Low Weight

My 2 1/2-year-old is refusing to eat anything. He only weighs 23 pounds and isn’t gaining. I discussed this with his pediatrician and he can’t figure out what the problem is. What could be causing this?

Dr. Greene’s Answer:

An average weight for a 30-month-old boy is about 30 pounds. But anywhere from 25 to 35 pounds does not provoke concern, since 5 percent of healthy 30-month-old boys do weigh less than 25 pounds.

However, this is still the level where you should look into possible causes for your child’s low weight. There are many problems that can cause this. When children don’t gain weight, it could mean they are not taking in enough calories, they are not absorbing enough of what they are taking in, they are burning too many calories, or they are not able to use the calories they do have for growth.

You can try boosting your son’s caloric intake by giving him high-calorie nutritional drinks such as Pediasure. You can also make delicious, high-calorie drinks at home with whole milk, ice-cream or yogurt, and fruit. Additional calories can be obtained by adding, high-fat foods such as peanut butter and cheese to his diet. I also recommend starting a daily children’s multivitamin.

There are many causes of failure to gain weight, and your pediatrician would be the best person to determine what type of evaluation would be needed in your child, if any. Keep a food diary for a week and bring it to your appointment with the doctor.

Your doctor may determine that your child is at the perfect weight for his height and doesn’t need any extra food. It’s possible that he’s following his genetically programmed size and decreasing his appetite to hit his ideal weight. If he is at a good weight for him, then you can relax while sorting out the feeding issues.

Dr. Alan Greene

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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