Q: My question concerns my 4 and a half years old daughter. She was a small baby and quite underweight at birth (2.25 kgs). I suffered from PIH from the eighth month of pregnancy which doctors attribute to being the cause of her being under weight. She grew up quite normally and an active baby, though all her physical milestones came in at least two to three months late. She gained good weight in the first 5 months of her birth but since then her weight gain has been very slow. Even now, she is underweight by at least 4 kgs for a child of her age. She has a small appetite though she eats well and I do not force feed. She is quite intelligent and goes to one of the best schools. Is there a tonic which can help absorb the nutrients better and step up her metabolism? I cant help but compare when I see other children her age eating and growing much better than her? She too feels very bad when teased for being the smallest kid in her class.

A:PIH is a common cause for low birth weight. Most babies however catch up during the infancy for any deficit in weight due to PIH. Subsequently, weight gain and height depend upon a variety of factors. Genetics, i.e. parental stature is an important determinant. Also, there is a range of normalcy for everything in health be it milestones, weight, height, blood pressure, etc. In general a 4.5 year old girl may have a weight in the range of 15-16 kg, and height around 100 cm. However, each child is a unique individual and grows in a unique manner. If your child is otherwise healthy and active and not suffering from any medical problem, you really have no issue to worry about at all. She certainly does not need any tonics. At this age it is far more important to aid development of healthy food habits in a child rather than worry about her stature. A well balanced diet containing milk, milk products, cereals, pulses and fresh fruits and vegetables is all that is needed by the body to attain optimum growth. In any case there is no way that one can make a child grow taller than she is genetically predisposed to be. Overfeeding shall only make her obese, which is not desirable at all. I am sure if you stop being overtly concerned about her physical appearance, child shall also soon stop bothering about it. Meanwhile, enjoy your childs childhood!