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Pediatrics/5 year old won't eat, losing weight & BMI


I have a newly turned 5-year old. She is super skinny now. In the last year, she's actually gone down about 1 1/2 pounds. I weighed and measured her tonight: 37.2lbs, 41.75 inches. Last year on her birthday she was about a pound shy of being able to get out of her toddler seat in the van. Now she's still in a 5-pt harness car seat. She won't eat hardly anything, and sits at the table for hours (literally) refusing to eat, saying her tummy hurts. I have to force her to drink her milk, and she never finishes a meal. When I serve a meal, I am always concerned about having dairy, meat, whole grains, and at least one serving of fruit and/or vegetable. She's been saying for months that her tummy hurts when she is at the table, but I keep writing it off as her being stubborn and trying to control the situation. My husband recently questioned whether there's actually a valid health issue that needs to be addressed by her doctor.

You were kind enough to answer me last June and August/September for this same child, with potty training issues. I should tell you that we still are not fully potty trained. She still occassionally poops her underwear (several times this past week). But I told her that when she turns 5, as she just did, that she is completely in charge of all the wiping and cleaning of herself. She glares at me like she absolutely hates my guts, but I force myself to remain calm and tell her that I no longer have to worry about doing this - it's her body, and if she chooses to use her underwear instead of the potty, then she is responsible for the mess. I remind her that I drew the line when her older brother and sister turned five, and I'm not changing it for her. She's not happy with me about it, but I'm not budging. My freedom on this issue came on her fifth birthday, and it is overdue.

Thank-you so much for any advice you can offer on her refusing to eat. When I checked her BMI, it said she is at 15, underweight. I'm a little concerned, but don't know what good the doctor can do...

Hi, Dawn,

I am the father of two super skinny young adult girls and this is the way they have been all their lives.  I tell you this to have you get some perspective where I'm coming from.  Skinny is not necessarily or usually bad. At age 5 one of my daughters just pushed 30# and she is of average to taller than average height.  

Your daughter is apparently not a "shrinking violet" type of person.  She has a forceful personality and knows what she can do to control the world about her.  I think your way of handling her poop issues is excellent and this method should spill over to the eating issues.  

She will not starve.  She will not be damaged with a few months of perhaps not the best balanced diet.  She will eat what she wishes and you can't do much about it.  Try to give her a balanced diet and let her eat from this what she wants. If she doesn't eat well at a meal, don't compensate for this by a bigger snack.  Keep the snack sizes independent on what she eats at a given meal.  Yes, snack are great, but not increased ones to enable her further with the meal control.

Chronic stomach aches always concern me, even those that seem to be manipulative behavior.  At the next routine exam, mention your concern to your pediatrician and see what he/she has to say.

Hope this is helpful to you, Dr. Olson  


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David Olson, MD


I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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