Question: Dear Doctors,
First of all, I would like to say Good Job to all doctors in this Webpage, your dedication to public is very very meaningful.
Selamat Hari Raja Haji to all Muslim Doctors and Happy Holiday to All on board.
My daughter is aged 4, weight at 13 kg, height at 94cm only (birth weight is 3 kg-normal birth), below the graph of child growth chart advised by child specialist, body check up shown no other sickness so far.
Her past history, she often vomit during infant time and refuse milk before age 1 for unknown reason. Even solid food also taken in small quantity since she dislike also. We have been trying various kind of food but most not work.
Since she refuse milk, we only able to give her milk during she asleep which is 1 time (10oz) when she is well asleep and another 1 time at dawn before she wakes up. Despite very tire wake up to feed for the past 3 years till now, we have no choice in order to help her.
We have been using motivation methods to encourage her to eat by using praise words or sometimes small gift but we are worry this will develop a motive behind to eat, and child will demand more as we can see now, especially in long run when she is getting bigger.
For afternoon meal, she takes in nursery school, school uses discipline method and teacher say she didn’t cry when forced to eat, but at home she will cry when forced to eat. Our concern is this method might not be the right way.
Despite not eating, she never complain hungry and she is very active everyday and full of energy.
Hope doctors can advise me on this matter, your help is highly appreciated.
Thanks a lot and a good day to you
Best regards,
Sally ching & Daughter Yuyu
Answer: Hi Sally, Thank you for your kind wish. Before I proceed in answering your question, there’s a few points that I’d like to make: 1) A single growth measurement does not tell much, a serial reading of the weight and height would give a better picture. And therefore, 3-4 readings of weight and height the last 6 months to 1 year would be helpful. This is because, your child seems to have a problem since infancy therefore it’s important to see if she has actually improve (even though seems little- whether she has been growing along the the same centile line on the growth chart all this while) 2) There are a 3 general reason why kids don’t put on weight or not growing as expected. And I can’t advise you whether it is psychological or not without knowing her full history/access to her medical record. So the 3 reasons are 1) Inadequate intake of food (which she seems to be having) 2) increase out e.g vomiting , loose stool ( she once had but has resolved) 3) underlying medical illness (which I don’t know and cannot be certain just based on your brief notes on your child). One or a combination of this factor may be a contributing factor. From your description , it seems she’s eating at school but not eating at home unless rewarded. The good thing however is that she’s active and that is a good sign. At this age, she needs more solid food and 1 bottle of milk per day is okay . Please refer to the tips in the article below that will answer your question. https://www.doktorbudak.com/2013/07/18/anak-saya-tak-mahu-makan/ Hope this helps.