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23 months child not gaining weight, having cold, cough and fever. What precaution should I take?

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Practicing since : 1982
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Hello Doctor
Good Day!
My daughter is 23 months old, her birth weight was 2.5 Kg, now she is 8kg, her activity are good but my concern is she is not gaining the weight she eats less and doesn’t feel hungry and neglects to eat , she goes to motion 2 to 3 times a day or after finishing her breakfast/lunch and dinner ,
Her stamina power is very less, cold cough and fever will come soon
Please provide me the chart to feed her timely with food details, what all problems can occur if she doesn’t gain weight, what precaution has to be taken and as she has taken more vaccination injections as suggested by the doctor.


Posted Fri, 27 Jul 2012 in Child Health
Answered by Dr. Taher Kagalwala 12 hours later

Thank you for approaching the XXXXXXX forum here to address your queries. Being an Indian myself, I can understand your concerns very well. Your major worries are about how your daughter is growing and whether this can have ramifications on her general health. You also need a "chart" of diet.

Actually, your daughter isn't that far off from being a normal child. If she started off with a weight of, say, around 2.5-2.8 kg, she is just about a kilo or a kilo and a half below the expected normal for this age. Many a times, children gain weight not based on what they eat but what they have inherited from their parent (s). For example, if either you or your spouse was like her at the same age, this may be a physiological thing, and not at all abnormal.

Her appetite seems "reduced" to you, but this, too, is physiological, that is, normal for her age. Children of this age eat substantially less and grow more in height than weight. For example, while a baby triples her birth weight in the first year of life, she just doubles that weight over the next 4 years (i.e. from the second to the fifth year)! These are the years of cerebral (i.e. brain) growth, and the child needs to be supple and active to explore the world around her and she needs as much time as she can get to do it. Eating a lot would defeat these purposes, so Nature has meant for pre-schoolers to eat less.

You will find, however, that although she does not eat properly at meal times or in the house, she will eat readily when you go out to a restaurant or a fast-food store or when you buy chips or chocolates for her to eat! Thus, to enable her to eat better at meal times, reduce the snacking to a bare minimum. Buy her a small pack of snacks or a smaller chocolate so that her stomach is reasonably empty when the meal time comes around. Give her less milk too, and stop bottle-feeding if you are still at it. Do not force feed her. Let her ask for food - and she will, when she is really hungry. Sometimes, a full day and night can pass before a toddler will ask for a meal. Don't worry. Just relax. She will be all right even if she "fasts" for such a long time. She won't get dehydrated, because she will continue to drink water, juices, etc. as before.

There is no point in devising a diet chart. Let her be. Ensure that she gets a balanced diet, fruit, salad, cheese, butter, protein in the form of dals or non-vegetarian items and whole cereal breads and chapati.

About the infections bit: most small children suffer from up to 6-8 nose and throat infections each year in the first 3-5 years of life. This is NOT excessive. It is abnormal ONLY IF the infections affect the long-term outcome or the health of the child or if they are in the nature of pneumonias or more serious problems.

That's about it. If you need any more clarifications, do contact me again. Thank you.

- Dr. Taher
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