[sak9645]

My daughter was 17 lb. at 18 months, and she grew very slowly. She didn't hit 20 lb. till she was well over age two. She didn't have a real growth spurt till she was about 10 years old. Now, at 12, she's in the 25th percentile for weight on the American charts, and that's probably ideal for her.

Our pediatrician was appalled by Becca's small head circumference and low weight on our first meeting with him. However, today, he is embarrassed to realize that he counseled me about the possibility of learning problems and such. Becca is way above grade level in all of her school subjects, and doing absolutely beautifully. She is also a well-adjusted, popular child.

Size is a lot less important than consistent growth. Failure to grow is a problem, and could be related to parasites -- Giardia can evade detection for the longest time -- and other issues. Failure to eat, and failure to move from liquids to textured foods, are indicative of feeding disorders that can be treated by a professional. But some kids -- and especially kids from Asian countries -- are simply small, but healthy and normal in their growth patterns.

It's normal for a toddler to want to self feed. It's part of a toddler's move to become more independent. It's also normal for a toddler to be rather bad at self-feeding, with only 10% of everything served making it into the stomach.

The parent should simply expect feeding to be messy and inefficient. And the parent should understand that a normal portion of a food for a toddler is very small -- about one tbsp. for every year of age. If you serve a toddler a small cup of pudding, and he/she tries to eat it with fingers, smearing most of it on his/her face, he/she will still manage to get a spoonful or two "down the hatch," as a general rule. And that is generally plenty.

Make a wide selection of healthy foods available. The child can eat most of what you eat, if it is cut up very small or mashed or cooked a bit longer than you would cook your own portion, so that it is softer. Omit the salt and sugar, if possible, when you prepare the food.

For breakfast, there are lots of options for the self-feeder -- scrambled egg, bits of toast with butter or jam, cut-up segments of clementine or tangerine, bits of banana, etc. And if you are willing to put up with the mess, try mixing Rice Krispies with a little flavored yogurt; offer a spoon, but don't be surprised if your child picks it up with his/her hands.

For lunch, slivers of chicken or tuna, small chunks of cheese, left over dinner veggies such as well-cooked green beans or carrots, crackers, etc. are easy to handle. Add some cottage cheese if you don't mind a bit of a mess. Some children may be willing to let you feed them a small bit of soup AFTER they have satisfied their self-feeding needs.

For dinner, some kids will eat "mixed" foods and some won't. As an example, lasagna is a "mixed" food, since it includes meat, cheese, sauce, and pasta. Some kids will love it. Others won't. If yours is one of those kids who won't eat mixed food, simply think about that when you are preparing dinner. Instead of putting all the cooked ground beef into the lasagna, serve your child a little of it plain or with a little pasta sauce. Make a small bowl of noodles and serve them plain or with a little pasta sauce. Cut or shred some of the mozzarella cheese to serve on the side And so on.

Dinner offers lots of options for self-feeders. Things like mashed potato or yam are pretty easy to eat. Noodles, though messy, are great if you cut them up a bit. Almost any cooked vegetable will work. Fish or chicken can be cut up very small. Some kids will eat tofu.

Snacks are probably the easiest things to serve the self-feeder. Put a little cream cheese on crackers. Slice apples very thin. Cut up little pieces of melon. If your child likes to "dip" foods, come up with nutritious options -- crackers and an avocado or spinach dip or a very mild salsa, bits of fresh fruit in a dip made from yogurt, etc.

Once kids start self-feeding, it's really, really important that you make and enforce the rule that ALL food must be consumed while sitting down in a highchair or at a table. Wandering around with food is dangerous, and can lead to choking. It also leads to a pattern of overeating. Needless to say, it also increases the likelihood that food will get mashed into the rug or stain the upholstery.

Always stay with your self-feeding toddler. This includes NOT letting your child eat in the car unless the motor is off and you can quickly grab your child if he/she starts to choke. Kids don't have a sense of how much food they should put into their mouth, or how long they should process it with tongue and teeth. It is VERY easy for self-feeding kids to stuff their mouths too full, or to try to swallow something whole.

Sharon