Healthy Weight Gain

[sportsmom20]

My daughter is 12 (almost 13) she weighs 8- lbs and is 5' 3" tall.  We went to the doctor for another issue and he ended up telling her that her BMI is 14% and he wants her to gain 22 lbs.  That is 1/4 of her body weight!!!!  He gave us no indication of how this was to be accomplished.  He has referred her to a pediatrician, however the appointment isn't for 6 weeks.  she hasn't gotten her period yet.  She eats well and eats healthy.  She would choose a bag of grapes over a bag of chips for a snack.  She likes all veggies, even ones most kids don't like.  She does not like a lot of carb rich foods.  She doesn't like rice, she eats pasta but not so much, doesn't like pizza, doesn't like hamburgers.  Loves steak, roast, seafood, chicken, pork.  Loves fruit and loves veggies.  Do you think for a girl who hasn't reached puberty that our doctor is right?  Should she gain 22 lbs?  If so, how can I help her?  Power bars, protein shakes.  I think I need to increase carb intake, but where do I find a list of good carbs and there values and how much should she have a day?  I have heard 250 -300 grams a day???

[Angelinthemorning]

First off, is your daughter very active??  I was extremely active at that age and was 5'4 at 86lbs.  For a girl who hasn't hit puberty this seems fine to me...I turned out just fine.  I was also told at 16 I needed to up my BMI, it was only 6%.  The doc only suggested this b/c I had not gotten my aunt flow yet.  And didn't until I was 17, which had no affect on me as a woman (I had two healthy pregnancies and two healthy babies)  The way you talk she seems very healthy.  Does she seem to have an eating issue to you??  Is she fatigued often or seem like she has low energy??  Were you or your husband small at that age??  
I personally would not get overly concerned if she isn't showing any signs like the ones I asked above.  I would wait to see what the pediatrican has to say.        

[Angelinthemorning]

Correction my BMI was 16%, my body fat was only 5% though.  Which is somewhat rare for a girl.(unless very active)

[sportsmom20]

Thank you for your comments.  First off I apologize for my typo (80 lbs).  To answer your question, yes she is very active.  She plays rep soccer, and competes provinically in track and field.  She also plays school sports.  As far as I am concerned she has no eating issues.  She has been fatigued lately and was very pale, that was why we went to the doctor initially.  I suspected anemia.   Since I had anemia when I was pregnant I thought I recognized the signs.  I have been adding iron rich foods to her diet (liver pate and crackers with lunch and spinach dip, as well she loves seafood some of which is high in iron), however I wasn't sure if I should add supplements such as B12, folic acid, and iron in a kid her age.  That was why we went to the doctor and he said (before any blood work was done) yes she is anemic and she is underweight 22 lbs.  I am sending  you for bloodwork and referring her to a pediatrician.  When I asked him about supplements for anemia he said to give her Centrum.  I really didn't think that was the right answer and felt that gaining 22 lbs was the wrong answer as well.  My feeling was kids grow at different rates and maybe she is taller and will fill into it.  I am short (shorter than her), however my husbands side is all tall and lean.

I am only concerned that if there is an issue that I should really be dealing with exists, that I should be helping immediately, not in 6 weeks. I don't have a lot of faith in this doctor.  He took over the practice from our original doctor and we live in an area that is short on family physicians, so it would not be easy to change.

[Angelinthemorning]

6 weeks is a long time to wait for bloodwork.  B12 is okay to give to children.  At her age she should be getting around 1.8 micrograms a day. Whether through supplements or food.  You might check out this website...It's based for vegans but has a lot of good info on vitamins in children...http://www.vegfamily.com/dietician/index.htm.  It does seem odd that he didn't suggest some iron pills since that's what's lacking for people with anemia.  You can buy some over the counter iron pills.  Just make sure you keep up the fiber as iron, I'm sure you know, can cause hard stools.  
I would put a call into the ped, tell them your concerns and see if you can't at least get a nurse to call you back and give some ideas.