Jan 9, 2025

What I Wish I Could Tell Pediatricians and Parents

Alexis Richardson, MS, OTR/L | Pediatric Occupational Therapist

As a mom and a feeding therapist, I’ve seen firsthand the pressure placed on both parents and pediatricians when it comes to a child’s weight and health. There’s a common belief that weight is the primary indicator of a child’s nutritional status, but I want to share with you why this may not always be the case.

✨ Weight is Not a Determiner of Nutrition Status!

It’s easy to equate weight with health, especially when pediatricians and parents are focusing on things like Body Mass Index (BMI) and growth charts. But here’s the truth: a child can be at a perfectly normal weight and still have nutrient deficiencies. On the flip side, a child may be underweight for their age and still have good nutrient levels. The number on the scale doesn’t always tell the full story of a child’s nutritional well-being.

Many of the families I work with come to me after their child has been labeled with Failure to Thrive (FTT). It’s often at this point that weight becomes the main focus. Parents are told to “push calories”—sometimes with suggestions like donuts, candy, and other high-calorie foods—but the conversation rarely shifts to the quality of those calories. The focus on weight can overshadow the importance of actual nutrient intake.

So, What’s Really Important for Kids to Thrive?

If we want our children to truly thrive, especially those who have received the FTT label, we need to start looking beyond just the weight. We need to focus on nutrient levels. Children can’t grow, develop, or function optimally without the proper nutrients, regardless of their weight. Ensuring they have the essential vitamins, minerals, and other nutrients is critical to their health.

It’s also important to note that nutrient deficiencies can contribute to picky eating behaviors. In my practice, I see a direct link between insufficient nutrient intake and an increase in selectivity with foods. This makes it even more important to address nutritional needs first, before tackling sensory and oral motor issues.

The Priority: Nutrients Over Calories

As a feeding therapist, my first priority is helping children get the essential nutrients they need to fuel their bodies. Once that foundation is in place, we can then work on the other components—such as sensory issues, oral motor skills, and food textures—that may be contributing to picky eating or other feeding challenges.

Want to Learn More?

I’ve created a FREE handout that outlines the 13 key nutrients children need for optimal health, along with the appropriate daily intake for each age group. If you’re interested in learning more about how to ensure your child is meeting their nutritional needs, simply fill out the form below and I will email the handout!

Let’s focus on what truly matters: helping our children grow strong, healthy, and happy, starting with the right nutrients, not just the right number on the scale.