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Thread: Underweight 2 year old. Allergies? Mal-absorption?

  1. #1
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    Default Underweight 2 year old. Allergies? Mal-absorption?

    This is really only breastfeeding related because we still breastfeed and recently night weaned but I want to know what you guys think.

    My son turned two in March. I took him to his wellness visit, he was 19lbs (<1%) and 31" tall (<1%) with a head in the 3rd percentile. I have worried about his size all his life, but something changed at his 2 year wellness visit. His pediatrician showed me how he gained slightly more weight from 18-24mo than he did from 12-18mo and I felt really good and in all honestly, completely stopped worrying. My kid was absolutely thriving, he was meeting milestones of 3 year old children.

    Fast-forward to now: We have recently (two weeks ago) night-weaned because of so much disrupted sleep (caused by a variety of changes in the past four months including potty training and moving from his crib to a twin bed). Now he is waking to pee in the night and not going back to bed because he is (saying his he) hungry.

    We do not get full nights of sleep anymore. He is up from 2-4 hours in the middle of the night 4-5 days a week and I have been trying to get help, from friends, from the internet, family, daycare provider. I have taken lots of advice and try to stick with everything for at least a few weeks as to not create too many variables.

    ---we took away his nap but it didn't help so we gave it back
    ---we moved him back to pull ups at night, he still wears them but it has not changed anything
    ---we tried night weaning
    ---we use lavender
    ---we have a very strict, detailed, bedtime check list that we use every night

    People who do not know my son but know our situation are suggesting is that he has allergies or absorption issues. My gut tells me there is no problem because he does not have any bathroom/diarrhea issues, he has never had a rash (aside from yeast when he was in diapers) and he eats well. He is just little, right?

    But he is SO LITTLE (size 3-6mo shorts, size 3 shoes, size 12mo shirts/pajamas). When I talked to my son's doctor this week he told me to give him melatonin before bed. We tried it last night for the first time and still had a very hard night. He pushed away from talking about any potential things that could be causing his middle of the night hunger and his small size and simply told me to only give him water in the night and make him return to bed as soon as possible.

    My husband and I are small-average build. I am 5'2"/130 and my husband is 5'9"/175. We were both very small/short/skinny as children. At this point is it okay to just listen to the pediatrician and write him off as normal? Am I being neglectful to NOT go see an allergist, nutritionist and/or endocrinologist and try to get to the bottom of this "problem"?
    Jack, my nursling (Oct 2015) Kevin, my preschooler (Mar 2012)

  2. #2
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    Default Re: Underweight 2 year old. Allergies? Mal-absorption?

    I think that allergies and absorption issues are the trendy new thing for armchair diagnosticians. I'm not saying they don't exist, because they certainly do! But if everyone who gets this suggestion had an allergy or absorption issue, we'd have some sort of crazy unrecognized global health crisis on our hands. Possible? Sure! Likely? Not IMHO.

    If we were talking about my kid, I'd probably buy the pediatrician's POV that you have a normal, albeit small, child. You and your husband are on the small side and were small as children. Your child is meeting his milestones and eats well. Aside from being small and not such a great sleeper, it sounds like he doesn't have any allergy/intolerance symptoms- no eczema or other rashes, no problems with his digestion.

    Regarding the sleep, I keep thinking about a friend who is a very skinny Jewish guy. He's 6'2" and probably weighs about 150. And he cannot- CANNOT- make it through Yom Kippur (the most important fast day on the Jewish calendar) without having a sandwich somewhere along the line. He just doesn't have enough fat reserve to fast for an entire 24 hours. Maybe your LO is the same- he can't get through the night without tanking up on calories? If this were my kid and he was waking up and saying he's hungry, I'd at least experiment with a nighttime meal. Something with both carbs and protein or fat, something that will digest nice and slow overnight. Turkey sandwich, scrambled eggs and toast, peanut butter and an apple...

  3. #3
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    Default Re: Underweight 2 year old. Allergies? Mal-absorption?

    We have gone back and forth from giving him snacks in the night. Albeit, never a "meal", it has mostly been quick things and carb loaded (dry cheerios/piece of bread). He complained he was hungry in the night before night weaning, but it seems like he complains more often now, but still never asks to nurse and only asks for actual food.

    Perhaps having a nutritious snack ready to eat in the fridge for his night waking would be smart. Our pediatrician is very against that and says he needs to get used to not having food in the night (but he was also pushing me to night wean at like 6 months and does not know I still breastfeed, let alone that we waited until he was over 2 years old to night wean). While I'd like to just trust everything he says and do whatever he says... I do not agree with it all. However, to my husband, the doctors word is the bible =)

    That said, he absolutely CAN make it through the night without food. He just has a difficult time falling asleep. Snacks have not seemed to help, but that may just be because eating a snack requires my son to be fully awake and then we are starting bedtime from scratch.

    Thank you llli*mommal!! You always respond to my posts and make me feel good
    Jack, my nursling (Oct 2015) Kevin, my preschooler (Mar 2012)

  4. #4
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    Default Re: Underweight 2 year old. Allergies? Mal-absorption?

    Metabolism can vary from day to day as can the exact amount eaten. I know I sometimes get hungry in the evening and can't get to sleep without a glass of milk or slice of toast or bread w/peanutbutter. Yea I could survive without it but a hungry ach in the tummy does make it really hard to get to sleep unless you are just so dog tired that you are passing out anyway.
    Follow your mommy instincts, Doctors are really only "practicing" medicine and don't necessarily always have all the answers (especially any one that pushes early weaning.)

  5. #5
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    Default Re: Underweight 2 year old. Allergies? Mal-absorption?

    Quote Originally Posted by @llli*kevins-mom View Post
    Perhaps having a nutritious snack ready to eat in the fridge for his night waking would be smart.
    I really like this idea. Maybe it would make sense to wrap up an extra plate of dinner, and set it in the fridge? That way there's something that's ready to go, and there's no temptation to fall back on the easy stuff, like goldfish crackers or chips.

    I totally agree with your pediatrician that most kids can and should sleep through the night without needing a snack or a meal. But most isn't all! There are plenty of adults who wake up for a midnight snack. And it's not like you have a chubby kid, one who really doesn't need the extra calories. You have a kid who might benefit from an extra helping.

    Quote Originally Posted by @llli*tclynx View Post
    Doctors are really only "practicing" medicine and don't necessarily always have all the answers (especially any one that pushes early weaning.)
    Love this!

  6. #6
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    Default Re: Underweight 2 year old. Allergies? Mal-absorption?

    Hunger is hunger. It's a signal the body needs food to grow and develop. If I woke hungry, I'd eat!

    If you want to nurse at night for hunger, go ahead! My DS (2y7mo) still nurses about 3 times at night out of hunger.

    One thing we've had success with for my hungry, slow-to-eat-solids son is a pre-bed meal, followed by tooth brushing and nursing to sleep. The growth spurt bedtime meal is high protein and fat for slow gastric emptying.

    DS sprouted an inch and a half in height and put on a pound in a week eating (self-selected) like this during his last growth spurt:

    ~7pm dinner, nurse both sides after
    ~9pm nurse both sides
    ~10pm 2/3 banana, 1tbsp natural peanut butter, 3oz beef (the first night I brought about half this amount and DS wanted seconds and thirds!)

    Night nursing: ~10:30pm, ~midnight, ~3am, ~6am

  7. #7
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    Default Re: Underweight 2 year old. Allergies? Mal-absorption?

    I suggest the book My Child Won't Eat. It is true that hunger is hunger. If a healthy child is hungry and they are offered food THEY WILL EAT until they are not hungry anymore. They just will not necessarily eat when, what and how much you want/expect them too. Especially how much.

    If bedsharing and nursing your child at night helps you get more sleep, bedshare and nurse your child at night. It can only help and cannot possibly hurt. I agree with alphawoman, it is a myth that older nurslings only nurse for comfort and do not nurse out of hunger. It is also a myth that breastmilk is not nutritious past a certain age.

    One of my good friends with four kids age 3- 8 has tiny sons and huge daughters. She and her doctor are confident that are all 100% healthy, but she gets comments even from absolute strangers about both situations. She has learned to politely ignore them.

  8. #8
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    Default Re: Underweight 2 year old. Allergies? Mal-absorption?

    Quote Originally Posted by @llli*lllmeg View Post
    If a healthy child is hungry and they are offered food THEY WILL EAT until they are not hungry anymore.
    In most cases, this is true. It is not, however, true in ALL cases. My 3.75 year old is perfectly healthy, 75 %tile for height and 50 %tile for weight. But he suffers from severe food neophobia and will not eat when presented with foods he's uncomfortable with (meaning almost all of them). His diet is severely limited; he survives on bagels, spaghetti with sauce, and cheese. One of the things people tell us is "he'll eat when he's hungry." And I'm always think, Are you volunteering to come sit with him for HOURS while he refuses to eat? Cause I'm not willing to do that.

    I realize that food refusal is not the OP's problem, but I felt I had to say that the common wisdom of "they'll eat when they're hungry" is not always true.

    One thing we found that helped us when DS1 was going through a phase of middle-of-the-night-hunger-attacks was to give him a snack immediately before bed. It seemed to help a lot.

    And I say if your kiddo is saying he's hungry in the middle of the night, feed him! Not only does it satisfy hunger, it teaches him to trust his own body, and also shows that you trust him.
    Breastfeeding, babywearing, sci-fi loving, total geek of a mom!

    Be who you are and say what you feel, because those who mind don't matter, and those who matter don't mind. — Dr. Seuss

  9. #9
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    Default Re: Underweight 2 year old. Allergies? Mal-absorption?

    Thank you for the information froggylogic. I had not heard of neophobia before. And I certainly agree that even in cases without a specific condition, there are often foods a particular child is going to reject and if that is all they are offered, they are very possibly not going to eat very well. I think you will see that I also said:
    They just will not necessarily eat when, what and how much you want/expect them too.

  10. #10
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    Default Re: Underweight 2 year old. Allergies? Mal-absorption?

    I completely agree with all the other ladies here. I would have no problem offering my child a snack in the middle of the night if he woke up saying he was hungry, particularly since you are a bit worried about his small size. I would also have no problem nursing overnight if that's what got everyone the most sleep--do you think the sleep situation has gotten worse since you nightweaned?

    I would also consider perhaps seeking out a new pediatrician if you aren't comfortable with the one you have. If you feel unsure about his recommendations regarding your son's size/health/etc. AND you already know he's got some parenting/nursing ideas that aren't in line with your beliefs, it cannot hurt to seek out a fresh set of eyes. It would be one thing if you were just butting heads over different parenting styles, but if you are also not entirely comfortable with his medical assessment of your son, it can't hurt to see someone new!
    Apologies for the short responses! I'm usually responding one-handed on my smartphone!

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