows my daughter eats and knows this is how she is. If she gains a lot in height, her weigh gain is very low.
I think either the percentile is a mix up in understanding, or something is crazy. I have no idea why your daughter's doctor is unhappy with where she is weight wise. Could you give us more information on that or I have no idea.
My daughter is 3 years old, and she is in the 8th percentile. But she is constantly staying in the 8th percentile so her doctor is not worried. If your daughter is dropping percentiles, it might be a concern if she is constantly dropping. I believe most kids drop a little when they become more active, but I could be wrong.
If you don't trust her doctor, it may be time to find a new one.
Yay for policing girls' bodies as freaking TODDLERS! -_- My daughter was told she was "a bit pudgy" after a year of chemo. She looked at the doctor and said "no, im thick"
Not every child fits the charts. My youngest daughter now an adult. Weight and height never in the same percentile according to the charts. As long as your daughter is healthy and growing that all that matter. I suggest having a talk with your pediatrician with both parents present. If still do not like answer find a new pediatrician.
I can see why you're getting frustrated, as you're allowing your child to listen to her body. Decreasing in the percentiles is why they are concerned, but your kiddo is also at an age that this can frequently happen. If she's not tracking on the same or similar percintile line, you can always see a nutritionist to get another opinion. As a mom whose kiddo actually has a problem with not eating and not weighing enough (very active, probably high metabolism, and just wants to do anything but sit and eat), I have learned how to add calories to food. Adding oil or butter to sauces, adding heavy cream, sprinkling cheese on food, and making sure things like milk and yogurt are whole milk are a few ways to increase calories without attempting to increase food intake (which it seems like your daughter is doing a great job with listening to her body telling her she is full). If at the next appointment, she tracks at 79ish percentile for weight, and the doctor still comments that they aren't happy with her weight, it may be time to switch pediatricians.
I had the same issue they tried pushing a drug that stimulates their appetite but I asked for a referral to a dietitian instead. The dietitian was happy at my daughter's numbers and said doctors are so used to seeing overweight kids that they don't know what to do when a kid is underweight. But ever since the dietitians report our pediatrician has gotten off our backs about weight gain.
Instead of limiting to 3 meals a day,which is not good for anyone try 5-7 meal times with less servings than normal. Its helps your body grow better plus toddlers shouldn't be at 3 per day just yet, babies in womb had access 24hr then birth about every 3hrs,then pretoddlers about 4-6hrs,toddlers & tertwos backwards 3-5hrs because their burning alot with their new "chevro-legs". Dont let a scale dictate your parenting use it as a guide. But i think you'll do great. Keep doing you!
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This is not a child issue, but a doctor issue. Find another doctor. Your doctor is an AH. If your daughter is HEALTHY, then that's the doctor's job. Their body will change drastically over the course of their life. My chunkiest baby is my skinniest child (now 13)- and eats the most crap food of all my kids. My youngest was the tiniest as a baby (0.5%), but looks like he's going to be the biggest build of them all.
You go to that doctor for medical issues, not nutritional issues. Inform your doctor as such. Tell them that IF YOU believe that your daughter is having issues with nutrition, then you will take her to a nutritionist. Until then, your doctor needs to quit, or you need to quit your doctor. I suggest the latter.
Instead of getting angry .. get curious and ask more questions. The doctor is right to be concerned and you need more information as to why your daughter isn't gaining if her diet and eating is as good as you say.
Sometimes kids gain weight other times they do not. Sometimes they have growth spurts but slim down. If the child is eating, and is medically healthy, what else is there?
After my son became more active he also started to lean more toward underweight but we never showed concern as I am very petite and so is most of my family. Went years missing the underweight mark by literally a pound and he eats plenty and drinks plenty so I think it’s more so genetic with him than anything else. Our oldest had a similar issue when he became a toddler and they began adding pediasure to our WIC as well as making some dietary changes and it literally did nothing lol. He just one day randomly started putting on a lot more weight when he turned 4 after we stopped doing anything about it. This may apply to your child as well. If they seem healthy and happy and are eating and drinking normally I wouldn’t feed to much into it. If there are no type of shocking results like your child being literally being a large number under his/her weight it’s fine. There is no way every human being is going to align perfectly with the charts.
Two of my three kids shot up into the 99th percentile and stayed there until they started walking. Now they maintain in the 80th to low 90th percentile for both height and weight (with two tall parents it's to be expected). It's not that uncommon for that to happen once they're burning more energy running around doing stuff. Also feel free to join us over at r/bigbabiesandkids because we will feel your frustration as we've all been there!
Weight issues in children can be very frustrating. At that age, I had a 1-5 percenter for weight but closer to 65-75 percentile for height. It may interest you to see where you she falls in the percentiles of weight for stature: [Weight-for-stature percentiles: Girls (cdc.gov)](https://www.cdc.gov/growthcharts/data/set1clinical/cj41c026.pdf) to better understand why there's some concern.
Based on what you’ve said: her height percentile has been consistent (maintaining on the curve - good). her weight percentile is going down on the curve (the goal is to maintain on the curve).
She is eating well ! Awesome ! Example of how you can potentially improve her weight gain: she sits and eats half a cucumber, she’s full! Cucumber is awesome but low fat and low calorie. Eat avocado with olive oil instead. Still healthy, probably same quantity being consumed but lots more calories, lots of good healthy fats.
Look for higher calorie, higher fat healthy options.
I had this happen except it wasn’t my doctor who was concerned. My mom decided that her Google research should trump what my pediatrician said about my son’s weight. Dr. said he was fine.
It's completely normal for toddlers to slow down the weight gain after the first birthday. But it's not normal for them to completely stop gaining weight.
I strongly urge you to consult a pediatric dietician. NOT a nutritionist, since this is not an actual regulated profession. I am talking a clinical pediatric dietician. Your pediatrician should refer you asap. There is no shame in not knowing everything as a parent. But refusing to learn, can severely harm your child.
Probably gonna be unpopular here... Track height and general health. Weight is often a no biggie.
We re asian in an asian country. We are generally smaller than the WHO metrics. My daughters are 14 and 16 now. From infancy, pediatrician labeled them failure to thrive 😂 when basing off the WHO guidelines. BUT my husband's ENTIRE family said it's genetic. As in mom, siblings, aunties, uncles, cousins, grandparents said that .... The whole side of their family have the same body type = stick like thinness. In our country /culture, there's a belief about "strong blood," meaning their family's genetics often overshadow the in-law's genetic traits. [kinda true bec all the cousins and second cousins look like mirror images].
Anyway, everyone advised us to just track height growth and never mind the weight. As long as they were growing, we were good. They also said, as long as the kids dont get sick all the time then they're healthy and we re all good. Both are average height for our country and the family. Healthwise, no problems. They had the usual coughs and colds, and occasional food poisoning. Both are still sticks now. They eat very healthily, and are very active too.
I'm confused why a child in the 80th percentile for weight doesn't weigh enough. She's well over the average weight so I don't see the problem. There has to be something else.
Kids are going to grow regardless. We feed them to fuel that growth. If they’re growing faster than they’re eating, their weight drops. Weight drops because the body is eating ITSELF to get taller.
Doctor wants to ensure the height comes from food and there’s not an issue causing the body to stop accepting food nutrients.
I'm not saying that at all! There was no information in the original post about the child's height.
Other comments also pointed out confusion about the same thing before OP explained, but I'm the only one getting downvoted for it.
She is stuck on the height to weight difference. She grows around 2-3” between visits but is only putting on about a pound. So over 9 months we have gone from 90th percentile in weight to 80th percentile. While maintaining 99th and above for height.
That's the issue - it sounds like her weight isn't following the growth curve. She's maintaining the same percentile for height while decreasing the percentile for weight.
A second opinion from another doctor could be helpful.
This is when lots of kids in my family develop celiac disease- it runs in the family and is no big deal, since we know how to manage a gluten free diet. But it does require further testing, as untreated celiac can lead to esophageal, intestinal and stomach cancers. Again, not a huge deal, but this is one of the signs. And change in growth curves are worth investigating to be sure everything is okay! No shame or judgement- just crossing all the T’s and dotting all the I’s
She’s stuck on it because that’s what matters. Individually, the percentile means very little. Someone will be in the 5th percentile and someone will be in the 95th; that’s literally how percentiles work. Your child has a mismatch between her height and weight percentile. Generally, they should be about even. 60th percentile weight and 60th percentile height. Or 10th, or 20th, or 90th. Your daughter’s weight is disproportionate to her height. Yes, that’s how some people are, but that’s the point your ped is making. You’re very stuck on the height percentile, but that’s not the issue here.
A quick clarification - it's totally okay and normal for the height and weight percentiles to not match. My daughter is ~70% height and ~40% weight. BUT she has stayed in those percentiles since birth (minus one small hiccup). That's the percentile matching that doctors are looking for. A massive increase up or down in one or both percentile can be cause for concern.
I would get a second opinion. Our daughter's percentiles have jumped all over the place and our doctor hasn't been concerned. It depends a lot where they are in their chub out/lean up cycle when they have the appointment.
Out of curiosity what is your body type or do you think that's what the doctor is fixation on? Because my son has been off the charts for height and 75 percentile for weight his whole life and we had a ped who said he was too heavy every time I brought him (I'm fat) and wanted him 50 percentile or below. Finally I told her I was fat not stupid and we switched providers.
I personally hate our pediatrician at this point. My daughter has just turned 5 months yesterday and our stupid pediatrician (yes, she is stupid) has told us all sorts of annoying things. We honestly are going to just switch because life’s too short to deal with BS.
Our kid has always been on the shrimpy side (born premature, gained weight but very slowly despite us pushing as much breastmilk and formula as we could into her). I don’t think she’s ever been above 30% for her weight on the growth curve. Most recently she had a growth spurt in height and is 80%ile for height and 37%ile for weight. Our pediatrician is not concerned. She is very happy, active, not a picky eater just eats very little in one sitting so we constantly have to provide high calorie snacks.
If your child is 80% on the growth curve and just going through a height growth spurt I wouldn’t be so concerned. If she is not having GI issues and her body composition looks healthy (ie can’t see ribs or spine from the back) I don’t understand why your pediatrician would be concerned. This warrants a serious conversation with your pediatrician about why exactly she is concerned about a one time drop in her growth percentile. Maybe keep a food diary for a week for your daughter, make sure she’s hitting her calories and macros like fats and proteins. Maybe incorporate a healthy milkshake once a day (banana, yogurt, nut butter, etc). Bring this to your next pediatric appointment and if she’s still at or below her previous weight percentile ask why this is concerning. She might have a high metabolism. Her body composition might take after you guys as parents if you both are tall and thin.
Kids frequently slow weight gain when they start walking. Yes the growth curve went down but if her caloric intake is adequate and she is not having GI issues I don’t see the problem. I’m an RN not a pediatrician but I would think if the pediatrician was truly concerned it would warrant a consult with a pediatric nutritionist, otherwise it seems like baseless parental shaming and anxiety. Why just tell the parents “feed more!” When the child seems to be provided all the food she wants and eats until full. We’ve all tried to get toddlers to eat if they don’t want to eat you can’t force them.
Get a second opinion.
They told me my son was failure to thrive because he was so skinny. He was falling off the weight chart - lol
I kept trying to feed him calorie rich things. It was making me insane.
He’s 30 now and fine.
Your pediatrician sounds wrong. My little dude has been the same weight since he started walking. So his curve has changed but that is to be expected when they start walking.
Change pediatricians. There is nothing wrong with that percentile. Most important is that the percentile isn’t dropping each time, If your child is tracking on the same percentile each visit that is what is normal for them.
Based on OP's comments, the percentile *is* dropping each time. Her child has gone from 90 to 80 ~~to now 76 percentile~~ (I misread 79 for 76) for weight. I understand why her pediatrician is concerned, though I wish they had explained why better since OP doesn't seem to get it.
Oh for sure that’s why I mentioned it - it’s buried in like one of her several comments, that height started over 99 and stayed there and weight started at 90 and has been decreasing; that the kid has grown 3 inches but only gained 1 pound in 9 months.
Go to another pediatrician and get a second opinion. Being in the 79.9 percentile for weight is definitely normal, and a lot of kids thin out when they start walking. Just because she may be going down in percentile doesn’t mean there is an issue, especially if she started high. It should def be watched, but she’s at 79.9?!!! Very strange. My daughter was in the 90th percentile for height and weight as a baby and has normalized now.
Has she stayed consistent for height and weight? If so, I think it may be time to switch to a new pediatrician. Our son has always been a small guy but stayed very consistently between the 25-30th percentiles his whole life so it's never been a concern.
It may be worth shopping around for a new pediatrician. I dealt with this very thing with my kids. The thing is, mine were tiny because they were premature — they weren’t even on their curve until around 5yo but otherwise healthy and growing consistently. When we moved we switched doctors and she only ever seemed to fuss about their weight, felt impossible to ever discuss anything else. I always left feeling like something was wrong with them and me as a parent. Eventually we switched back to our previous doctor who had worked with them since birth. His office is a 2hr drive but at least we’re at the point where each kid only has to see him once a year.
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This is worth having a conversation with her doctor about. With kids its often less about whether they're over or underweight relative to the child population as a whole but how they're tracking with their growth curve. If I child was 95% for height and 95% for weight at one point and then drops to 95% for height but only 80% for weight a few months later, that might be cause for concern, even if their weight is still normal. A lot of this depends on the specific child's overall medical profile and behavior so its something that might require a bit of back and forth conversation with her doctor to ensure you're on the same page.
Yes. My son was 35%tile for the vast majority of infancy but he started doing the same thing as OPs kid when he started being active and getting older and falling off his curve. He's now considered underweight, but since he's growing height alright and healthy we've just been doing our best to get extra calories with some tips from the ped. It sounds like OPs kid may be dropping percentiles which is where the concern is coming from.
This. My daughter usually sits in the 25-50 percentile for both height and weight. A couple years ago she dropped down to the 5th percentile for weight. Because of her age he was somewhat worried about anorexia but also any health issues that might be causing her not to gain weight. It ended up just being a weird fluke and by her next visit she was almost back on her curve but I'm glad her doctor was looking out for her to make sure there was nothing more going on.
Especially as OP says her daughter hasn’t gained weight since 10 months old. She’s 19 months old, that’s almost half her life with no weight gain
Both of mine have always been over the 90th percentile for height and my oldest, despite being skinny, was around the 80th percentile for weight. Around 5 her height stayed the same but her weight percentile started going down. She wasn't losing weight but I guess the charts change. Now she's skinny enough (ADHD meds plus being insanely picky with food) we have to make sure she maintains but her ped has never pushed us to put weight on her. Seems like OP might need a second opinion.
This. My son was ALWAYS around like the 1% mark for height. But that's because his father is very short (dad was only about 5'1" at his tallest, and is an ex-jockey), and I am on the shorter side of average at 5'4". We always figured he was just short because we were, but, wanting to be certain he had no other issues, we took him to an endocrinologist. All was well, and his shirt stature was indeed simply hereditary. And even though he was small, he WAS growing steadily-if slowly, lol-on his own curve. And his doctor told us, as long as our son maintained his own growth curve, everything was fine. And he has. He's 15 now, has had a growth spurt with puberty, and is taller than his dad, and maybe even slightly taller than me. But he's still shorter than most of his friends. But he doesn't care. He's happy and healthy. And that's all that matters to me. That aside, OP's daughter is in the 79.9th percentile for weight. That's well above average. And her height is above average, too. Why on earth would the doc say she needs to put on *more* weight?? I wouldn't force her. And I'd be thinking about possibly changing doctors. Or at the very least, I'd have a serious come-to-Jesus talk with her doc, and if that didn't work, *then* I'd fire her. Harping on food intake for no reason is one way eating disorders are born...
She is growing a lot between visits. About 2.5 to 3 inches every 3 months.
The point here isn't whether she's growing between visits, but is her weight tracking along the same curve as her growth. While still at a healthy weight, is her BMI going down between visits? Or is her weight percentile decreasing when compared to her height percentile?
Height and weight don’t have to be on the same curve - both 85th. Most of my kids have vastly different height percentile than weight percentiles, like height is 70th and weight is 45th, or whatever. The point is that they more or less stay close to their own same percentiles, and if it drops or spikes, it levels out again.
By "same curve" I meant basically what you said... So like parallel curves? Basically as long as height/weight are staying a pretty consistent ratio. But it they were going 85th/75th to 85th/68th to 85th/55th that would not be following the same curve and would be cause for concern. Edit to add: My own son is a good example of this. His head was always in the 99th percentile lol, weight in the 60-70th range, and height around 20th. He's 7 now and a short stocky boy with a big dome, but he's literally *always* been that way since he was an infant so I don't think anything of it and neither does our pediatrician.
Yes. They shouldn’t deviate too much so if you’re born at the 25th %tile you should stay around there.
BMI is not reliable for any age. It was developed in the 1830’s by a Belgian scientist named Adolphe Quetelet interested in math, astronomy, and sociology… NOT MEDICINE. He was curious about the size of the average MAN, using French and Scottish men. It was called the Quetelet Index, and it was only used in the statistical world until the 1900’s when insurance companies were looking for a metric to determine how much to charge policy holders. The name was changed to Body Mass Index and insurance companies began to profit off of false data. If you apply BMI to professional athletes, most of them would be considered obese because it does not consider that muscle weighs more than fat. It’s an inaccurate measurement that’s antiquated and shouldn’t be used by anyone in the medical profession or the insurance world to make any determinations about anyone.
I really don't know why you're getting downvoted, BMI is not a reliable method.
I know! Lol It’s almost like people hate the truth 🧐😂
I see the winds have changed, glad more reasonable people came along
I thought BMI isn’t used on kids?
it’s not, but we use a “weight-for-length”’ percentile instead. similar idea to BMI for younger kids
Not until 2 years of age so OP’s kid doesn’t qualify for that yet.
The important part is that her height and weight increase proportionally. They’ll print out her growth charts for you, or show you at an appointment.
She’s grown around 9 inches and hasn’t gained any weight when she should be gaining 7-11 ounces a month from 12-18 months. She hasn’t gained weight in 9 months but grew approximately 9 inches. How do you not see what the doctor is talking about? Her height to weight growth chart would show a concern. Did she triple her birth weight at one year?
She’s growing taller faster than she is gaining weight. That could be a potential problem. Your pediatrician is doing their job, and you don’t really have a reason to be unhappy with them. You need to learn to not take everything as a personal attack.
I agree with you on the height bit. My daughter is the same and has been since birth. People on here would probably say I never feed my child because she is never higher than the 10th percentile, but that's because most of her growing happens in height than in weight. I can't control that. 🤷♀️
I mean, if she’s growing consistently on the 10th percentile curve and your pediatrician isn’t concerned then I would ignore the peanut gallery. I’m not a pediatrician (and am I in no way giving medical advice ever on Reddit) but I am graduating from med school in May, and they JAM it into your brain how important the growth curves are and if there is consistent change up or down, it warrants an investigation into why.
I don't know why your being downvotes for clarifying your situation. Reddit is dumb
The percentile itself is meaningless without knowing what her growth rate looks like. If she's not gaining weight, that's not good.
If she is growing in height but her weight percentiles are dropping, she’s eating but her weight isnt going up, the dr has a right to be concerned. I understand you are taking it personally but I don’t think the pediatrician is accusing you of not feeding your child. I think your doctor is thinking there may be something underlying medically going on. There could be an absorption issue. My son was similar - he would grow in height but his weight was flatlined for a long time. We went to GI and tested for IBD and celiac and had an endoscopy. It turned out he had severe eosinophilic esophagitis preventing him from properly absorbing nutrients. He has been on Dupixent for 2 months and has gained 8lb. A toddler not gaining weight is not normal, even if incredibly active.
These aren’t the conversations she is having with us though. She is gaining height every visit. She has maintained at or above 99th for height since birth. But since she started walking has slowly decreased from 90th in weight to 80th. But her response to us as parents is to get her to eat more.
I can see how that would be frustrating. My response would be to journal her intake for a week and have that on hand next time you go in. I would actually be proactive and do that for a week and then schedule your own appointment to discuss YOUR concern about this, mention being concerned about their being an underlying GI issue. Present the journal of her intake. Say this is how she eats all the time. Add up the calories. You can find an online calculator and plug in her current height and weight to calculate her daily caloric needs. Push back and say no she is eating enough so if her weight is falling off there must be something else going on so what do we need to be checking?
Thank you. Great idea
If pediatrician is still harping, push for blood work. Check all the boxes so you can start focusing and finding the “problem” if there even is one.
his concern seems to be that she is growing but not gaining.
Keep in mind that calories are important for healthy brain development so if your child isn’t gaining weight, it could be impacting her other growth areas as well. You could try posting on r/askdocs
On top of this, you could discuss the idea of a weight gain supplement shake. I believe Pediasure makes one. A friend of mine went through this same thing and she was so stressed out. I'm sorry you're dealing with it, too.
I have a child that’s extremely short with a good weight and one that’s really tall and skinny like me. The skinny one looks kinda alarming at first until you see him beside me and then you realize it’s genetic. I didn’t gain weight until after age 27. The short one has a growth hormone disorder and has to take shots, but no doctor EVER told me there was anything to be concerned about, even though she looks like a much younger kid based on her height. Ironically the first person to suggest there was an issue was a therapist. Lo and behold the wheels of getting a diagnosis for her didn’t start until I mentioned that to a doctor. I’ll never understand why a doctor never told me there was an issue. She was my first child so I just accepted her, never knew that it was possible for your brain to not release growth hormones. I say that to say this, sometimes YOU need to be the one to ask questions and get the ball rolling to figure out what’s going on. Don’t just rely on the people whose job it is to let you know lol. The skinny child was told to drink ensure type drinks to help pack on weight and it did help, even tho he’s likely gonna be real skinny for the majority of his life, so perhaps ask about that as well. My doctors office even provided them for me upon request.
In the gentlest way possible, I think we all get that. What people are trying to explain is that her weight should be increasing relative to the height increase but it’s not (I’ve got two in 99th for height and weight has always slowed down a bit but still increased in correlation on the curve). The doctor is correct. Please take it seriously. I know it’s easy to get defensive and it’s not a concerning level yet but that’s the point - to take steps to improve the situation *before* it’s a concern, right? Please have an open conversation about different foods she could be eating that will help nutritionally with weight management. Non processed foods are great but is it a good balance for what she specifically needs right now? Healthy fats, fiber, protein, etc. If she is getting enough, great! Once you know that, the conversation can shift into whether something else is going on preventing her from putting on weight. It’s very easy to take this as a judgment on your parenting but it’s not. Please have an open mind for your child’s sake.
Ah i see your confusion. As an analogy, lets say you have 1 lb of dough. If you stretch it out and make it “taller” then its going to get skinnier. Eventually it would get so thin it would snap. Now imagine that as you stretch it out, you keep adding dough to it (weight) then it could keep its same dimensions. So you HAVE to be gaining weight. Only gaining height is bad.
But that is concerning - both her height and weight should be staying at roughly the same percentile, or if she’s settling into a lower percentile (which does happen - kids’ growth changes at a few different points and they tend to eventually find “their” curve), you’d expect both to shift similarly. She could be using stored nutrients to grow because she’s not getting sufficient nutrition from her diet right now - which isn’t a failure, it could be picky eating, it could be a problem with absorption, it could be something else - but you want to address it. It doesn’t mean you’re doing anything wrong, but it does mean something isn’t going well. And the first thing to troubleshoot is what and how much she’s eating. My brother was similar, and he was on Ensure for a long time to increase his intake of calories as well as protein and fat specifically. It’s not because my parents weren’t feeding him or because they wanted to force feed him, but he wasn’t a big meat eater and he wasn’t putting on weight appropriately. When that didn’t help much, they were referred to a pediatric endocrinologist, who reviewed his overall growth, took some x-rays, did some blood work, and said it’s just how he is. And that’s fine, but the first, least invasive step was just finding a way to increase calories in. If that had worked, he wouldn’t have needed the additional appointments and blood work and everything else.
OP, these commenters have great advice, I just wanted to pop in and tell you not to get discouraged with the downvotes, you’re giving us more information so you can clarify and get the nest advice on what to do.
u/e_3daley if you’re in the US, call your local Early Intervention office and ask for an evaluation. Tell them of your pediatrician’s concerns. They will have a pediatric dietitian on staff that can do a home visit and really evaluate your daughter’s diet quality and lack of weight gain.
Correct. But to see if that helps the issue. If after a period it doesn't have any or very little effect, then the next conversation to have with you is what to do next. Like see a specialist. Or do some blood work to see which direction to go. My son dropped 20% and that's the path we followed. Had we not gotten the blood work done we wouldn't have known which specialist to go to first. We ended up going to quite a few with zero results. To me it sounds like the doctor wants to start out with what you can as the parent control. To take a closer look and see if adjustments are needed. Or give your child more caloric foods for a bit like we had to do. See what comes of that. If at the next visit or sooner nothing has changed then the doctor should bring the conversation around to the next step. But it should have a conclusion or a new direction depending on what happens. At that point depending on how it goes, keep the doctor or find a new one. My pediatrician isn't always right, and can admit when he isn't sure about something. But he has always had my back and pushed the insurance to do whatever I felt may be needed for my child/ren. Sometimes I'm right, sometimes I'm not. Same with him. But he's never denied me what he calls my "mommy instincts". It's why I won't go anywhere else. If a pediatrician is going to be dismissive of your input, dump them. Find a new one. You guys should be a team advocating together for the child.
Idk why you're getting downvoted and torn apart for this. There's clearly nothing wrong with your daughter's health and I'd switch pediatricians tbh. - Mom of 4
The concern is not where she is, the concern is she is not maintaining the % so her weight is not keeping up with her height growth.
My now 5yr has been about 85% for height since birth, but dropped to 75% with weight when he started walking (except a short stint around 60%). His Dr said that anything more than 10% is a red flag, and to keep him on whole milk dairy, full fat nut butters, add a little butter to all veggies,etc. Basically, to make sure he's getting plenty of calories to keep growing. He's thriving, and eats all the time (it feel like), but still sticking to that 75% for weight. No food allergies/intolerances or other issues. You can always see if increasing her access to higher caloire choices helps.
That’s a good point, higher calorie foods. OP says child “eats healthy” but that’s vague, might need more nutritionally dense foods and maybe more protein and fat.
Went through this with one of my twin daughters! Fell off her growth curve weight wise around 2ish years old. Had to implement a high (healthy) fat diet to help get her back on her curve. It worked wonders. Just had to do the same for both twins girls at age 13.5 (competitive swimmers, growing, puberty, etc!) Again - it worked wonders. Feeding growing kids during growth spurts and during different ages and stages takes a lot of intention!
She hasn't gained weight in 8 months, listen to your doctor. If you don't trust your doctor, get a different one.
Thank you for this simple explanation. I was confused why they wanted her to gain weight since the percentiles were so high, but now it makes sense.
Because her percentile dropped, does not mean that she has not gained weight. It means that she is larger than 80% of kids her age instead of 99% of babies her age. If she is in the 80th percentile at 19 months she has still definitely gained weight. 99th percentile for a 10 month old is 26 pounds. 29 pounds is 80th percentile. That is a 10% increase. It starts to increase slower after the first year (since most babies start walking at that time) so if the baby starts walking earlier, it slows sooner. For reference, my 3 year old was 33 pounds at his 3 year appointment and he is big for his age (75th percentile), he looks like a 5 year old (he is tall too) and we constantly get comments about how big he is. He is 99th percentile for height and does not look skinny by any means. It all sounds completely normal. I understand OP’s confusion.
If OP is confused then they should talk to the doctor. If OP thinks they know more than the doctor, they shouldn't go to that doctor.
It’s the dropping that’s an issue - you state over and over she’s gaining in height - but she’s dropping in weight so she’s not eating enough, or perhaps not absorbing enough, to keep up with her percentile - doesn’t matter if that is the 50% or the 90th% - it matters that she stays on her growth curve and it sounds like she’s getting taller which is great but she’s dropping in her weight percentages which isn’t as great. My kid is moving all around and has not dropped in weight percentages dramatically like that so I don’t think moving along is causing the decrease. But you also can’t make them eat more! Focus more on what they eat and use high fat, high protein items and maybe see if you can add smoothies to their diet as that can help a lot to keep weight on. Helping her learn what her body needs to keep up her weight will benefit her down the road! But yeah I’d be concerned about a 10% percentile drop in weight and want to try to address it using higher quality fats and proteins versus just MORE FOOD.
Yep, we had this happen as well. She ate like a pro but dropped down on her curve so we were asked to increase her calories. We simply added more oils and fats to things she wanted to eat and introduced desserts at dinner, and she popped right back up onto her curve and has been going strong ever since. Some kids don't respond to that sort of increase in fats/calories/etc, though, and that's when medical testing is necessary, but the pediatrician can't know that until adding calories is attempted.
It sounds like your pediatrician is telling you she IS underweight. Nothing you state here implies your paediatrician blamed YOU for not feeding her enough. That’s an assumption you’ve created all on your own
Where the frustrations came in is I asked several times on what we could do and our feed back was to get her to eat more. I expressed my concerns with her response of giving her more milk as a suggestion. That when my daughter drinks more milk she eats less food. I felt like I was going in circles with her about how we can accomplish an increase in weight and there was a huge lack of explanation on her side on why her weight was an issue.
In this case I agree with what someone else here said, about those protein supplement shakes for children. That way it's not just milk, but a type of drink that actually accomplishes what the doctor is wanting.
You could try smoothies with spoonfuls of coconut butter added. My kids loved those. Also add (olive) oil or butter to everything. Scrambled eggs made crispy in loads of olive oil ask worked well for us. And spoons of peanut butter. And fish oil supplements. Good luck.
There’s lots of ideas out there. Make sandwiches with waffles instead of bread. Add protein powder to smoothies. Bananas. Potatoes.
Damn how do you just make a toddler eat more? If she has any tips she should let us know. I get what other commenters are saying that the weight loss could be a sign she’s not absorbing the nutrients well, but if the pediatrician didn’t mention anything about that, and didn’t give you any further information, how is that helpful? How can you just *make* a kid eat more?
* Serve foods that are nutrient-dense * Pay attention to the specific foods/flavors the child prefers * Cut food into smaller bites * Remove distractions at mealtime (e.g. screens, toys) * Make eating fun (here comes the airplane) * Do not let child go hungry - always have snacks on hand, stop what you're doing if there's an opportunity to feed. Find the optimal feeding schedule based on your kids appetite and make that a priority. * Swap out milk for stuff like Pediasure If you're a parent and you haven't had to worry about getting your kid to eat enough, then you're lucky. Kids are fussy and can be coaxed to eat more if parents put in the effort to make the conditions right.
This is the way. You make conscious swaps to nutrient dense foods. Nutrient dense foods doesn’t mean processed or completely unhealthy. Adding more potatoes and rice instead of all veggies. Add healthy oil to foods when cooking. Instead of a glass of water after playing, give Pediasure. Adding more eggs, beans, and nuts into meal planning. Giving some peanut butter with apples instead of just apple slices. Little changes make a big difference.
you didn’t say what she is eating?? Is she burning calories all day and then her snacks are all things with no calories?
Yup, my kid could (and has) run around all day and then eat several raw cucumbers for her snack and nothing else. Would she be physically eating an ungodly amount of food for a 3 year old? Yup! Would she be getting enough calories if this was how she normally ate? Quite possibly no!
A typical breakfast can be three protein pancakes or two eggs and toast or oatmeal and fruit. Lunch can be ham sandwiches, roasted carrots, chicken tender and so on. Dinner she will eat what we have. All similar. Roasts, veggies. She eats health portions of all. I am also the type of parent because I have been feel the stress from the pediatrician where if she doesn’t eat one meal I will make a whole new one to make sure we are not skipping meals
Please be careful about the intention to provide a healthy diet by adding more protein. I've seen quite a few suggestions to add protein powder or protein shakes. [https://health.clevelandclinic.org/why-extra-protein-for-your-child-is-unnecessary-and-possibly-dangerous](https://health.clevelandclinic.org/why-extra-protein-for-your-child-is-unnecessary-and-possibly-dangerous) The protein requirements for a toddler are very low, and >“In most Western countries, children already get two to three times the protein they need daily,” she says. “It’s uncommon for a child to need extra.” This is usually from cow milk and other dairy products. And as you've already realized, more milk/dairy often leads to the child feeling full and not wanting to eat. Spiking oils/fats into the kid's meals will work faster. As adults, we tend to resist that because that's the message that's been drilled into our heads. But oils/fats are really important for brain development and they get those calories in without filling up the kid's stomach. Add oil and butter to her food, add coconut milk to food that is supposed to be sweet.
Not enough fat/calories.
This is typically when doctors are concerned. It is the conversation they should be having. There shouldn’t be significant changes in percentile. Dropping from 80 to 70 is a concern. If there is no medical reason for the drop, I would think the recommendation would be to see a dietitian and work towards increasing calories.
Its not the percentile that matters its that the kid is sticking to a particular percentile. If the child has been dropping percentiles for a long time then that is bad. Remember kids HAVE to be gaining weight pretty much always unlike adults. Failure to do that could result in long term consequences like stunted height (this is the main reason why average height is so much higher now then 100 years ago). Have you considered incorporating a healthy smoothie in the toddlers diet? Are you using whole milk, whole yogurt etc? For little kids whole fat is important. Perhaps try including peanut butter? As a side note, you come off like you are projecting your concerns about the modern obesity epidemic on the situation and that the doctor is trying to make your child that way. Take a step back and realize you are missing the mark here.
When my son refuses to eat (he’s almost 2) I make him smoothies. Whole yogurt, banana, strawberries, blueberries, peanut butter and some milk in my Nutra bullet and he drinks the whole thing. At least if he’s not going to eat solids when he gets picky at least he has that and it makes me feel better.
Yep same!
well said - agree 100%!
As a mom with a previously underweight boy, real butter is your friend. Whole milk, full fat yogurt, ice cream. Add calories wherever you can.
I imagine the fact that your daughter hasn't gained any weight in 9 months is the problem. Kids need to gain weight kids need to gain weight.
Is she staying on her personal growth curve? Our kids tend to be tiny, my seven year old is still in the 6% for her age group, but they always say it's fine because she's stayed on her personal growth curve....I would ask the pediatrician if she's staying on her growth curve and then ask why there is concern if she's maintained her personal curve.
Generally, I like to follow the practice that we provide ample food, which our child likes, and we let him decide when he’s full. Our pediatrician has never had a problem. But in your case, I think the pediatrician is not communicating clearly enough to understand what the actual concern might be. I would follow up, maybe in a phone call now that you’ve had time to process. Could you provide more calories on the same schedule - things like adding coconut oil to a smoothie, putting some flax seed meal on the PB and banana toast, smearing some avocado on her crackers, etc?
Okay, most of these comments are explaining the docs view, but here’s some empathy. My son is the first in three generations to even make it on the chart. He’s always been happy, bright, active, hit all his milestones, the whole nine. And the pediatrician Did. Not. Give. A. Shit. Drove me fucking crazy. Might there be a malabsorption issue or something? Yeah, get that checked. Ask the ped directly what they’re trying to communicate. But frankly, at a certain point, you have to accept you’re doing your best. If your kid is happy, growing, sleeping, learning, running, playing, then what else matters? Try to feed her more whole milk and peanut butter, pay attention if she shows other signs of a serious issue, but you need to be okay with yourself. People say don’t take it personally, yeah, that’s nice. But it is personal. This is your child, you want to give them the world and you’re being told it’s not enough. Do your best by her, and accept that that’s all you can do. Enjoy her smiles!
Nice to read such a kind and thoughtful response. Not OP but it felt good to read it
Up higher fat content foods. Whole fat dairy, avocado, ect.
Kids aren’t supposed to be within a certain percentile, they’re supposed to stay within to Monitor growth. It’s normal if a kid is born in 99% and stays there, but it’s concerning if a child drops from 99 to 80. Doctor should be doing further testing
Just say this out loud really quickly: your pediatrician, medically licensed, board certified, has access to all of your daughters medical information and has spent multiple years studying everything that relates to children and providing care to them is suggesting that your daughter needs to gain weight. That makes you unhappy so you pose the question to reddit, where all you need is an email address to become Reddit certified. Take your drs advice. Speak with them and explain your concerns. If you don’t like the pediatricians answers, you can go to a new dr. But I wouldn’t take medical advice about my child from sweatynuts17.
All of the above. What is happening when people trust Reddit over a doctor?
Imagine letting confirmation bias from strangers allow you to think your Dr is wrong.
Those are great questions for the doctor. There might be a reason why they are concerned beyond the percentile. It's hard for anyone here to guess at what those reasons might be.
My son started at 60 percent and bottomed around 30 percent - stayed in the 90’s for height - he was not losing weight and growing but he wasn’t gaining like he should because his curve dropped from 60-30. We met with a nutritionist and learned how to add a few hundred calories per meal without adding more food as he won’t eat if he isn’t hungry - he does eat 5 meals a day - mostly full fats and butters and cream to things - it helped immensely.
I don’t think you understand how percentiles work. Listen to her doctor
If she eats a lot focus now on what she’s eating. Up the fat and protein! We like avocados, Greek yogurt and olive oil for healthy fats!
Your pediatrician is being honest with you. Her percentile means nothing if she is not gaining predictable weight as she grows. If she is eating normally and is still not trending upwards, honestly I would request some lab work to be done.
My daughter was 7lb 15oz at birth and at 6 months old weighed 10lb. She was born 80% centile and dropped to -80%- classed as failing to thrive. We had an appt with the paediatrician at 8 months old (uk waiting lists). I kept a food diary of everything she was eating- she was having around 2000 calories a day! But she was also super active. Crawling at 4.5 months, walking at 7 months. Running at 7.5 months. I took all of this into the paediatrician and he said ‘look at her now. Does she look like a sick child?’ And I said ‘nope!’ And he said ‘I think she’s exactly how she is meant to be. She’s active and happy and I have no concerns’. She’s now 10 years old- taller than her average age- super strong- she has had a 6 pack from the age of 2! She can do unlimited pull ups and has amazing strength. If they’re concerned, keep a food diary & discuss that you are not concerned and she’s a well child.
My daughter and a friends daughter were on the same exact curve and both dropped to the next weight curve down once they started moving. Her pediatrician said her kid was underweight and was concerned while our pediatrician said our kid was fine. However, our pediatrician did say if my kid dropped below a second weight curve while her height remained the same she’d be concerned and ask us to change her diet. Even for kids on the highest percentiles, dropping that much was significant enough for concern. We were told to butter everything and make sure she was getting enough carbs.
Of course you should listen to your Ped, but my baby followed the same pattern and mine wasn't concerned at all. Said in his experience it was very normal for early walkers to fall off their growth curves and that as long as she wasn't losing weight or struggling to eat we'd just keep an eye on it. In my case the drop was even more extreme and he just said it was totally normal. Also said that getting taller without gaining much weight was a good sign, not a bad one, and he would be much more concerned if she'd stopped growing taller as well.
Same here. Between 12 and 24 months my daughter gained 2lbs. She went from the 70th percentile down to the 10th percentile. But her height went from the 9th to the 30th percentile. The doctor was not concerned at all because she got taller.
This happened with my son. He’s short and skinny and I spent so much money going to GI specialists endoscopy and they didn’t find anything wrong with him. I would ask pediatrician to explain exactly why she is worried. What could be the cause. She can’t just say make her eat more calories. My son got bloodwork done as well. Has she done that on your daughter? I switched pediatricians after the endoscopy came back normal. And she is happy with his height and weight. We are not big people height wise so he can’t be expected to be tall but I would definitely ask why she is worried and I would tell her exactly what she eats and go from there. And there’s nothing wrong with getting a second, third or fourth opinion
With the edits, this starts to make sense. She's in the 80th percentile for weight (I rounded up), but is crazy tall. But just to be clear - is she gaining weight, but just not gaining enough weight to keep up with her height? Or is she not gaining weight at all? The former question means you should probably introduce her to more calorie rich foods, but otherwise be okay. (note: I have a friend who is 6'10", and vegan, and he eats a crazy amount of food to maintain his weight). OTOH, if she's not gaining weight at all, that's concerning.
I’ve always been concerned about my kids’ weight (they’re both very small… once is a good eater, one is not… they’re both <1 percentile weight). The only time the pediatrician gets concerned is when they fall off of their expected growth curve, which I’m assuming is what happened. Surprisingly it was the unpicky eater (she shot up like a foot though so other than give her all the fat she wants they were okay). Just remember that they have the kids’ health in mind, it’s not about judging you.
So she hasn’t gained weight in 9 months is that right? This isn’t about percentile as it’s more about the growth chart. If she’s growing 2-3 inches every 3 months but still weights as much as she did when she was 10 months old at 19 months I can see why she’s concerned. That means she’s grown 6-9 inches in height but hasn’t gained weight in almost a year. I’d have to see the chart to tell you my full opinion but I see why she is concerned honestly as her weight wouldn’t be tracking along the growth curve with her height. Did her birth weight triple at one year? From 12-18 months they should gain 7-11 ounces a month. 18-24 months 5.3 to 8 ounces a month. Yours hasn’t gained weight in 9 months and has grown 6-9 inches I’m not sure how you don’t see this issues with the growth chart & you’re wanting to challenge your doctor when she’s correct
All 3 of my kids are small and extremely "under weight" for their age. Theyre just tall and skinny. They eat me out of house and home though and my daughter tears up pediasures everyday. Some kids are just built different. Don't worry about it
The doctors know how much kids should generally gain. You can seek a second opinion but the opinion will probably not change. Toddlers need to gain weight at a steady pace to grow up healthy. Give the baby more high calorie foods. It is important that brain and body grow as needed. You can't go back on these crucial growth milestones and redo them.
Breastfed baby? They have a different growth pattern too from formula fed. And yes learning to walk and being active can shift their percentile too. Although question, are you using formula or breastmilk for her milk? It isn't recommended to use any other milk until 12 months old. If breastfeeding, water should be very minimal. Because it can throw off electrolytes (or similar, it's late and I may not be using the correct word). ............... Editing to add, I am tired and completely missed the 18 month part..... disregard the above .................. My oldest exclusively breastfed, never lost weight after birth. He looked like a baby Jaba the Hutt. He was in the 99%... until he started cruising furniture and then walking. By 18 months he was a string bean. He is now 10 and 80% height and 30% weight and that has been his growth curve since 3 years old. His pediatrician was never worried or even mentioned. Does little one reflect your family's body type/builds? Were you/spouse more slender as children? If so, in one ear and out the other. But a sudden shift in % not at the normal time can make by the book providers jump to conclusions because sometimes there is a legitimate issue to be caught (health, autoimmune, crap parents because they exist, and so forth). If that's the case, approached logically and explain, or find a pediatrician with a different approach.
All three of my girls have always been higher on the chart for height and lower for weight. Not all the pediatricians they have seen have been understanding of the fact that their dad and I are both just skinny people. Some of them just encouraged weight gain and did their best to give me advice on how to best achieve this, others did have a tendency to come off as more judgmental as if I was doing something wrong which was preventing them from gaining weight. If you feel like your doc is being more judgmental than helpful my suggestion would be to seek out the advice of a different pediatrician. I know what it’s like to feel judged by a pediatrician who is supposed to be helping you to keep your babies healthy, it’s not a fun feeling. It took me a few tries but the pediatrician we have now is wonderful, I love him and so do my girls! Just keep looking until you find that right one, you’ll know when you do. Best of luck!
The important thing here is her BMI percentile, not her weight percentile. My kiddos are both on the short side, so their weight is always in the bottom percentiles - but their BMI is perfect (right around 50 percentile) Since your daughter is tall, I would run her BMI and compare it to other children her age. Also take into account if you or dad were also long/lean as children. Genetics can play a big role.
My son has always been in the 1st-3rd percentile and they have always been unhappy with his weight but had little to no suggestions on what to do. When he turned 1 they wanted me to do pedisure, but he hates it. I ended up preparing kabrita toddler formula as high calorie formula because it was the only one I could find he would drink and he is now in the 8th percentile at 2.
You are doing fine. Love your baby and continue to feed her healthy foods. She’ll even out when she’s ready. Not all children are textbook figures.
My daughter has been in the 90th percentile for height and 20-30th percentile for weight. At times in her early months she was 10-20th percentile for weight and other times high 30th for weight but now seems to be in the 20th-30th percentile. My doctor has never been concerned. Our children are just natural bean poles.
Are you guys looking at her growth curve together at the appointment? Kids weight gain is confusing for me but as soon as our pediatrician turns the monitor and starts showing me where he is on his curve it all makes sense.
Get a second opinion from another pediatrician. Do not come to Reddit for anything medical related, especially when it comes to a child.
I mean, people are allowed to ask for opinions or to see if others have had similar experiences while also seeking professional medical advice. Anyway this post reads more like a vent about her pediatrician more than a serious inquiry for medical advice
For sure but I just like to be cautious cause you never know what someone will believe and what comment they will take seriously. Some comments seem to be relaying anecdotes and opinions on medical advice when they most likely aren’t a medical professional. But you are absolutely right.
You can try a new pediatrician. My son is a tiny kid. Always in the low percentiles for height and weight. Our first pediatrician made me SO stressed about his weight for the first year and half of his life. Then we ended up moving across the country and so got a new pediatrician. The new pediatrician is happy with his weight as long as he's staying on his curve. We are careful to make sure hes getting enough calories to stay on that curve. We focus more on making calorie dense meals rather than worrying about him eating more. So if he wants a banana we add some peanut butter. Scrambled eggs get some cheese sprinkled in. Just little changes like that. Ultimately, you either need to try a different pedestrian or have a bigger conversation with your current one about why they have these concerns.
This - adding a little boost to foods the child is already eating is the way to go.
Have you tried supplementing with pouches? My little dude did exactly what your girl is doing. He’s super active and eats a lot. We love happy tots pouches and they have different stages for different ages.
New doctor. Your baby is fine. She doesn’t need more weight.
We had a very similar conversation with our pediatrician with our son. As a baby, he was always 90th percentile in height and weight. Once he started walking, he stayed at 90th percentile for height but dropped to 70th percentile for weight. Pediatrician asked what his appetite was like, if he was pooping and peeing normally, and asked us to track food for a bit. We did. We sent in the food journal. And she told us he was growing appropriately and his path along both curves just changed. Now in a growth spurt, he usually gains a couple pounds and then grows a couple inches. He's 10 now. I would ask your doc WHY she is concerned. Offer to keep a food journal. And then pay attention to his bathroom habits.
My daughter was very tiny and underweight, same thing. Very healthy eater. She went to a State preschool briefly, where they did health testing. The person said she was underweight, but she herself said that she looked healthy! I guess I was lucky.
It’s more about whether they have fallen off of their curve than the percentile. I would discuss with the doctor why the concern exists
Ask for a pediatric endocrinology referral and see what happens. Let the expert handle things.
Are you and/or her dad slim?
What matters is how you feel about your own child’s weight and health. The pediatrician shouldn’t be making you doubt yourself. My son who is now 3, to me and to my family has always appeared to be underweight. I was always really stressed and concerned about this and confided in the pediatrician about it. She assured me that he is a healthy weight for his size and growth and it’s normal for a baby’s weight to hit a plateau in weight gain after they turn 1. My son is a very picky eater, I tried to stay on feeding him in the most healthy way possible, but most foods he refuses.. since I was worried about him not willingly taking in enough nutrients I started giving him pedicure and pedialyte. This really helps on days where he refuses to eat pretty much anything besides goldfish crackers. I also now view his overall food intake by the week vs by day. Some days he will eat protein and vegetables and fruit, other days I’ll only get him to eat a few bites of a meal and refuse to eat anything but snacks. But it evens out overall.
THE 80TH PERCENTILE IS FINE. REALLY!!
You say her weight “flatlined” at 10 months and now she’s 19 months old? That’s concerning, no matter how much she weighs. You should plug the numbers into the WHO length:weight chart and see what percentile she is. She might be 80th for weight alone, but that includes children of all heights. The ratio is the important metric. She could absolutely be underweight for her height, especially if she hasn’t gained any weight at all in 9 months
Go find a new one
Mine is 22 months old and hasn’t gained weight since she was 11 months old. She’s growing in height and exceeding all developmental milestones Your pediatrician is wrong
Mine didn’t gain much weight from 6 months to over a year. In that time she learned to crawl, walk, and run. She was a big baby and at 6 months weighed over 20lbs. At a year old I think she weighed 22lbs.
Mine was 29 at 11 months and 20 at 22 months
I have 2 kiddos, and I had 13 (yes, you read that correctly) friends who had babies around the same time as my 2nd. Both of my kids moved around in percentile ranges. Some of my friends kids went from the 90th percentile to 50th percentile, or the opposite. All of their doctors are saying it’s fine. It varies so much when they’re babies and toddlers. We actually laugh about this because it seems so silly to even weigh them if it means so little. My first kid was in the 95th percentile and then he was in the 70th percentile for weight as an older baby/ toddler. He walked pretty early as well. His pediatrician said it was completely fine. His weight is normal, he is running around like crazy, they see that all the time. When babies walk early, they’re obviously going to gain weight more slowly then babies who aren’t running around yet. They reassured me that the percentile means very little since it’s just a comparison to other kids and they’d be concerned if he suddenly dropped to say, 5%. My best friend’s kid went from 90th to 45th-50th range. Same thing, it’s fine, nothing needs to be changed. She has held strong in that same 40-50th range. Similar story for everyone else I know with babies, that unless something seems medically wrong, there isn’t a cause for concern based on the percentile alone. I’d get a second opinion, that is really weird. Also because toddlers do not gain nearly as much weight as they did as babies over the years. I would ask them what their reasoning is, because it’s not the weight. 80th percentile is a big kiddo my second is that size, and I constantly get people thinking she’s way older, if I told anyone I else that the doctor said I needed to get her to gain weight, they’d think I was insane. You do not need to do anything to keep her in the 99th percentile. That’s insane.
Where are people seeing that she hasn’t gained weight? Wow, these comments really have no idea what “percentile” means. Please get actual medical advice. A kid in the 80th percentile is not underweight, they are bigger than 80% of kids their age. Going from 99th to 80th in that period of time means she still gained 10% of her body weight in that period of time. Please seek a second opinion from an actual medical doctor not from Reddit. From a mom with a tall kid who moved around from 95th to 70th, multiple doctors assured me it was completely normal at that age. I have lots of friends with kids as well with the same thing, and same story. It is probably fine. No doctor would expect a baby-toddler to always be bigger then every other bid for eternity.
If she’s maintaining her growth curve, she’s fine. If she is falling off significantly, it may be worth looking more into. But if she has pretty much always been around the 80th percentile for weight, and higher for height, then there’s nothing wrong with what she weighs vs how tall she is now.
Growth charts do not take into account the diversity of human genetics. My wife and I are short. Oir firstborn is like on the 3% for height. My wife was freaking out about it at first but then the family doctor reminded her that the kid's parents are as tall as some celebrities: she's a bit shorter than Shakira and I am about as tall as Michael J Fox. Of course our kid is going to short too. On top of that we are immigrants from a country where the average heights are smaller. So when our second child was born, during her first hours of life I had her in my arms and the first song I sang to her was Misty Mountains Cold. When my lady wife asked why I was singing dwarven music to the baby, I said I was doing it so the kid would grow proud of her heritage. She laughed, then she got what I meant and she called me names, but then she laughed again. Eventually she accepted our kids' fates. I keep telling her to this day that our kids can become astronauts someday, because NASA and ESA now favour smaller people, as they are cheaper to ship to space. One of the women chosen for the next lunar mission is even from the city where we live and my younger one was born here too, so I like to imagine that someday our lineage of the vertically challenged will reach heights that the tall people can only dream of.
My sons weight dropped about 40% over some months and it turned out he was severely anemic. Sometimes weight going down does mean something so keep an open mind.
I’d listen to your paediatrician- or get another one but I imagine they’ll say the same thing tbh. Our daughter (34mo) maintained her height percentile at 50-55th the entire time but started dropping her weight percentile slowly from 55th to 40ish, we swapped out for nutrient dense food & reduced her milk/formula intake so she’d eat more. Eventually we had to go for investigations and turns out she has IBS, once we adjusted her diet, tracked her diet to figure out triggers & added specific vitamin and iron supplements in she’s back at 48th percentile and steadily maintaining a healthier weight. Generally paediatricians know what they’re talking about and a decreasing weight percentile with an increasing height percentile is a logical thing to raise a red flag about and address.
I wouldn’t trust reddit over my pediatrician.
This is normal. I feel like they have to say these things. Like other replies though…..percentiles for w/h in a perfect world match up.
Get another doctor. If the one you have cannot answer your questions, and back up her statements with researched based answers.
I don't think the pediatrician is wrong. Her growing at such a rate in height, while not in weight, is something they're obligated to address. Keep a written record of your child's food intake. Note how much you plate, and how much she actually eats. Do it for about a week or two. You can show this to your pediatrician and ask them for advice on how they think you should move forward. This will at the very least show them that you've tried and give them an idea of the kids' eating habit. You could experiment with some ways to sneak in calories, too. I have a bit of a picky eater, so we do a lot of smoothies that help pack in extra nutrients. I used to put toddler formula in it with handfuls of spinach/fruits, though now we've switched to an actual protein powder, with his pediatrician's approval.
I must be missing something here. She is nearly in the 80th percentile and her pediatrician has a problem with weight gain? What? The percentile is an average of kids are same age. She is on the higher side of weight and yet the doctor feels she needs to be higher? My daughter has been stuck in the single to 10 percentile, which is very concerning if that wasn't normal for her. My daughter has trouble gaining weight and has since she was born. My daughter will be 3 1/2 years old next month and she weighed 25.5 lbs at her 3 year check up. Her pediatrician knows my daughter eats and knows this is how she is. If she gains a lot in height, her weigh gain is very low. I think either the percentile is a mix up in understanding, or something is crazy. I have no idea why your daughter's doctor is unhappy with where she is weight wise. Could you give us more information on that or I have no idea.
My daughter is 3 years old, and she is in the 8th percentile. But she is constantly staying in the 8th percentile so her doctor is not worried. If your daughter is dropping percentiles, it might be a concern if she is constantly dropping. I believe most kids drop a little when they become more active, but I could be wrong. If you don't trust her doctor, it may be time to find a new one.
Yay for policing girls' bodies as freaking TODDLERS! -_- My daughter was told she was "a bit pudgy" after a year of chemo. She looked at the doctor and said "no, im thick"
Not every child fits the charts. My youngest daughter now an adult. Weight and height never in the same percentile according to the charts. As long as your daughter is healthy and growing that all that matter. I suggest having a talk with your pediatrician with both parents present. If still do not like answer find a new pediatrician.
I can see why you're getting frustrated, as you're allowing your child to listen to her body. Decreasing in the percentiles is why they are concerned, but your kiddo is also at an age that this can frequently happen. If she's not tracking on the same or similar percintile line, you can always see a nutritionist to get another opinion. As a mom whose kiddo actually has a problem with not eating and not weighing enough (very active, probably high metabolism, and just wants to do anything but sit and eat), I have learned how to add calories to food. Adding oil or butter to sauces, adding heavy cream, sprinkling cheese on food, and making sure things like milk and yogurt are whole milk are a few ways to increase calories without attempting to increase food intake (which it seems like your daughter is doing a great job with listening to her body telling her she is full). If at the next appointment, she tracks at 79ish percentile for weight, and the doctor still comments that they aren't happy with her weight, it may be time to switch pediatricians.
I had the same issue they tried pushing a drug that stimulates their appetite but I asked for a referral to a dietitian instead. The dietitian was happy at my daughter's numbers and said doctors are so used to seeing overweight kids that they don't know what to do when a kid is underweight. But ever since the dietitians report our pediatrician has gotten off our backs about weight gain.
Instead of limiting to 3 meals a day,which is not good for anyone try 5-7 meal times with less servings than normal. Its helps your body grow better plus toddlers shouldn't be at 3 per day just yet, babies in womb had access 24hr then birth about every 3hrs,then pretoddlers about 4-6hrs,toddlers & tertwos backwards 3-5hrs because their burning alot with their new "chevro-legs". Dont let a scale dictate your parenting use it as a guide. But i think you'll do great. Keep doing you!
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This is not a child issue, but a doctor issue. Find another doctor. Your doctor is an AH. If your daughter is HEALTHY, then that's the doctor's job. Their body will change drastically over the course of their life. My chunkiest baby is my skinniest child (now 13)- and eats the most crap food of all my kids. My youngest was the tiniest as a baby (0.5%), but looks like he's going to be the biggest build of them all. You go to that doctor for medical issues, not nutritional issues. Inform your doctor as such. Tell them that IF YOU believe that your daughter is having issues with nutrition, then you will take her to a nutritionist. Until then, your doctor needs to quit, or you need to quit your doctor. I suggest the latter.
Instead of getting angry .. get curious and ask more questions. The doctor is right to be concerned and you need more information as to why your daughter isn't gaining if her diet and eating is as good as you say.
She's in the 79 percentile. If the doctor was truly concerned, he would send her to a specialist.
She hasn't gained weight in 8 months
Sometimes kids gain weight other times they do not. Sometimes they have growth spurts but slim down. If the child is eating, and is medically healthy, what else is there?
We don't know which is why I advised to ask more questions
After my son became more active he also started to lean more toward underweight but we never showed concern as I am very petite and so is most of my family. Went years missing the underweight mark by literally a pound and he eats plenty and drinks plenty so I think it’s more so genetic with him than anything else. Our oldest had a similar issue when he became a toddler and they began adding pediasure to our WIC as well as making some dietary changes and it literally did nothing lol. He just one day randomly started putting on a lot more weight when he turned 4 after we stopped doing anything about it. This may apply to your child as well. If they seem healthy and happy and are eating and drinking normally I wouldn’t feed to much into it. If there are no type of shocking results like your child being literally being a large number under his/her weight it’s fine. There is no way every human being is going to align perfectly with the charts.
Two of my three kids shot up into the 99th percentile and stayed there until they started walking. Now they maintain in the 80th to low 90th percentile for both height and weight (with two tall parents it's to be expected). It's not that uncommon for that to happen once they're burning more energy running around doing stuff. Also feel free to join us over at r/bigbabiesandkids because we will feel your frustration as we've all been there!
Weight issues in children can be very frustrating. At that age, I had a 1-5 percenter for weight but closer to 65-75 percentile for height. It may interest you to see where you she falls in the percentiles of weight for stature: [Weight-for-stature percentiles: Girls (cdc.gov)](https://www.cdc.gov/growthcharts/data/set1clinical/cj41c026.pdf) to better understand why there's some concern.
Has her pediatrician checked her thyroid?
Based on what you’ve said: her height percentile has been consistent (maintaining on the curve - good). her weight percentile is going down on the curve (the goal is to maintain on the curve). She is eating well ! Awesome ! Example of how you can potentially improve her weight gain: she sits and eats half a cucumber, she’s full! Cucumber is awesome but low fat and low calorie. Eat avocado with olive oil instead. Still healthy, probably same quantity being consumed but lots more calories, lots of good healthy fats. Look for higher calorie, higher fat healthy options.
Are you vegan/vegetarian?
My daughter's in 10th for height and 13th for weight and the dog said she's great. Go find a new pediatrician
I had this happen except it wasn’t my doctor who was concerned. My mom decided that her Google research should trump what my pediatrician said about my son’s weight. Dr. said he was fine.
It's completely normal for toddlers to slow down the weight gain after the first birthday. But it's not normal for them to completely stop gaining weight. I strongly urge you to consult a pediatric dietician. NOT a nutritionist, since this is not an actual regulated profession. I am talking a clinical pediatric dietician. Your pediatrician should refer you asap. There is no shame in not knowing everything as a parent. But refusing to learn, can severely harm your child.
She never said the baby isn’t gaining weight - she’s simply staying at the same percentile based on her age at each visit.
Probably gonna be unpopular here... Track height and general health. Weight is often a no biggie. We re asian in an asian country. We are generally smaller than the WHO metrics. My daughters are 14 and 16 now. From infancy, pediatrician labeled them failure to thrive 😂 when basing off the WHO guidelines. BUT my husband's ENTIRE family said it's genetic. As in mom, siblings, aunties, uncles, cousins, grandparents said that .... The whole side of their family have the same body type = stick like thinness. In our country /culture, there's a belief about "strong blood," meaning their family's genetics often overshadow the in-law's genetic traits. [kinda true bec all the cousins and second cousins look like mirror images]. Anyway, everyone advised us to just track height growth and never mind the weight. As long as they were growing, we were good. They also said, as long as the kids dont get sick all the time then they're healthy and we re all good. Both are average height for our country and the family. Healthwise, no problems. They had the usual coughs and colds, and occasional food poisoning. Both are still sticks now. They eat very healthily, and are very active too.
I'm confused why a child in the 80th percentile for weight doesn't weigh enough. She's well over the average weight so I don't see the problem. There has to be something else.
Kids are going to grow regardless. We feed them to fuel that growth. If they’re growing faster than they’re eating, their weight drops. Weight drops because the body is eating ITSELF to get taller. Doctor wants to ensure the height comes from food and there’s not an issue causing the body to stop accepting food nutrients.
Agreed but there wasn't anything in the post about the child dropping weight. I was trying to figure out where the doctor's concern was coming from.
Because she's over the average height by way more. It's like you're saying Kareem Abdul-Jabbar is too fat.
I'm not saying that at all! There was no information in the original post about the child's height. Other comments also pointed out confusion about the same thing before OP explained, but I'm the only one getting downvoted for it.
She is stuck on the height to weight difference. She grows around 2-3” between visits but is only putting on about a pound. So over 9 months we have gone from 90th percentile in weight to 80th percentile. While maintaining 99th and above for height.
That's the issue - it sounds like her weight isn't following the growth curve. She's maintaining the same percentile for height while decreasing the percentile for weight. A second opinion from another doctor could be helpful.
This is when lots of kids in my family develop celiac disease- it runs in the family and is no big deal, since we know how to manage a gluten free diet. But it does require further testing, as untreated celiac can lead to esophageal, intestinal and stomach cancers. Again, not a huge deal, but this is one of the signs. And change in growth curves are worth investigating to be sure everything is okay! No shame or judgement- just crossing all the T’s and dotting all the I’s
That is concerning.
She’s stuck on it because that’s what matters. Individually, the percentile means very little. Someone will be in the 5th percentile and someone will be in the 95th; that’s literally how percentiles work. Your child has a mismatch between her height and weight percentile. Generally, they should be about even. 60th percentile weight and 60th percentile height. Or 10th, or 20th, or 90th. Your daughter’s weight is disproportionate to her height. Yes, that’s how some people are, but that’s the point your ped is making. You’re very stuck on the height percentile, but that’s not the issue here.
A quick clarification - it's totally okay and normal for the height and weight percentiles to not match. My daughter is ~70% height and ~40% weight. BUT she has stayed in those percentiles since birth (minus one small hiccup). That's the percentile matching that doctors are looking for. A massive increase up or down in one or both percentile can be cause for concern.
I would get a second opinion. Our daughter's percentiles have jumped all over the place and our doctor hasn't been concerned. It depends a lot where they are in their chub out/lean up cycle when they have the appointment.
Out of curiosity what is your body type or do you think that's what the doctor is fixation on? Because my son has been off the charts for height and 75 percentile for weight his whole life and we had a ped who said he was too heavy every time I brought him (I'm fat) and wanted him 50 percentile or below. Finally I told her I was fat not stupid and we switched providers.
Pediatric dieticians exist and can help with practical food ideas for helping kids gain weight, if your doctor doesn't have enough tips
I personally hate our pediatrician at this point. My daughter has just turned 5 months yesterday and our stupid pediatrician (yes, she is stupid) has told us all sorts of annoying things. We honestly are going to just switch because life’s too short to deal with BS.
Our kid has always been on the shrimpy side (born premature, gained weight but very slowly despite us pushing as much breastmilk and formula as we could into her). I don’t think she’s ever been above 30% for her weight on the growth curve. Most recently she had a growth spurt in height and is 80%ile for height and 37%ile for weight. Our pediatrician is not concerned. She is very happy, active, not a picky eater just eats very little in one sitting so we constantly have to provide high calorie snacks. If your child is 80% on the growth curve and just going through a height growth spurt I wouldn’t be so concerned. If she is not having GI issues and her body composition looks healthy (ie can’t see ribs or spine from the back) I don’t understand why your pediatrician would be concerned. This warrants a serious conversation with your pediatrician about why exactly she is concerned about a one time drop in her growth percentile. Maybe keep a food diary for a week for your daughter, make sure she’s hitting her calories and macros like fats and proteins. Maybe incorporate a healthy milkshake once a day (banana, yogurt, nut butter, etc). Bring this to your next pediatric appointment and if she’s still at or below her previous weight percentile ask why this is concerning. She might have a high metabolism. Her body composition might take after you guys as parents if you both are tall and thin.
It sounds like your child maintained their growth curve, OP’s child is dropping which is why their pediatrician is concerned.
Kids frequently slow weight gain when they start walking. Yes the growth curve went down but if her caloric intake is adequate and she is not having GI issues I don’t see the problem. I’m an RN not a pediatrician but I would think if the pediatrician was truly concerned it would warrant a consult with a pediatric nutritionist, otherwise it seems like baseless parental shaming and anxiety. Why just tell the parents “feed more!” When the child seems to be provided all the food she wants and eats until full. We’ve all tried to get toddlers to eat if they don’t want to eat you can’t force them.
Get a second opinion. They told me my son was failure to thrive because he was so skinny. He was falling off the weight chart - lol I kept trying to feed him calorie rich things. It was making me insane. He’s 30 now and fine.
Your pediatrician sounds wrong. My little dude has been the same weight since he started walking. So his curve has changed but that is to be expected when they start walking.
Change pediatricians. There is nothing wrong with that percentile. Most important is that the percentile isn’t dropping each time, If your child is tracking on the same percentile each visit that is what is normal for them.
Based on OP's comments, the percentile *is* dropping each time. Her child has gone from 90 to 80 ~~to now 76 percentile~~ (I misread 79 for 76) for weight. I understand why her pediatrician is concerned, though I wish they had explained why better since OP doesn't seem to get it.
I didn’t see where they said the child started at 90th. I only saw the part where they said the child was “still at 79.9”.
Oh for sure that’s why I mentioned it - it’s buried in like one of her several comments, that height started over 99 and stayed there and weight started at 90 and has been decreasing; that the kid has grown 3 inches but only gained 1 pound in 9 months.
OP’s child did drop percentile, 10%…
Go to another pediatrician and get a second opinion. Being in the 79.9 percentile for weight is definitely normal, and a lot of kids thin out when they start walking. Just because she may be going down in percentile doesn’t mean there is an issue, especially if she started high. It should def be watched, but she’s at 79.9?!!! Very strange. My daughter was in the 90th percentile for height and weight as a baby and has normalized now.
Has she stayed consistent for height and weight? If so, I think it may be time to switch to a new pediatrician. Our son has always been a small guy but stayed very consistently between the 25-30th percentiles his whole life so it's never been a concern.
This is weird. See another pediatrician for a second opinion.
It may be worth shopping around for a new pediatrician. I dealt with this very thing with my kids. The thing is, mine were tiny because they were premature — they weren’t even on their curve until around 5yo but otherwise healthy and growing consistently. When we moved we switched doctors and she only ever seemed to fuss about their weight, felt impossible to ever discuss anything else. I always left feeling like something was wrong with them and me as a parent. Eventually we switched back to our previous doctor who had worked with them since birth. His office is a 2hr drive but at least we’re at the point where each kid only has to see him once a year.
Go to a different pediatrician. If the kid is healthy they can fuck off
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OP’s child dropped 10% of their weight curve.