Growth Concerns for a 2-Year-Old: Weight, Eating Habits, and Speech

Growth curve for a 2-year and 2-month-old child?

Hello, Doctor: My son is currently 2 years and 2 months old, and I would like to ask you some questions regarding his development.
Thank you for taking the time to respond.
1.
My son weighs 13.4 kg and is 90 cm tall.
Is he too underweight for his age?

2.
My son does not like to eat rice (but he loves noodles).
Is it possible to use traditional Chinese medicine to stimulate his appetite? He is very good at chewing rice, and I am unsure how to handle this situation.
3.
Since my son is not yet speaking much, I took him to see a pediatrician who said that if he is not speaking by 2 and a half years old, we should conduct further evaluations.
Currently, he can say a few words like "bye-bye," "hello," "dog," "brother," "dad," "aunt," "hug," "daddy hug," "baba," and "baby." However, he understands everything we say to him, can perform basic actions, and prefers to do things by himself, such as opening and closing doors, taking off his jacket, standing in the bathtub to wash, riding a tricycle, and walking around in adult slippers.
He also pours himself water to drink and gives his dad his slippers while putting his dad's dress shoes back.
Given this information, should I continue to observe my son until he is 2 and a half years old? Am I at risk of missing a critical window for intervention? Thank you for your answers, Doctor!

Xiao Yu Er, 20~29 year old female. Ask Date: 2007/03/29

Dr. Chen Rongtai reply Pediatrics

The letter mentions concerns regarding a child's growth and development.
Firstly, the current weight is 13.4 kg, which falls within the 50th to 75th percentile for the same age group, and the height is 90 cm, also within the 50th to 75th percentile.
Therefore, the child's physical stature appears to be standard and not overly small.
Secondly, regarding the issue of picky eating, this is indeed a common concern among many parents.
The child does not like to eat rice but enjoys noodles.
It is important to exercise patience, as dietary habits need to be developed gradually.
As for the use of traditional Chinese medicine to stimulate the child's appetite, I personally do not oppose it, provided it is prescribed by a qualified practitioner and comes from a safe source.
Lastly, concerning language development issues, generally speaking, signs of delayed language development may include: (1) no vocabulary by age two, (2) no sentences by age three, (3) unclear speech that is difficult to understand after age three, (4) frequent errors in sentences after age five, and (5) becoming less verbal as they grow older.
Based on the description in the letter, the development seems to be somewhat slower but may not reach the level of delay.
It would be beneficial to engage in more conversations with him to provide additional learning opportunities.
If you remain very concerned, seeking a specialized evaluation sooner would also be advisable.

Reply Date: 2007/03/29

More Info

When addressing growth concerns for a 2-year-old child, it is essential to consider several factors, including weight, eating habits, and speech development. Based on the information provided, your son weighs 13.4 kg and is 90 cm tall. To assess whether he is underweight or within a healthy range, we can refer to growth charts that track the average weight and height for children of his age.

1. Weight and Height Assessment: For a 2-year-old boy, the average weight typically ranges from about 11 kg to 14 kg, and the average height ranges from approximately 85 cm to 95 cm. Your son's weight of 13.4 kg and height of 90 cm place him within the normal range for his age. Therefore, he is not considered too thin. It is important to monitor his growth over time, ensuring he continues to grow at a steady rate.

2. Eating Habits: It is common for toddlers to exhibit selective eating behaviors, often preferring certain foods over others. Your son enjoys noodles but is not keen on rice. While it is important to encourage a balanced diet, forcing a child to eat foods they dislike can lead to negative associations with mealtime. Instead, consider introducing a variety of foods gradually and in different forms. For instance, you could try incorporating rice into dishes he already enjoys, such as fried rice with vegetables or mixed with his favorite sauces.
Regarding the use of traditional Chinese medicine (TCM) to stimulate appetite, it is advisable to consult a qualified TCM practitioner. They can provide safe and appropriate remedies tailored to your child's needs. However, it is crucial to ensure that any supplements or herbal treatments are suitable for young children and do not interfere with their overall health.

3. Speech Development: At 2 years and 2 months, children typically begin to combine words and expand their vocabulary. Your son can say a few words and understands commands, which is a positive sign. The pediatrician's advice to wait until he is 2.5 years old for further evaluation is reasonable, as many children develop at different rates. However, if you notice that he is not progressing in his speech or if you have concerns about his communication skills, it may be beneficial to seek an evaluation from a speech-language pathologist sooner rather than later.

4. Monitoring Development: It is essential to continue observing your son’s growth and development. Regular pediatric check-ups will help track his progress in weight, height, and developmental milestones. If you have any concerns about his growth patterns or overall health, do not hesitate to discuss them with your pediatrician.

In summary, your son appears to be growing within a healthy range for his age. Encouraging a balanced diet, being patient with his eating habits, and monitoring his speech development will support his overall growth. If you have ongoing concerns, consulting with healthcare professionals, including a pediatrician and possibly a nutritionist or speech therapist, can provide additional guidance tailored to your child's needs.

Similar Q&A

Assessing Growth Concerns in a 2-Year-Old: Nutrition and Health Tips

Hello, doctor. I would like to ask: My son is currently 2 years and 1 month old. Over the past year, his height has only increased by 6 cm and his weight has increased by 3 kg. He was 52 cm tall and weighed 3360 grams at birth. At 2 months, he was 63 cm tall and weighed 5400 gram...

Dr. Xiao Kaiwen reply Pediatrics
Common colds should not affect height. The factors that influence height generally include nutritional status, adequate sunlight exposure and exercise, sufficient nighttime sleep (as growth hormone is secreted at night), and an important factor: genetics. If the parents are not t...

Why Two-Year-Olds Don't Need Excessive Milk: A Pediatric Perspective

My son is already two years old. At birth, his growth curve was only in the 3-15% range. Currently, he weighs 11 kg and is 84 cm tall, still around the 3-15% range. He drinks 200 ml of milk in the morning and before bed, and his meal portions are very small. I have to offer him a...

Dr. Xiao Kaiwen reply Pediatrics
As long as a baby's growth percentiles for height, weight, and head circumference in their health booklet are consistently following their own curve without significant fluctuations, it is considered normal. Therefore, it is important to compare the baby to themselves rather...

Understanding Weight Concerns in Toddlers: Tips for Healthy Growth

Hello doctor, my daughter is currently 2.5 years old, but she only weighs 13 kg. However, her diet and development are normal. Is this a concern? How can I help her gain weight? Thank you.

Dr. Pei Rensheng reply Pediatrics
Hello: Your daughter is currently 2.5 years old, weighs 13 kg, and her diet and development are both normal. This places her at the 50th percentile, which is an average weight, so there is no need for excessive concern. To gain weight, she should eat more, and you can increase th...

Concerns About Chewing Skills in a 2-Year-Old: What to Know

If he refuses to eat any solid foods and only drinks milk, could this indicate a delay in some aspect of his development?

Dr. He Shenglong reply Pediatrics
Hello: It's important to try various methods for introducing complementary foods without forcing it; keep the atmosphere relaxed and enjoyable. I recommend referring to the Children's Health Handbook (new edition, pages 54-55, on introducing complementary foods) for mor...