Q&A: My toddler is underweight but she won't eat anything. What do I do?

First, gather some hard data about your daughter's growth and nutrition. Look at her height and weight on a growth chart (your doctor has one if you don't) and see if she is falling on her curves (getting skinnier). Then, keep a diet diary for two weeks, where everything she puts in her mouth to eat or drink is recorded.

Toddlers are 'grazers'. They often eat as much again in snacks and nibbles as they do in meals, and many parents are pleasantly surprised when they look back over a two-week period.

Then, if her growth isn't suffering, re-frame the issue in your mind, not as one about nutrition but as one about control. The great goal of toddlerhood (besides making large messes) is independence, and struggles over control often center around toileting and feeding. The bottom line is you really can't control any longer what she chooses to swallow, though you can certainly influence it greatly. On the other hand, hunger is a powerful drive, and children won't deliberately starve themselves. If a parent plays it right, toddlers end up growing up and out of their picky phases.

So, how to play it right?

• Don't let her fill up on milk, juice, or non-nutritious snacks, thinking it's better than nothing.
  
• Try to limit intake a few hours before a meal, to give her a chance to get hungry for that meal.
  
• Offer reasonable portions, filling a very small plate with a variety of foods. A full, adult-sized plate can overwhelm a small child.
  
• Offer a balanced meal. Include some favorites, but add some new foods too. Then let her choose what to eat. What isn't eaten in 20 or 30 minutes can be wrapped and re-offered as a snack next time she's hungry.
  
• Don't let yourself get so stressed that mealtimes become tense. Toddlers are very sensitive to the stress and it becomes more difficult for them to eat. If this becomes hard, leave the room and let someone else take over.
  

At her next check-up, your pediatric provider will again plot her growth on a chart and hopefully reassure you that she is getting what she needs to grow.