I hae a 12 month old daughter. Her pediatrician is very concerned taht she is not growing. He requrested I give her antihistimine before bed to increase her appetite. I am very reluctant.

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I have a 12-month-old daughter. She was 6 weeks premature and weighed 5 lb. 8oz. She has been very healthy her first year and had good weight gain the first 6 months. The second 6 months she has only gained 2 1/2 pounds. At her one year check up she weighed 18 lbs. 13 oz. and is 29 1/2 inches tall.

Her pediatrician is very concerned that she is not growing. He has requested that I give her an antihistamine every night before bed to increase her appetite. He also indicated that it would help her sleep better. He wants to try this for 3 months and see how her weight gain is. I am very reluctant to give her medication for this. She eats very well and is very active. I’m not sure what I should do from here. Do you have any suggestions?

Your daughter is average for height and average for weight though she is at the low end of the weight range for her age. A healthy weight range for her is 18-23 pounds. Her BMI (body fat estimate) is 16 with a normal range of 15 – 19 for 12-month-old female.

Each child follows their own growth curve. Some children grow in spurts and some grow at a constant rate. I would suggest you ask her doctor for a height – weight chart so that you can plot out her weight and height gain since birth. If your daughter’s height and weight start to flatten out for 3 months, then I would suggest some intervention. But if her height and weight continue to increase, then she is growing, but the rate of growth still needs to be assessed against the norms for her age.

You did not state how much antihistamine your daughter’s doctor prescribed. I would ask for a specific prescription, even if the antihistamine is an over the counter medication. I would suggest you talk to her doctor and tell him you are reluctant to give your daughter pills. It is true however, that antihistamines do cause sleepiness, but have other side effects such as drying nasal passages and mouth.

I would recommend you see a Registered Dietitian who can assess your daughter’s food intake and make specific recommendations. A dietitian could also plot out your daughter’s weight and height to evaluate her growth pattern. For instance, she should drink whole milk rather than low fat milk and you can feed her more often. Toddlers need at least 6 small meals per day, but still don’t need that many calories. I estimated that your daughter’s basal energy needs (without any activity included) to be about 520 calories, 17 grams fat, 16 grams protein and 72 grams carbohydrate per day. This is the amount of calories your daughter would need lying flat in bed. I didn’t include her activity level as you did not provide it and her activity could double this basal calorie level. Generally, children need about 1000 calories by 12 months of age. So use this as a guideline for how much food your daughter should be eating.

You could also talk to a dietitian about her sleep and activity habits for some recommendations. Though most toddlers don’t need planned “exercise” programs as they seem to be active enough on their own.