Q: Our 4-year-old daughter’s weight (25 pounds) is at the first percentile for her age, but she is otherwise healthy, energetic, creative, polite, and well-behaved. Our only real problem occurs at meals during which she picks at and dawdles over her food. We end up coaxing her to finish, telling her how important it is for her to eat so she’ll grow, and so on. Sometimes, she has been there so long we’ve taken her plate away, but we are reluctant to do that because we don’t want her losing any weight. Are we worrying for nothing?
A: First of all, let’s understand and put into proper perspective what it means that your daughter’s weight is at the first percentile.
Percentiles are nothing more than a means of comparing people along a certain dimension or concerning a certain skill. In the case of your daughter’s weight, the first percentile means that 99 out of a typical group of 100 American girls her age weigh more than she does. If, for example, there are one-half million 4-year-old girls currently living in America, then 5000 of them weigh approximately 25 pounds.
No matter what, a certain number of people are always going to be at the first percentile. For example, I am at the first percentile with respect to pole vaulting. But staying with the current example, if the lightest 4-year-old girl in America weighed 50 pounds, then 50 pounds would be the first percentile. My point is that weighing 25 pounds at age four does not, in and of itself, indicate a problem. My 10-year-old granddaughter’s weight has been between the first and fifth percentiles since she was very young. Nonetheless, she’s always been the perfect picture of health.
With respect to your daughter’s appetite, if she’s healthy, then she’s eating enough. When she’s consumed what her body needs, the healthy thing for her to do is to stop eating. Overeating is not a good thing for humans of any age. Encouraging your daughter to eat when her brain is telling her not to eat is not going to accomplish anything. The constant coaxing is, however, putting her at the center of attention during meals (not a proper place for a child under circumstances other than a piano recital), turning meals into unpleasant occasions for all concerned, and quite possibly setting the stage for the development of an eating disorder. When the family sits down to eat a meal together, you need to talk about anything but your daughter’s eating habits.
Be proactive about this. Before you sit down to eat, you and your husband should decide exactly what you’re going to talk about during the meal. Settle on three topics and stick with them. When your daughter begins picking at her food, ask her if she wants to be excused. Tell her it’s all right if she wants to get up from the table and go play. Enough about her eating already!
Are you worrying for nothing? I’m going to assume that you’ve discussed your daughter’s weight with her physician, and since you didn’t make mention of a problem, either he’s not concerned or he’s taking a “wait and see” attitude. In either case, yes, you’re worrying for nothing. You’re doing a lot of talking for nothing too.