> >Does anyone have experience with using Megace > > > >I. Chao, MD > > 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 How funny or realistic things are, I have the exact same experience than Michael, and in a e-mail string as this one but in spanish the same conlutions were reached. Fightg, fight, fight, ocasionally subside and give some junk, be happy.