Managing Underweight and Frequent Illness in Young Children

The child is underweight and frequently catches colds?

Dear Dr.
Chang,
My daughter is almost five years old, but her weight has never exceeded 20 kg; it has been between 16 to 18 kg for over two years.
Her height is 113 cm.
She is not very picky with food but cannot eat much; in the past, she would vomit after eating just a small bowl.
We have consulted many doctors who have said that her gastrointestinal absorption is poor, but her bowel movements are normal.
Previously, she had hard stools with a little bit of bleeding (however, she drinks a lot of water daily and eats fruits and vegetables).
A doctor prescribed probiotics, which seemed to help.
I would like to ask if there is a dosage limit for young children taking probiotics.
With so many brands available, could you recommend a better brand (or one commonly used in hospitals) or other alternative products? Are there any restrictions on their use?
Additionally, since my daughter started kindergarten last year, she has been frequently getting sick (many children in her class are ill).
She used to get dehydrated easily from fever when sick.
Last year, she was sick quite often, and after returning to school this year, she caught something again.
Her symptoms are mainly a runny nose (she used to cough but has improved a lot) and nasal congestion.
However, she has been on medication for too long (before February, she was treated for sinusitis due to persistent colds).
Currently, her symptoms are just a runny nose.
Could you provide some health maintenance methods, or does she still need to take medication? I would prefer to let her body’s immune system heal itself.
Thank you very much for your guidance!

kiki Chen, 20~29 year old female. Ask Date: 2006/03/10

Dr. Zhang Wenwang reply Pediatrics

1.
Relying on medication is not the best option.
Your baby's growth curve is still acceptable and falls into the tall and thin category.
Paying more attention to a balanced diet is the best approach.

2.
If the symptoms are not too severe and do not significantly affect daily activities, you may consider stopping the medication for a while.

Reply Date: 2006/03/10

More Info

Managing underweight and frequent illness in young children can be quite challenging for parents, especially when the child is not gaining weight appropriately and is frequently falling ill. In your case, your daughter, who is almost five years old, has consistently weighed between 16 to 18 kg while being 113 cm tall. This indicates that she is underweight for her height, as the average weight for a child of her height would typically be higher.

Understanding Underweight in Children
Firstly, it is essential to understand that underweight in children can stem from various factors, including genetic predisposition, metabolic issues, dietary habits, and gastrointestinal problems. Since you mentioned that your daughter has had issues with vomiting after meals and has been diagnosed with poor gastrointestinal absorption, it is crucial to address these underlying issues.

Nutritional Considerations
To help your daughter gain weight, focus on providing nutrient-dense foods that are high in calories but not overly filling. Foods like avocados, nut butters, full-fat dairy products, and smoothies can be beneficial. Encourage her to eat small, frequent meals throughout the day rather than three large meals. This approach can help her consume more calories without feeling overwhelmed.

Probiotics and Digestive Health
Regarding the use of probiotics, there is generally no strict dosage limit for children, but it is essential to follow the recommendations on the product label or consult with a pediatrician for personalized advice. Probiotics can help improve gut health and may enhance nutrient absorption, which could be beneficial for your daughter. Some reputable brands include Culturelle Kids, Garden of Life, and Renew Life, but it is always best to consult with your healthcare provider to determine the most suitable option for your child.

Managing Frequent Illness
As for your daughter's frequent illnesses, it is common for children in daycare or preschool settings to catch colds and other infections due to close contact with peers. To bolster her immune system, ensure she is getting a balanced diet rich in vitamins and minerals, particularly vitamin C and zinc, which are known to support immune function.
Encouraging good hygiene practices, such as regular handwashing and avoiding close contact with sick children, can also help reduce the frequency of illnesses. If she does fall ill, it is crucial to monitor her symptoms closely. While it is understandable to want to avoid overmedicating, sometimes medications may be necessary to alleviate symptoms and prevent complications, especially if she has a history of dehydration due to fever.

When to Seek Further Medical Advice
If your daughter continues to struggle with weight gain or if her illnesses become more frequent or severe, it may be beneficial to consult a pediatric gastroenterologist or a nutritionist specializing in pediatric care. They can conduct further evaluations to rule out any underlying conditions that may be affecting her weight and overall health.

In conclusion, managing your daughter's underweight status and frequent illnesses requires a multifaceted approach that includes nutritional support, monitoring her health, and ensuring she receives appropriate medical care when necessary. By focusing on her diet, encouraging healthy habits, and seeking professional guidance, you can help her achieve better health outcomes.

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