• Keep a really accurate food diary for a few days. Often looking at it can solve the problem; just one biscuit may take the edge off a child’s hunger, or a bottle of milk may need to be dropped to encourage more solids to be eaten.

• Keep snacks healthy and to a minimum if you are worried about poor eating at meals.

• Don’t avoid fat in the diet. Babies need fat for growth and brain development and a diet that is healthy for an adult trying to lose weight will not provide enough fat for a child. Don’t use semi-skimmed milk or low-fat products.

·        Not getting enough calories: poor diet, not enough fat in foods or certain milks or milk substitutes.

·        Feeding problems: meal times have become a battleground, parents are over anxious or the child has been allowed to develop fads and ridiculous rituals associated with eating.

·        Illness: recurrent ear and throat infections, chicken pox, measles, surgery and many other illnesses can cause weight loss and poor weight gain. Chronic illnesses like cystic fibrosis, diabetes and coeliac disease affect digestion. Also neurological damage can affect swallowing and weight gain.

·        Genetics: certain body types run in families. Children have growth spurts and pubertal growth spurts at different ages. The parent’s height also affects the child’s growth.

·        Constitutional delay: this also runs in families where both parents will have been small as children. The child is smaller and shorter than you would expect and the bone development is also delayed. These children usually catch up and grow normally.

·        Hormonal: growth hormone and thyroid hormone deficiencies can delay growth.

·        Depression: if the mother has exhaustion or depression, or the child is miserable, they may not grow properly.