At 12:27 PM 8/20/99 -0400, wrote: > > >Does anyone have experience with using Megace for appetite stimulation in >children who have poor weight gain without organic disease and poor appetite? >If so, what is the dosage? Thanks > >I. Chao, MD I've never heard of Megace. In my experience - in the absence of organic disease - poor appetite (which may or may not lead to poor weight gain) is almost always behavioral (food battles with parents) or due to other poor eating habits (drinking massive amounts of milk and/or juice, etc.). Genetics, with a history of one or both parents being thin as kids can also play a part. Occasionally I'll refer to a pediatric dietitian who will do a three day calorie count and see if there is truly an inadequate intake. The dietitian can also reinforce the basic diet advice I've already given and give additional, more detailed advice. In almost all cases feeding problems in children older than one-year can be "solved" if the parents do the following: Stop the bottle (if the child is still taking it). If the child refuses milk through a cup but has been taking it through the bottle, be tough. When he/she gets thirsty enough, they will drink it with a cup. Reduce milk intake to less than 20 oz/day (this will almost always happen automatically when the bottle is stopped). Eliminate all juice (except maybe a cup of calcium fortified orange juice with breakfast). Provide healthy meals and snacks, each containing at least one food the child has shown in the past he/she will eat. Permit junk food in occasional and small quantities for older children (let's be realistic - it's a part of life). Leave the child alone and don't force anything! When the child is hungry - he/she will eat. When they are not, they won't. Look at food intake over days and weeks, not meal-by-meal. If a family follows this advice, I'd say that 99% of the time the child will gain adequate weight over the next 3-6 months. And as an added bonus, meal times will be happier for the child and the parents. Michael Sachs, M.D. General Pediatrician