[an error occurred while processing this directive] [an error occurred while processing this directive]

Answer to your Health Question

Question:

I have an infant who lacks good appetite for food.

He does eat but very little and also his drinking is little.

He rather has energy and is so playful and is not a sick though his weight is usually about 10kgs at 1 and 9 months.

Please advise what I should do because his weight worries me.

Answer:

The average weight of a boy 2 years old is 12.3 Kg.

You doctor should check his white-cell count.

If his white-cell count is normal, your doctor may suggest feeding your son with more fatty foods.

Poor nutrition is the most common cause of poor growth.

You doctor should 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.

Based on the Growth Chart of the Centers for Disease Control and Prevention your child is lying below the 5th percentile curve.

Most doctors would consider this percentage (below the 5th percentile curve) to be consistent with a moderate degree of under nutrition.

This level of undernutrition, if confirmed, should result in a concerted effort to find the cause and correct it.

It is important to recognize and treat children who are not gaining weight normally because it may be a sign of undernutrition or an underlying medical problem that requires treatment.

Undernutrition can have complications, such as a weakened immune system, shorter than normal height, or difficulties with learning. These complications are more common in children who are undernourished for a long period of time.

The goal of treatment is to provide the child with adequate nutrition so that he or she can "catch up" to a normal weight. There is a range of normal weights for a particular age. Catch-up growth may require changes to the child's diet, feeding schedule, or feeding environment.

The parent and healthcare provider should work together to develop a plan that meets the needs of both the child and the family.

The type of treatment needed depends upon the underlying cause of poor weight gain, any underlying medical problems, and the severity of the situation.

Most children who are mildly to moderately malnourished can be managed at home with help from the child's healthcare provider, and in some cases, other specialty providers (e.g., dietitian, occupational or speech therapist, social worker, nurse, developmental specialist, child-life worker, psychiatrist).

Children who are severely malnourished are usually hospitalized initially. While in the hospital, the child's diet and weight can be monitored closely.

In older children, calorie intake can be increased by adding cheese, butter, or sour cream to vegetables, or by using calorie enriched milk drinks instead of whole milk.

During catch-up growth, the amount of calories and protein that a child eats is more important than the variety of foods eaten. For example, if a child is willing to eat chicken nuggets and pizza, but refuses all vegetables, this is acceptable. At meal and snack time, solid foods should be offered before liquids. Fruit juice should be limited to four to eight ounces of unsweetened 100 percent juice per day.

The older child should eat often (every two to three hours, but not constantly). The child should have three meals and three snacks on a consistent schedule. Snacks should be timed so that the child's appetite for meals will not be spoiled (e.g., snack time should not occur within one hour of meal time; snacks should not be offered immediately after an unfinished meal).

Examples of healthy snacks include crackers, peanut butter, cheese, hard boiled eggs, pudding, yogurt, fresh fruit or vegetables, or pretzels. A multivitamin and mineral supplement may be recommended in some cases.

Eating environment - Changes to the area where the child eats may help the child to eat more. All members of the child's household should be aware of the importance of these changes.

The child should be positioned so that the head is up and the child is comfortable. The child should be allowed to feed him/herself (e.g., by holding a bottle or eating finger foods), but may need to be fed soft foods with a spoon. A certain amount of messiness is to be expected as the child learns to feed him/herself. Allow the child to finish eating before cleaning up.

Meal time distractions, such as TV, phone calls, and loud music, should be minimized.

Make meal time routines consistent, no matter who feeds the child.

Meal time should be relaxed and social; eating with other family members and pleasant conversation (not related to how much the child eats) are encouraged. Eating with others allows the child to observe how others make food choices, hopefully encouraging healthy eating habits.

Do not be discouraged if the child refuses a new food. New foods may need to be offered multiple times (even up to 10) before they are accepted.

Meal time should be free of battles over eating; caretakers should encourage, but not force, the child to eat; food should not be withheld as punishment. In addition, food should not be offered as a reward.

The child should be praised when he eats well, but not punished when he does not.

 

Do you have any other questions? Enter your health question

[an error occurred while processing this directive]