Response to reader

Dear Ms Brown,

We have three children. The first two are girls and they are healthy and appear to have normal body weight. Our son, however, is 10 years old, but I feel he is underweight. He is 4'6" but only weighs about 72 lb. He has regular check-ups with the paediatrician but the doc just says that he is small-framed and has left it at that. Would you provide some suggestions?

- Concerned mom

Dear Reader,

When we have one child we sometimes have no yardstick to grade our performance, but with more than one we try to improve the second time around. This can be an advantage as we try to do it better when we get a second chance, but it can also be a disadvantage as each child is unique and comparisons can often be misleading.

I understand your concern, as I have a son who was always smaller than his peers. He was a very picky eater in addition to other factors. You compare your son to his sisters and girls tend to grow at a faster pace than boys of the same age (you did not mention their ages) but later they slow down to a much steadier growth rate only for the boys to shoot by them.

You mentioned that the paediatrician told you everything was all right with his growth and that he is small framed but you are still uncomfortable. You should look at yourself and his father in terms of frame and stature. Ask about Daddy's stature when he was your son's age. If your son is still the odd one out, this is so because he is unique. Based on the information I received from you, I did a quick assessment but if I had you in a face-to-face session we could look more in-depth at nutrition history.

Slightly below average

Based on the US Centers for Disease Control and Prevention's growth chart, your son is just slightly below the average child for weight compared to age and it is the same for his weight compared to height. It is important for you to find out from his paediatrician if this is the same channel he has maintained for a while, say, from age two. This would indicate that this is his norm. Based on children's growth pattern over years, they maintain a certain norm when compared to the population, although their height and weight change, so your son's norm is probably slightly below the 50th percentile of the population for his age group and that would be normal when all else is considered, such as his nutrition history.

If his eating is all right and he has a good appetite and is being provided with food from all the food groups and a good supply of staples to provide him with the energy he needs at this age, I would say he is OK.

Rosalee M. Brown is a registered dietitian/nutritionist who operates Integrated Nutrition and Health Services; email: yourhealth@gleanerjm.com.