Is Your Child Eating Enough? (Dr. Sears, citat obtinut prin amabilittea lui Babymom 75)

"Doctor, I don't think he eats enough" is a guaranteed concern sometime between the first and second birthday. The question is, Does baby eat to satisfy mother or grand mother (no child eats that much!) or himself. Try this step-by-step approach. [...]

Step One: Plot Your Baby's Progress on a Growth Chart
Using a growth chart, record tour toddler's height and weight.[...]
A gradual fall to a lower weight percentile over several month is a common occurance. We call this "leaning out". This happens most noticeably between six and twelve months, when baby is learning to crawl, and between twelve and eighteen months, when baby is learning to walk and run. during this period, infants burn off a lot of their baby fat. So don't be surprised at your baby's one-year checkup to see that he has gone from a chunky ninetieth percentile to a leaner fiftieth percentile on the weight curve. And do not be alarmed at the eighteenth-month checkup if your already slim toddler has gone from the twenty-fifth percentile down to the tenth percentile.

[...] Take into account that breastfed infant and formula-infant grow differently during the first year of life.

Step Two: Examine Your Toddler for Signs of Nutritional Deficiency
Here are the most obvious signs of nutritional deficiencies:
Hair: brittle, easy plucked, dry, wirelike, sparse

Skin: wrinkled and loosely attached to muscle, dry, flaky, easily bruised especially in areas not usually exposed to falls, spiders (broken blood vassels in the skin), irregular pigmentation, delayed healing, areas of thickened or thinned skin, pale

Eyes: dull and lusterless, bloodshot, night-blind, fatty deposits in nasal corner, dark circles underneath

Lips: fissures at corners of the moth that heal poorly, pale, swollen

Gums: bleeding, spongy
Theeth: cavities, brittle
Tongue: smooth, fissured, pale
Nails: thin, concave, brittle
Bones: bowed legs, proeminent ribs
Feet: swollen (edema)

Step Three: Record a Dietary History
Record the type of food eaten, the amount, and the number of calories in each serving. Complete the food record for several straight days and total the number of calories ech day. It is normal for a child's food record to vary from day to day. This is why a weekly average is more accurate. As a rough guide, an infant should average 50 calories per pound per day (about 23 calories per kg). Don't expect to be accurate to the last calorie. Even professional nutritionists aren't.
If your toddler eats a weekly average of around 1000 to 1300 calories per day, chances are he is getting enough. This figure include the calories obtained from milk, so if your child is still breastfeeding a lot, the number of calories from food would be somewhat lower.

The Right Kind of Food
Determine if your child is getting not only the right amount of food but the right kind of food. Don't expect a balanced day. Shoot for a balanced week.

The Wisdom of the Body
Usually a calorie count suffices to determine if your child is getting enough nourishment. Studies have shown that if presented whith a buffet of nutritious foods, toddlers will, over a period of time, naturally eat the right balance foods. Nutritionists believe that the body has inner sense of wisdom in craving the right balance of nourishment. Besides doing the calorie count, using the food-balance calculation is a valuable exercise in learning about your child's eating preferences and principles of good nutrition.

Step Four: Look for Other Circumstances Affecting Your Toddler's GrowthExpect a leveling off of growth, especially weight, during a prolonged or recurring illness, such as diarrhea or frequent bouts with colds. Appetite lags and nutrition that would have gone into growth is redirected into healing. Anticipate a period of catch-up growth when your child is well. Between nine and eighteen months, crawling and walking slow down weight gain but not height gain, as your toddler normally begins to "lean out".Besides medical and developmental reasons, emotional setbacks may slow growth and diminish appetite. If something happens to upset the parent-infant relationship (for example, untimely weaning, premature mother-infant separation, marital disturbances, family crises), the baby may fall down a few notches on the growth chart. One of the most fascinating areas of research is the need that some infants have for close parent-infant attachment in order to achieve optimal growth - that is, to thrive. We foresee the day when researches will uncover biochemical links between nurturing and growth. 

Step Five: Obtain a Complete Medical and Nutritional Evaluation
If after going through the preceding steps, you suspect your toddler is under nourished, consult a nutritionist for an evaluation of your child's food record and obtain nutritional counseling. [...]
Besides an examination of your toddler's nutrition, a thorough medical checkup may uncover reasons for his undernourishment.There may be physical and emotional reasons that he is underweight. Your doctor may obtain laboratory tests to determine if your child is getting enough protein, iron, vitamins, and minerals.