Underweight toddler not eating

[Javalavashiloh]

Hi Renee,

I worry constantly about my daughter, who is 2 years old, 20 lbs.  She was at the 5% for weight until 6 months of age, then completely dropped off.  She does have a diagnosis of functional constipation and is on daily Miralax.  Her workup has included a negative upper GI series, and bloodwork negative for celiac dz and allergies.  Sometimes, she eats "ok", albeit small quantities.  When she IS eating, she enjoys a variety of meats, veggies, fruits, textures, etc.  However, she goes on extended eating strikes lasting several weeks, where she will not eat any food, but only takes bottles.  She still gets 3 bottles a day, but only after meals - never before food is offered.  I have tried repeatedly to get her to drink Pediasure, but she refuses.  When she's on an eating strike, even tempting her with "junk" does not work.  It is heartbreaking to hear "No thank you Mommy" and watch her go day after day, without eating any food.  I do not want to create further problems, force her, or make eating any more stressful that it already is....but I am sick with worry over her not eating.  I wonder how she can sustain life at times.  She is ahead of her milestones developmentally, very bright, very active, and happy most of the time.  I do give her PolyViSol daily.  During these episodes she will lose weight, so she never really seems to get ahead as far as growth.  She is very thin.  I am small - 4'11" and my sister was very similar to my daughter at the same age - tiny, and "never ate" according to my mother.  Any advice appreciated - we try so hard to offer nutritious high calorie options but whether or not she eats is up to her.  Thanks, a very worried mother.

[MomtoDrew]

Hi,

I go to www.myduocal.com and there is a link to purchase. It sends you to the company's webpage and there is order info from there.  Also, you can do a google search for Duocal.  You will find out more information about the product that way, too.  If your daughter is still seeing a gastroenterologist, does he/she work with a nutritionist?  If so, I am sure that the nutritionist could get you a sample.  

[Javalavashiloh]

Hi Renee,

Thanks for your answer.  I have tried making smoothies/milkshakes, but she doesn't seem to want them.  She does, however, like ice cream.  I will try the suggestions you listed in your reply.  Unfortunately, she will often pick items that have no fat and few calories (fruit, etc) and refuse the high-calories items I have prepared.  It's hard as I cannot force her to eat.  

Hi Mom to Drew - thanks for the post - I will look into the Duocal.  Where do you purchase it?

Thanks.....

[MomtoDrew]

Hi,

Sorry to hear about your baby girl.  My 19 month old son's growth pattern is very similar to your daughter's.  He just turned 19 months and is 18lbs 10oz.  We have tested for ciliac, have had a few different blood tests, they thought it might be growth hormone. No Celiac. Blood tests are good.  His height and HC are both above 10th percentile. We have been under the care of a nutritionist for about 4 months now. There is a product that the nutritionist suggested for my son.  It is called Duocal http://www.myduocal.com  Basically, you can add it to most liquids, they don't suggest adding it to juice, and most moist foods. It's completely soluable and tasteless.  It adds fat and calories to foods that your daughter might already eat.  I add it to my son's milk.  I cannot say for sure that it has helped my son gain weight, but I think that it has prevented him from losing weight during his times of "starvation,"  if you will.  Hope this helps you.  I totally understand what you are going through. God Bless!

[Renee Radenberg]

Her weight is below the 3rd percentile and her height is above the 10th percentile for her age. Have you tried giving her milkshakes (milk, ice cream and fruit – if accepted – blended together) since she likes her milk and not Pediasure. The milkshakes will give her additional calories and protein similar to the Pediasure. When she is ‘eating’, suggest increasing her calorie intake by the following: If she likes pasta, then add meat or cream sauces to the pasta instead of plain tomato sauce or plain pasta. Add dry milk to oatmeal, mashed potatoes, gravies, creamed vegetables, and creamed soups (add additional meats to soups). Use all fat dairy products and not low fat foods to give her for the extra calories she needs. If she drinks soups (no light broths) or stews add powdered milk to them for additional protein and calories. Hoped that helped you.