Worried about whether baby is growing enough

Hi--pls. tell me if I'm being paranoid or if this is a real cause of concern. I have a 10-month old son who has always been in the 5-15th percentile for height and weight. My husband and I are both Asian and petite(I'm 5'0'' and he's 5'7'') so this is only to be expected. However at his 9 month check-up, my son weighed only 16.5 lbs.(5th percentile) and measured 25.5''(NOT even on the curve). Since his 6 month check, he only gained 2 lbs and an inch(I think). His pediatrician is unconcerned, saying my son looks well-nourished(I agree).

I try not to think about this too much--my son is hitting all his developmental milestones, is a happy and active baby and a good eater but there are days when I worry about whether or not he is growing enough and if there is anything more I should be doing. Is my pediatrician right? Will my son eventually catch up with his peers? I don't want to give my son a complex about his height and I'm afraid all my worrying will do just that. But I'm also afraid of not worrying enough about something which maybe I really should be worried about. Advice from other moms with petite babies will be greatly appreciated. Thanks. concerned mama

I am doing the only thing I can be doing - giving him a well-balanced diet, and I've begun to emphasize proteins and fats more. I'm actually counting calories to see where he can get more protein/fat 'bang for the buck' so to speak. It doesn't sound like that was a concern for you, but I'm resolved to watch his diet even more closely than before.

It is disconcerting to say the least, and it's hard to put aside my concerns. I work hard at reminding myself that he's healthy (apparently!) and meeting all milestones and looks like one incredibly happy baby.... and leave it at that. I understand how you feel - feel free to email if you'd like. Hope that helps! Claudia

If you are breastfeeding, can you increase the number of times your son nurses? If not, then (as long as he's not allergic) you can supplement with formula that you fortify with cod liver oil and egg yolk--see the recipe on this page: http://www.westonaprice.org/children/recipes.html

You said your son is happy, active, a good eater and developing well, so that's great. It's a good sign. Personally, I've tried lots of recipes from baby cookbooks. There are some good recipes in the archives on BPN. Other advice I've gotten is to add butter or oil to everything, and maple syrup or honey. My baby likes yogurt, cheddar cheese, cream cheese, avocado, egg yolk, pureed sweet potatoes with lots of coconut oil or butter. I'm working on the pureed meat and salmon but it's often gotten rejected, so I just offer again next mealtime without pressure. I read that as long as they get a mixed and well-rounded diet, not to worry about them rejecting this or that particular food. After reading chapters on nutrition in the book ''Your Baby and Child'' by Penelope Leach, I felt better.

If you are still afraid of ''not worrying enough about something which maybe you really should be worried about'' (I totally get this) try having your child tested for food allergies, or even talking to a registered dietitian who works with a gastro-intestinal doctor. They can allay your fears, or help with recommendations either way. anon

13-month-old not gaining weight

I put a request in for advice already about my 13 month old who hasn't gained weight in three months and who has frequent and loose stools. I am now also looking for advice on a nutritionalist and a pediatrician who might be willing to give a second opinion (some doctor's won't see you unless your kid is a patient already.) Jessica

7.5 month old not gaining, not eating

My baby is 7.5 months and 14 lbs,i worry alot,i know i should'nt be stressing about it,but the thing is that he just does'nt seem very fond of food. He had started eating rice cereal,bananas,beans pretty well at 6 months( 4 months we had'nt had much luck either),but then he fell sick in the middle,and now all the progress that we had done,seems to have fallen through.He totally clamps his mouth shut,or turns his head side to side. I have caught myself trying to even pry his mouth open with the spoon,which i know is wrong,what do i do?? I sometimes sit there crying ,feeling so frustrated.I see cousins his age ,who are so fat and chubby, and then start comparing. I think i should be the one seeing a doctor :) I know that he can eat, so am baffled as to what to try. I've tried feeding him on the bouncer,high chair,cold, warm cereal, peas, bananas,rice..Is his weight normal?? Paedtrician does not seem concerned.. Anyone in the same boat as me?? Stressed mom

I just want to share a couple of things I have learned as a first time father (we have a 14 month old daughter). First of all, baby's go through phases - sometimes they eat like a brick layer, sometimes almost nothing. I understand your concern as I have felt it myself, but I assure you it is perfectly normal for their food intake to fluctuate.

Second, 14 lbs for a 7.5 month old baby is perfectly normal. If you still worry I recommend seeing a doctor. They have tables of the correlation between normal weight and height and I'm sure you'll find that your baby is doing just fine. Our girl is tall and slender. We worried at one point if she was gaining enough weight. We went to see the doctor and everything was fine. No, it was perfect. She's just a tall, slender girl that's all.

One thing I noticed; you're feeding your baby banana. We had a problem with our girl getting congested from eating banana, which incidentally made her eat less until we fed her prune-mush and cleared the system. Maybe your baby doesn't have problems with bananas, but I wanted to mention it. Good luck! Martin

One thing I learned is that breast milk and formula have a higher calorie content than food, so it is not unusual for a baby to stop gaining or even lose some weight as he moves to a solid food diet. How does the saying go? ''Food is just for fun until one year of age.'' Something like that. As long as milk intake is good, don't worry too much about the food, at least for the first year.

The other very hard lesson I had to learn was to let food go. I came to this after months of crying at every meal with him. The BPN archives have great advice on this topic. My version: don't force food into your baby, don't insist on being the one to feed him, and don't make him stay clean. I found that trying to do so made the problem worse rather than better. As the stress level rose, each meal became worse and worse. Instead, put a bowl of food in front of him, a plastic sheet on the floor if necessary, and let him play. Can he self-feed? Even shove a hand in a bowl of cereal and lick it off? Let him try. He may distrust the situation for a while (my son did), but eventually he will relax again. If he screams and cries, get him out of the chair and try again later, or not until the next meal. Your child won't starve himself.

Only now, at 13 months, is my son beginning to try a variety of foods willingly, and even then only if he is in a good mood. He didn't eat dinner tonight, and that's okay with me.

It still upsets me to think about how much time we lost fighting over meals, how much stress we created, and how much pain we both went through. It's just not worth it. Relax. Expose your son to food, let him learn how it feels in his hands, and occasionally how it tastes in his mouth. It will get better. learned to relax about food

i wouldn't force baby to eat and i would just try different things to see if anything appeals.

if you trust your doctor and they are not worried please try not to be either! anon

- Six months is a rough guideline for introducing solids. Some kids are ready earlier, some later. Also, at your son's age he should be getting most of his nutrients and calories from breast milk/forumla still. Have you looked at the nutritional value of rice cereal? There's barely any calories. At 6 -7 months rice cereal is more to get them used to the concept of eating solids, of exploring textures and tastes.

- Babies are animals with natural instincts. They eat when hungry and will usually stop eating when full. They learn bad eating habits from us, such as eating when you're not hungry, and as they get older they know it's a weak spot for us. Like kids who won't eat so a parent will break down and give them a cookie, just to get something in their stomachs. That's the start of a bad cycle. My son would sometimes go a couple of days refusing just about all food. I would keep offering him stuff w/ out any pressure and would leave stuff sitting out for him to graze on if he wanted. It was EXTREMELY hard not to break down and just give him something not so healthy just to get him to eat something. I'm glad I didn't do that. He is now 4.5 yrs and is very good at eating until he's satisfied; give him a piece of cake or ice cream and if he's full, he won't finish it. He has very healthy eating habits.

- If your pediatrician isn't worried, you shouldn't be.

- Toddlers are often way too busy playing to want to take time out to eat. And they use so much energy playing and growing. So until age 2 it's important that they have a diet high in fat in order to get enough calories. My pediatrician gave an example of looking at a gram of fat and a gram of proteien, the fat will have way more calories.

Don't stress, your son will just pick up on that. Momma of an ex-picky eater

I know exactly how your feeling, so hang in there and know that it will get better, especially if you can let go of some of the worry! M other of another food refuser

For the record, I hate postpartum hormones. They cloud judgement and make like not so fun. You have my sympathy.

If you're worried about baby's weight, and your pediatrician isn't, get a second pediatrician opinion and set aside lots of couch nursing time (or offer the recommended formula amount), and get a great book on different yummy baby foods to make. If two pediatricians are not worried (i.e. perhaps the adults in your family are small.... - I WISH my child had been a whopping 14 pounds at 7 months), then take a deep breath, take a walk in the sun, and put in writing your blessings. Perhaps the first could be that 2 pediatricians are not worried about any of your baby's developmental milestones (are you worried about development, or only weight?). Take care. mom of 2 little chefs

Weight loss or slow weight gain is also not a big deal when it's for an obvious reason, like an illness, or increased activity level when a baby learns to crawl or walk. If your baby's doctor is not concerned, you almost certainly should not be. Some babies are kinda chubby, others are long-n-lean, either can be healthy and normal. It's not about how many pounds the baby weighs at a given age, it's whether he is growing at a reasonable rate. Every baby has a somewhat different curve.

Make sure your baby is still nursing, or consuming bottles, at about his former level and producing plenty of wet diapers. And continue to offer solid foods at family mealtimes, but don't push. He'll eat 'em when he's ready. Holly

that being said, during one of my (very 'rational' and sane) kvetch sessions about my child not consuming much food (and i think she was rather sick at the time), my mother told me a story about taking me as a toddler to the pediatrician because i 'wasn't eating.' the pediatrician's response was something like that last he had checked there were no children in this county dying of starvation.

i really liked the book 'super baby food.' i learned how to offer my child a healthy balanced diet from the beginning. there were many interesting topics to read about diet and eating issues. and some of it i definitely skipped over. but it gave me a guideline to believe i was heading in the right direction and everything would fall in place. even on the days my daughter refused to eat.

if your baby is giving you a big smile that lights up your life, you are doing a lot of things right. i want MEAT!

4-month-old not gaining enough weight

My 4 month old son weighs only 10lbs, 12oz(24 inches long), which is only about 8 or 9 oz more than what he weighed at 2 months old. We are working with a doctor and lactation consultants (l.c.)since his weight gain has been a problem from the start. He was born at 7lbs, 14oz, all natural birth and latched on perfectly within 5 minutes of being born. The l.c. says I have good milk supply, he latches on well, and seems to get a lot of milk. We are mystified. At about 4 to 5 weeks of age, after working with an l.c. to help him gain weight and being unsuccessful, on the l.c's advice, we switched over to formula exclusively for a couple of days. He gained weight and we weaned him off formula, back to breast milk exclusively. Developmentally, he is ahead of the game (according to pediatrician), grabs things, rolls extensively (he rolled at about 2 months), coos, smiles, giggles and generally shows no signs of being unhappy or underfed! He is starting to teeth early, which does make him cry more than usual. He is a marathon feeder and I often have to limit him to 20 minutes at each breast. I feed him every 1 to 3 hours except at night when he sleeps from around 9pm to between 3am and 4am and then back asleep until about 7:30am. I have checked with babysitter (comes about 8 hours/week) and husband, and they agree with my perception that I feed him very, very often. Until I see the pediatrician again this week, we are trying: nightime feeding to be 8 oz. formula,take away pacifier,in the care of Dad or babysitter, supplement with formula as needed if run out of expressed breast milk. My other problem is that I only pump around 2.5 oz at a time and my breast milk goes bad in the freezer. I am crying a lot trying to figure this out and feeling anxious about breast feeding: is he gettting enough, should we just give him formula freely, will I mess up breastfeeding since it is supply and demand, etc. I don't want to be rigid about breastfeeding, the goal is for my baby to gain weight. Any advice or similar stories? Any babies who were this small at 4 months? K

My father-in-law is a very respected pediatrician in his community, where he has practiced for 50 years. This is what he told me with respect to growth curves: Rate of weight gain (and other growth indicators) is the key, not the amount. As long as she was at 10% or above she should be fine and small is OK. As long as growth curve ratios remained stable and in-sync with one another (10% for height, weight and head circumference) and did not slip out of sync (for example if her weight gain suddenly outstripped her height), or she did not suddenly shoot up in her total percentile (from 10% to 25% in three weeks, for example), she was OK. It would be good but not necessary for her to slowly move from a lower to a higher growth curve ratio. It was ok for her to fluctuate slightly between curves (btw 10 and 15%), it was not good if she sank below 10% at any time, nor for her to swing around on the growth curve. He mentioned that the growth curve that is in use came out of the 1960s studies in the Midwest, and that it is based on formula fed Caucasian (Scandinavian) American babies, and it therefore is an inflated curve when compared to babies who are not white, American, or formula fed (formula fed babies commonly gain more weight more quickly). I think the WHO has recently produced revised infant growth curve charts. sara

FIL mentioned that she would gain weight at a slightly faster rate when she started eating solid food (6 1/2 months), which was true. BTW, she has become less interested in breastfeeding since she started eating solid food. I started my period at her 7 mo mark, and that seems to have decreased my milk supply as well I now pump 1-2 times a day for a total of 7liquid oz on a good day; and she nurses about two to three times a day as well. She is now nine months old and has FINALLY doubled her birth weight and then some... 16#8oz. (25%!) She is in daycare, and I am surprised by how petite she is compared to the other babies her age. She is growing, she's bright, curious, funny, very physically active and adept (standing with support &trying to balance without support), and very verbally curious. She is still small, but she is MIGHTY. It sounds like your little boy is the same. a wee and wonderful kid. sara

But I did want to give you two tips. First off, you might try just letting him completely drain one breast at each feeding, rather than breaking him off of one breast in order to offer the other in the same feeding. The fattiest milk is usually the stuff left at the end, so it is good to let him get as much as he can from one breast, and then just start the next feeding with the other one two hours later, or whatever.

The other tip is about introducing solid foods. I didn't realize just how much less fat and calories are in solid foods than in breast milk (or formula). Around 4 to 6 months is when people generally introduce solids, and so we did that at about 4 1/2 months. Well, at his 5 month check up, my son's weight had dropped down to the 5th procentile (from the 10th). So, in retrospect, I probably should have waited on offering any solids, or offered only really fatty stuff (like whole milk yogurt - I recommend Trader Joes natural yogurt over Yo Baby). Avocados would also be OK, but try to avoid carrots or things like that. Rice cereal has plenty of carbs, but no fat, so unless you add fat to it (like with flax seed oil) your baby won't be maximizing the calories.

Anyhow, this is something you'll struggle with for the next year, probably, and if you are anything like me, you'll look at all the other chubby babies and wonder what the difference is. But you can try to take comfort in knowing that in a country of overweight people, being naturally thin probably isn't so bad. And then there is the bonus of actually getting to use all the baby clothes you have, since he won't outgrow them so fast! Mom of a ''Mick Jagger'' baby

These are the things that worked for us, and it turned out that our daughter was just a petite person, but she is developmentally and physically perfectly healthy. I can't tell you not to worry, because sometimes you will, but hopefully reading the things we've done for our child will help you with yours! Good luck! mom of lil' one

Help, 9-month-old baby not gaining weight!

Hello, I am very worried about my 9 month old. She is gaining weight very slowly. In fact, after going through her records, I noticed that she has actually lost weight in the last few months. In November, she weight 14 lbs. 12 ounces (clothes on). This Monday, during a doctor's visit, she weighed in at 14 lbs. 8 ounces. It baffles me because she seems to eat quite well. She is taking solids 3 times a day. With lots of encouragement, she usually eats about 2 containers of baby food. Her milk consumption is low, however. She only drinks between 14-16 ounces of formula a day. And, although I've been told that it's normal, she also has 3-4 bowel movements a day.

I need to mention that she's had lots of medical problems. In September, she had heart surgery for a patent ductus. She bounced back from the surgery quickly and gained 2-3 pounds in less than 2 months. We were all so happy to see her thriving. But since then, she isn't gaining anything. She also sees physical and orthopedic therapists for torticollis and clasped thumbs, although both problems are no longer issues. She also has an abnormal aortic valve (mild case) and a tethered cord. We have gone to genetics for these issues but they have not pinpointed a specific syndrome. They think she's just had the misfortune to be born with these complications. In addition, due to the intubation from the heart surgery, her left vocal cord was damaged. But, like I said, it doesn't seem to be impeding her solids intake.

Anyway, I would appreciate any advice regarding the lack of weight gain. Could it be an infection? I just don't know. For such a little one, she's gone through so much. I just want to figure this out and move on. Thanks for any recommendations.

3-year-old not eating enough - gastrostomy tube?

Hi, I was wondering if any of you parents out there have any experience with gastrostomy tube feeding. We're facing this decision with my 3 yr old son right now because he is not eating enough to grow. I've read a lot on the internet but I'm wondering if anyone has personal experience they can share with me. Thanks

Sometimes it gets pulled only partway out and needs a physician to look at it. Another problem is that sometimes putting a lot of food directly into the stomach causes bloating, cramping, gassiness and the liquid food itself leads to looser stools.

Also, I have worked with some kids who simply throw up the liquid that you have just put into them. So, it really is not a perfect solution. What has your physician done so far to try and find out why your child is not eating? Does you child gag or cough when eating? Is it certain textures or flavors? Does you child drink liquids alright or seem to have more trouble with those? Has an Ear, Nose, Throat specialist done an exam of your child's mouth, throat, palate? If even one little thing has been identified as questionable, did they do a barium swallow study? Has an x-ray or scan been done of the upper GI tract, especially the esophagus? Has a gastric reflux diagnosis been looked at and ruled out? Does your child complain of pain or any other bad feeling after eating, or throw up often? There are so many things to think about and look at before deciding to put a piece of plastic in a toddler's tummy. And even if this is what you end up needing to do, you still have not gotten to the root of why the child is not eating. At the very least, if you have looked at all of these things and more, they could try a naso- gastric tube for a trial to see if the child tolerates the feedings. That will only work though if your child leaves the tube in (same actually goes for the g-tube which is lightly tacked into the body with stitches.) As the parent, you have to do what you feel will best help your child. But please speak up and ask the Dr. to exhaust all means before turning to this, it is not a perfect solution by any means! My heart goes out to you, this is not an easy decision you are dealing with. healthcare mom

1-year-old has dropped below 25 percentile

I have a one year old baby boy who has always been on the thin side, but now his weight is off the charts and his height has dropped to below the 25th percentile (it was around the 50th). My pediatrician said to stop nursing him at night (he frequently wakes to nurse) and to add butter to his vegetables. The baby eats very little in the way of solid food. Is it wise to try to decrease breastfeeding, and if so, then what is the best way to put weight on an infant in a healthy way (i.e., as opposed to increasing saturated fat)? Concerned mom

16-month-old hasn't gained weight or height in 6 months

Our pediatrician is ''a bit worried'' because our 16 month old son hasn't gained any appreciable weight or height in the past 6 months. He started out around the 90th percentile and is now about 50th. He is otherwise healthy. He's not a big eater but is still breastfeeding regularly. Her advice is to cut down on breastfeeding to make him hungry and want to eat more. Not only is this hard to do when my son is insistant, but it feels counterintuitive. Has anyone else gone through this? Any advice for reluctant eaters? Should I be worried?

- We let him snack whenever he wants, and on days when he refuses to eat a regular meal I just put out something on a plate for him to go to while he's playing. This morning he refused his usual cereal so I made a waffle, put butter and jam on it and left it cut up on a plate on a chair. Over the course of an hour he ate it. It really helps to teach them some basic sign language regarding wanting food/drink, and at this age they pick it up quickly. My son now brings his fingers to his mouth to let me know he's hungry, rubs his hands together like he's washing them to say he wants water, and moves his fists up and down like he's milking a cow to say he wants milk. At this age their food demands/wants seem to fluctuate from day to day, so it helps that he says what he wants. Maybe a couple of days go by where he barely wants milk, the next he signing for it every couple of hours.

- Give him more bottles of milk throughout the day. Supplement your breastfeeding w/ whole milk or soy milk. They really can get what they need from whole milk at this age.

- We put butter or olive oil on/in everything. Butter in his Cream of Wheat, cook carrots in oil instead of steam them, etc. It has been hard for me to loose my knee jerk reaction to fats and remember that they really need them. I don't remember the exact numbers, but our doctor gave us the example of something like 1 gram of protein has 4 calories and 1 gram of fat has 10, so it is more efficient. anon

To the extent that cutting back on breastfeeding works, it only does so if the breastmilk not being consumed is replaced with higher-calorie-per-ounce foods. And much of what most toddlers eat isn't more calorically dense than breastmilk. If your son tends to ''snack nurse'' a lot during the day, it might in fact be easier to get him to eat a better overall diet if you institute more of a schedule; on the other hand, plenty of toddlers are perfectly healthy on a diet that's still 90% breastmilk, so as long as your son is growing and developing well, and isn't actually losing any weight, do what seems right to you. anon

15-month-old losing weight, is anemic

I've got a 15 month old girl and ever since she was 9 months old she's only weighed 17lbs. I never thought of it as a bad thing. She was healthy, active and ate a lot of food. I've never had any trouble feeding her. But when I took her into the doctor for her 1 year shots my doctor said she was under weight for her age. That is when she fell off their chart. Now she is just getting over pneumonia, and we also found out that she is anemic. But now we're at home, she seems to be doing better but she will hardly eat or drink anything anymore, and I don't know why. I've tried everything I can think of. She's now back to eating all baby food and pureed food. She was eating hard food before and now it's a struggle to get her to eat anything. I hope you can give me any information that could help. jennifer

Long story and not to alarm you but at 16 months (he was weighing approx. 17 lbs still too and had the ''failure to thrive'' diagnosis) he had an operation to insert a feeding tube because ingesting anything orally is not allowed with that condition. So it is important to check everything out with the right specialists. We went through Children's hospital in Oakland.

He has been without the feeding tube for about five years now and fine physically just check everything out to make sure it's not the same situation. Sharlene

It may be possible that your child is not only alergic to wheat, but may also have this disease that can effect the digestive system. If you had been (and are) feeding your child wheat and oats cereals then the damage can be causing the symptoms you describe- lack of appetite, loss of weight etc.. The wheat damages the colon and inhibits the absorbtion of nutrients and fats. The good news is it will regenerate if 'gluten' (wheat,oats,rye) are no longer in the diet.

I too have this condition and was miss diagnosed for a while, showing 'normal' blood tests. I would encourage you to talk to your MD, talk to a GI Dr., and read more about this Celiacs on the web. It may not be the answer to your problem, but I would hate to have any child suffer do to a misdiagnosis. Please feel free to correspond for more info. If you do find that this is the cause, I have much to share how to live with this. We are keeping my son (2 years) gluten free also. Eileen

1-year-old not gaining weight

My baby is now a year old and still only weighs 17 lbs. She was 16 pounds at 6 months, and has only gained a pound 6 months later. I've been having a lot of difficulty feeding her. When I first started her out on solids (at 5 months), she was a good eater until she hit the 6 month age mark. Since then, she doesn't want to eat no matter what I do or put in front of her. I try to distract her with toys, videos, whatever and slip food into her mouth. The only thing she really likes is oatios and rice chex. I should also mention that she has a ton of food allergies too (that's another topic). She's allergic to dairy, eggs, wheat and nuts. I try to feed her fatty items, such as soy margarine, avocado...sometimes she'll take it, sometimes she just won't open her mouth. Her pediatrician has run about 9 blood tests on her and everything came back normal. He also checked her stools for blood and that came back negative. We're waiting for more tests on whether there may be parasites found in her stool. I'm not sure what else I can do to get food into her. I started feeding her soy formula recently (whatever, to get calories into her). Since she doesn't take the bottle, this has been a slow process as well. Today I managed to get 4 oz of formula into her by giving it to her in a cup. Does any parent out there have any advice you can give me on this. It's been very frustrating, and I'm starting to get really worried. She's very thin and continues to not gain weight. In fact, she's now off the charts in terms of weight for her age. Thanks very much, I really appreciate any help you can prvodice. may

My son is 17 months old and has been off the chart since he was 10 months old. He now weighs a mere 20 lbs, however, he is very bright and active and he has been hitting all of his developmental milestones right on track. My son is half Filipino and half American (my husband is 6'' where I am only 4'11)I am very petite so part of being small could be in the genes. As long as your daughter is plotting her own chart- it might not be as rapid as you would like but perhaps she might be small by nature (if you and/or your husband are small, also she could just be a small baby but grow to be a bigger person. If your daughter is alert and active and happy then I think this should be your measurement for her.

Still putting genes aside, good nutrition and eating well are very important to a growing baby.My son although not a picky eater, does not eat that much and has no interest in anthing but bread, fruit and yogert. He too did not take to formula from a bottle (he was bf until 13 months) but he does like milk now from a sippy cup. Our doctor recommended putting formula in his foods for more calories. I understand your daugther has food allergies so perhaps the soy formula added into her food might help.

As one small baby mommie once told me, we should be so lucky our babies are easy on our backs and that we can use the Baby Bjorn for awhile while other big babies have busted out! Good luck!
Proud Small Baby Mama

Let the child touch the food & eat with fingers.
Talk in a quiet and engaging manner.
Be engaging, but not overwhelming; take care not to overwhelm the 
child with talking or behavior.
When the child is self-feeding, remain present in the situation, 
but don't take over.
Let the child decide how fast to eat.
Let the child decide how much to eat.
Respect the child's food preferences.
Respect the child's caution about new foods.
Remember, all children learn to eat eventually.

Some principles that have helped us survive

1) Make as much of the pureed foods at home as possible, using fresh veggies/fruits. From the beginning, she refused to eat any of the bottled foods but would manage to eat some of the home cooked food.

2) Spice everything. I found that my daughter really likes strongly flavored foods, and through trial and error, I have found her favorite flavors.

3) Keep her on a routine. I found that she would prefer to do anything but eat. (I found it wasn't true that ''she would eat when she was hungry.'') But, with a little vigilance on my part about routines, she has come to expect eating certain things in certain orders at certain times during the day (e.g., breakfast, then fruit, then snack, then milk, etc. all within roughly same time periods each day).

4) Distract her throughout the feeding (I always put her in a highchair so I can control her) with lots of animated discussion, related to either her toys, books, or tv shows on hand. I also make sure no one else is in the room during feeding and that I am not distracted by anything else (such as phone, spouse, etc) b/c she will quickly stop eating.

5) Use sippy cups and glasses for beverage items and mix as much formula/milk into solid foods as possible - b/c my daughter refused the bottle, I trained her to use a sippy cup and then a glass for drinking very early on. Also, while I was at work, all foods served to her (including the fruit purees) until she was regularly drinking soymilk from a glass (see below) would be mixed with some breastmilk so she would get at least a few ounces with the solid feedings.

And, here are some quirky foods that seem to work for her (and are not on your list of allergic foods)

1) Instant oatmeal and quinoa flakes hot cereal (I buy both buld at Whole Foods). I put a sweetener (such as Molasses), spices (cinnamon,nutmeg and cloves) and cook it with a combo of whole milk and water. You can also make it with soymilk.

2) Baby cereal, formula (My daughter likes a particular organic dairy formula I use) and a large banana, all blended together. The consistency is pretty thin and I spoon feed her. Even though she has outgrown these foods, I still feed this to her everyday because she still likes it.

5) Soymilk to drink in glass (she refuses any cow's milk and she only likes Silk Soy, which is fortunately readily available)

6) Superfood Juice from Odwalla (curiously, she seems to really like this and b/c it is very nutritious I try to give her some every day, usually after a vegetable serving).

6) Tofu-based products- She likes tofu products quite a bit, such as baked tofu and veggie dogs . She has been eating thin slices of baked tofu since she was a year old.

7) Dried beans of all kinds (boiled and seasoned with different spices). When she was young, I would puree some boiled rice and different beans together with spices and some breastmilk.

Hope this helps. Good luck and hang in there. While your daughter may not ''grow out of'' her fussiness anytime soon, it will get marginally easier as she grows older b/c there will be a wider variety of foods and food preparation methods available to you. And, while I always worry about my daughter's weight (she too is really low in the charts), the pediatrician has never been worried and says that she is an extremely healthy, curious and physically active child.

mom of an extremely fussy eater