Dr. Robert Needlman
Specialist in pediatric behavior and development.
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 Ask Dr. Needlman
Worries about Underweight Toddler | | | QUESTION | | | Dear Dr. Needlman
My two-year-old grandson weighs 21 pounds. He has shown little to no weight gain in a year. His doctor checked his white-cell count and says it's normal, and then suggested feeding him more fatty foods.
My son is divorced, and we have the grandchildren only on weekends. My grandson usually will eat two or three pancakes at breakfast; peanut butter for lunch; and meat, carbo, and vegetables for supper. He drinks whole milk and eats bananas and appears to be healthy. How concerned should we be about his lack of weight gain?— Concerned Grandmother in Rhode Island | | | ANSWER |
June 12, 2001 | | | Dear Concerned Grandmother,
Poor growth is a worrisome symptom in young children. Any number of medical, nutritional, psychological, and social problems can result in poor growth. It's important to detect and treat many of these conditions in order to prevent severe consequences. Poor nutrition, which is the most common cause of poor growth, can also result in poor brain development and learning problems.
The first step is to consult with a pediatrician or family doctor who has experience caring for children with growth concerns. The doctor will start by carefully weighing and measuring the child, and plotting the height and weight on a standard growth chart. Obtaining measurements over time allows the doctor to see when the problem began and how it has progressed. When a growth problem is diagnosed, doctors often will bring in a team of professionals that may include a nutritionist, social worker, child development specialist, and others.
At 24 months, according to the standard growth charts, the average or ideal weight for a U.S. boy is 28 pounds; 95 percent of boys weigh 23 1/2 pounds or more. A weight of 21 pounds is only 75 percent of the average weight and is well below the 95 percentile mark. Most doctors would consider this percentage to be consistent with a moderate degree of undernutrition. This level of undernutrition, if confirmed, should result in a concerted effort to find the cause and correct it.— by Robert Needlman, M.D., F.A.A.P. |
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