Dr. Alan Greene on 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?

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 a multivitamin, feeding him a high-calorie drink, and serving him high-fat foods.

Also consider meeting with a pediatric gastroenterologist. Keep a food diary for a week and bring it to your appointment with the doctor. Many pediatric GI programs have occupational therapists who observe feeding and work with food aversions.

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.

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.