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Is her doctor worried about her size? I have a 2.5 yr old niece who weighs only 21 pounds. She healthy, just small. She's a picky eater and my sister in law and her family are on the small side (she is only 4ft 10in). So if you or your husband or anyone in either of your families are small, then she just may be taking after them.

Once they reach this age the weight gain slows down a lot also, when they are babies they grow very quickly but by the toddler years the growth is a lot slower and more gradual. She sounds fine to me. My almost six year old son is only 36 pounds and my almost 9 year old daughter is only 48 pounds. I weighed 100 pounds up until i got pregnant with my first child.

As long as she acts ok, is happy and active she is fine. You should look at how she acts this is more important in telling you how healthy she is. Weight is just a number, she could weigh enough and still be sickly.

Assuming she has no medicasl problems, usually we work to make whatever she does eat and drink, be as fattening as possible.

For example, you can add a cup of powdered milk to a quart of whole milk to make 'super milk'. Give a lot of milk shakes. Add lots of butter or oil to her food, etc. Offer her nothing but fattening foods.

The idea is you can't make her eat more, but you can make whatever she does eat be more caloric.

See how your pedi likes to handle this. Some parents even find a visit to a nutritionist helpful in this regard.

My daughter was 22 lbs at about that age. If they are "gaining weight" and your pediatrician is not worried--then don't worry. Also, think about genetics and if it seems to fit into your family. TRY adding a little more fat to her diet. Like WHOLE Milks....

I'm in the same boat with my youngest daughter. She too was born of average weight (7lbs 7 oz) and now is 18 months old but only weighs 18 lbs. She is very active and eats well. She often eats as much or more than my older daughter who is 4 years old and weighs 34 lbs. Up until she turned a year old, I attributed her small size to because she nursed, and I had always heard that nursed babies are generally smaller than formula-fed babies. But she quit nursing at 13 months and for the past 3-4 months she has exclusively eaten table food. We have calculated her daily diet to be 900 to 1000 calories. However she has 3 or 4 bowel movements per day! (Also my husband is 5ft 11in/190 lbs and I am 5ft 6in/160lbs, and no one in family is very small.) She eats blueberry Nutrigrain bars, oatmeal, fruits, peanut butter sandwiches, cookies, lots of orange juice fortified with calcium/vit D, chips, meatloaf, spaghetti, corn, beans, chicken, nearly whatever we are having. Trust me, she is having the BMs to prove it. I think somehow she is just not absorbing enough nutrition from it.

So we have been concerned as well as her pediatrician about her weight and so she requested blood work and fecal testing for lipid content, pH I think, and reducing substances or something. The only thing that came back weird was that her thyroid I think T4 level was fairly high (suggesting hyperthyroidism) BUT her TSH level was perfectly normal, so that ruled it out if test was accurate. So primary pediatrician sent us to Ped endocrinologist at Vanderbilt Children's hospital.

Endocrin doctor redid the blood work but added a test for gluten allergy/Celiac Disease and also a sweat test to screen for Cystic Fibrosis (which NO ONE in our family has had that we know of and our daughter has never had a lung infection in her life!!). Anyway her bloodwork this go around came back perfectly normal on all accounts, except that she had an elevated "sedimentation rate" which he said indicates an infection of some kind. She had a cold/runny nose when the blood work was done and the doctor agreed that could be the source there. The hospital wasn't able to fit us in for a CF test last week so we have to go back this week. So tomorrow we take her for the CF sweat test. I felt sure the hypothyroidism fit because I have thyroid problems myself (although I have hypothyroidism).

Does anyone have any insights as to what direction to go next?? She is a very happy child. She has an orangish complexion probably b/c of orange juice, carrots, and her love for mandarin oranges. The endocrinologist said that no doubt her weight has already been affected by her ailment and her height has started being affected too. He said the weight is affected first and next the height. I'm sorry this is so wordy but I wanted to paint a complete picture.

do not worry sure she is fine being she is a nibbler try giving her 2 pedisures a day you can get them at almost any store for about 10.00 for 6.try that for a couple of weeks .for that is what the dr. had me do for my son and in no time he was at the weight he needed to be for his height.and remember not all kids are the same that chart is just a guide

Hi there,

Everyone here has given great advice, including mamamary321 above. I just wanted to encourage anybody with trouble getting their kids to gain weight to rule out all the options, including cystic fibrosis.

My dd has cystic fibrosis, and nobody in our family ever had it either (usually that's the case) AND she's not had a respiratory infection and she's almost four. It is common not to know that being a carrier runs in your family, and it's fairly common not to have respiratory problems early on. I just wanted to say that to encourage anyone who is having trouble getting their dc to gain weight to push, push, push your doctor for that sweat test or genetic test. (Even pediatricians aren't always up to date on what common symptoms are for CF, and might tell you that CF kids always are really, really sick and that it's impossible your healthy child could have it. Not true.)

I'm not saying any of the above cases are CF -- I have no idea, obviously, and there are plenty of other reasons kids have trouble gaining weight, including just being picky! But because this is something I happen to have experience with -- I just want to make sure people don't think it's so rare or impossible that they don't rule it out. CF is better treated earlier, so getting it diagnosed soon is a big deal.

I have a daughter that was born at just 6 lbs which is an average weight also. She is now 5 and only weights 28 lbs. Her Dr. has checked just about everything you can. We have come down to both my family and husband family are small so she is too. My daughter also eats a little here a little there. I'm not sure what to tell you because no one is sure what to tell me. But it is nice to know there is other people out there going thought the same thing.

My best friends child had a similar issue, at 17 months only 19 lbs. The peds were very worried about him and tried everything to get him to gain weight. A month ago they finally figured out that he's lactose intolerant and he's gained some weight rather quickly, however he is a very picky eater, since he's gone this long with stomach issues. His mom also has to watch how much he's drinking because he likes to fill up on juice and then not eat at mealtime. Hope this helps!!

you have nothing to worry about. my son was born 6lbs 11oz and he is 17 months old now and only weighs 22 pounds and his sister who is 3 years old weighs the same as him and our doctor is not concerned. as long as your girl is eating and like you said she is active then you have nothing to worry about. just be thankful that she doesnt have a weight problem.

It is good to rule out anything medical going on but as the others said, she just may be a peanut. It is very common for toddlers to stop gaining weight at this age or gain very very slowly, since they are so much more active and don't take in as many calories as when they are infants. The rule of thumb is as long as she is not losing weight and still growing height wise, she should be fine.

My youngest is by far my smallest child, she was born average weight for a girl @ 6lbs 4oz but she was only 17 inches long, my others were much longer and heavier. She is almost 4 yrs old and still only weights 24 lbs and about 34 inches tall, peanut girl. She has met all her developmental mile stones and does grow/gain weight, just painfully slow.

As Dr. P. says, try to fatten up what she does eat and try not to worry to much, she is probably fine.

Good luck.

Sounds exactly like my 6 year old sons story right down to the runny nose during the bloodwork. He was an average size baby until his 1 year appointment & then he dropped completely off the chart. We went through the all sorts of tests including the sweat test (negative) & ended up with a a diagnosis of aquired hypothyroidism. He takes synthroid daily and has for the past 5 years which seems to be keeping his thyroid T4 level in a normal range. We see a pediatric endocrinologist every 4 months to monitor his growth and will continue to see him regularly. The endocrinologist is not completely convinced that the thyroid is the only problem but there are soooooo many conditions it could be we may never have an accurate diagnosis. All his organs work properly & he has no disabilities other than short stature & low weight so I guess we just wait. The say that pueberty is the next major milestone where there could be issues (nothing serious mostly growth issues) Question for you: What do her fingers look like? My sons pinkies turn in & he is very double jointed in his pointer finger. It may be a characteristic of a syndrome (johnson silver?) but htere are no conclusive tests for such syndrome. Good luck with the testing & such. FYI the next step may be a genetisist (sp) to rule out certain genetic disorders

I agree with the PPs. Don't worry about it. if your little one is eating and drinking, having normal urination and BMs and his/her development and demeanor is normal you shouldn't waste even a minute worrying about it. We've talked to our dr. about it (both boys are small, the first was a preemie, second full term)and the team there doesn't generally even recommend 'fattenning up' foods. It used to be that was the general recommendation for any young child under the 30%ile,and certainly under 1o0% but they've each child is different. As long as they are eating, content,and doing well in all other ways(is healthy just small and not losing weight)it's just fine. Adding too much fat or throwing off the balance of fat/calories, etc. to liquids can be unhealthy in it's own way. Do what your dr. recommends but really i wouldn't waste any time worrying about how tall/heavy your little on 'should' be, it's all averages every child is different.

hi, this is the first time i have put a post on but i couldn't resist---- your daughter sounds so like my son. He is 18 months old and weighs just under 20 lbs and is 31 inches tall. he is the same weight as when he was 9 months old. We are going mad trying to get high calorie foods into him... he eats well but won't drink milk so we only get milk into him on cereal etc. They thought he had cows milk protein intolerance and he was dairy free for 3 months but he is back on dairy now. Tested for cf and that was fine. He has a low iga level, is slightly anaemic. Waiting for repeat of celiac screen. Not sure how hard to push the paeds about it.... my instinct says there is something going on. My 16 yr old is 6ft, my 5 yr old is also v tall as are my husband and i. Have you had any answers about your daughter yet? any advice and info from anyone is really welcome, thanks.