Too Young to Diet

Noelle's parents were concerned. Their 21-month-old daughter had failed to gain any weight in nearly six months. Such failure to thrive is usually the result of illness, poverty or neglect, but Dr. Michael Pugliese found that the child was basically healthy and the couple well-to-do and doting. In fact, the parents were so committed to caring for Noelle (not her real name) that they had placed her on a stringent low-fat diet in an effort to ensure that she did not become obese. Told that the strict regimen was stunting the toddler's growth, they were surprised. Says Pugliese, a pediatric endocrinologist at North Shore University Hospital in Manhasset, N.Y.: "They really felt they were doing what was right for the child's long-term benefit."

A growing number of children under age two are, like Noelle, victims of misguided parental notions of a healthy diet, warns Pugliese. Restrictive diets, he notes, now account for about one-fourth of the cases of failure to thrive seen at the hospital. Pugliese and Pediatric Nutritionist Michelle Weyman-Daum reviewed the records of seven children, age seven months to 22 months, and found that the youngsters were all on low-fat, low-cholesterol diets and getting only 63% to 94% of the calories they needed. Parents typically substituted skim milk for whole, fed their toddlers lean meat and complex carbohydrates, and forbade eating between meals.

Such obsessive parents often have a family history of either heart disease or obesity. Noelle's father, for example, struggled to lose weight through his teens. "In many cases," says Pugliese, "the diets parents choose are proper for adults--the kind suggested by the American Heart Association--but they are not appropriate for a growing child." Counseling is sometimes necessary to change parents' thinking, he adds. But once youngsters are placed on expanded diets, they quickly recover. After two months of balanced meals and whole milk, Noelle started growing again, and now, notes Pugliese, "she's doing very well."