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DrGreene Content
 My 4-year old daughter is 38 inches tall and weighs 27.5 pounds. She hasn’t been eating much for the last year. Now I’m lucky if I get a meal into her. She has started loosing her hair and is not gaining much. At age 4, isn’t she off the charts? What can I do?
 27.5 pounds for a girl who is 4 years old puts her below the 5th percentile for girls her age. Her height is about the 25th percentile for her age, meaning she is taller than about 25 out of 100 healthy girls her age. Even though she is shorter than average, her weight for her age is also below the 5th percentile.
Five percent of healthy, well-nourished girls are at or below the 5th percentile. Still, her low weight could indicate that she is not getting the calories she needs. A doctor should consider any child who is below the 5th percentile – especially one who is having other symptoms, such as hair loss. Often pediatricians are a great place to begin, but if any questions remain, pediatric gastroenterologists often have a good perspective on this issue. Endocrinologists also look into growth issues, but they are usually best if the height is the one off the charts. Either way, a visit to a nutritionist is wise, both to evaluate what your daughter is actually taking in, and to suggest ideas for increasing her calories, if appropriate.
In the meantime, a good multivitamin with minerals can provide a safety net for the important nutrients. I rather like Centrum Kids. The Nutrition Action Healthletter compared different vitamins and Centrum Kids had the best values overall. Most kids like these chewable Shamu-shaped vitamins.
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