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Children's Health

My three year old daughter will not eat!

03/27/2009

Question:

My three year old daughter is 95% for height and was 75% for weight. Since she was last seen 3 weeks ago almost she has lost 1lb. She is very tall and now only weighs 32(bearly). I have to say she is not picky, she loves fruit, sushi(cooked) all veggies and really only eats healthy, so opposite my son! I can`t get her to eat, she will have a bit or two and that`s it she says she`s full! I wonder, is this of any concern and what do I do about this?

Answer:

The weight loss is a little surprising if she is healthy and active. The height consistent with the 95th percentile for girls who are 3 is 39.5 inches. A weight of 32 pounds for a 3 year-old girl is at the 50th percentile or exactly average, with half of girls 3 years of age weighing more and half weighing less. If she is 39.5 inches tall and her current weight of 32 pounds is accurate, her body mass index (or degree of body fatness) is between the 25th and 50th percentiles, which is totally normal. Three year-olds and really all preschool children are finding their genetically inherited growth curves and are also slimming down their body fat to its lowest level. these are totally normal changes. If you go to the Centers for Disease Control growth chart website http://www.cdc.gov/growthcharts/ and look at the BMI charts for girls and boys, you will see that unlike the upward marching progress of growth in height and weight, there is a dip in body fatness between 3 and 6 years of age. This is normal and protective against becoming overweight. You will also see a bit of a sag in weight gain for girls during these years on the weight chart.

It is very commendable and positive that she has such a healthful diet and certainly would not recommend changing her foods and beverages to high, fat unhealthful choices in an effort to increase her weight gain. I do recommend not making a fuss over her eating. At three years of age, children are still very much into declaring their independence by resisting parent directives and suggestions. They also have an uncanny ability to recognize when we care too much about something, such as their eating, and recognize a prime chance to say "No!" to whatever is a parent wants them to do.

I would stick with allowing your daughter to decide whether or not to eat the food you offer her at regular times (about 3 meals and 2-3 snacks per day) and how much she eats, if she eats, with the exception of dessert, which is only ever 1 serving. Your job is to offer healthful foods at regular intervals so that she is hungry for meals and snacks and can depend on a regular schedule for food.

If you find that she continues to lose weight or is not her normal, energetic self, appears pale and tired or has easy bruising and many bruises, she should see her doctor.

My favorite book to recommend for parents of young children is Child of Mine: Feeding with Love and Good Sense by Ellyn Satter (2nd edition). I also recommend her newer books:

1) Secrets of Feeding a Healthy Family: How to Eat, How to Raise Good Eaters, How to Cook
2) How to Get Your Kid to Eat-- But Not Too Much

I hope this is helpful information!

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University