Dear T.,
I had two babies that were tested due to slow growth. Both were happy, social, and developmentally right on target. I loved my first pediatrician. When she saw their dad (not a big man) she told me she wasn't really concerned about my son's size - but that we owed it to him to find out if something was wrong. We did weight checks every two weeks and some other testing. We had to change pediatrician's due to an insurance change. This next doctor was a pediatric endocrinologist. She did some more tests on my son and diagnosed him as "delayed growth," saying that he would enter puberty late and continue growing after everyone else stopped. (She was wrong by the way.) Then my third child, a girl, stopped following the growth curve around four months. The doctor told me to breast feed her like normal, then give her two ounces of formula (which I thought was insane!). This didn't work - she didn't want the formula after she nursed (duh!) The doctor told me to wean her. It was a nightmare - she had been taking a bottle at least once a week while I was working - now she wouldn't take the bottle anymore - even with breast milk in it. When she didn't gain weight with formula, I was told to give her Pediasure - this was a worse nightmare! She screamed when I tried to feed her - she was never hungry, and now she was LOSING weight. At six months, the doctor thought she figured out what was wrong and admitted her to the hospital for tests. They ruled out what the doctor thought was wrong. I went in the following week for a follow-up visit, and had all sorts of questions: why is her appetite decreasing, why is she losing weight on the high calorie stuff, how do you know this isn't delayed growth like her brother, etc . . . The doctor had no answers for me - except to say, I don't know. All I can tell you is that you will be crucified if she doesn't start gaining weight." I left the office nearly hysterical, waiting for C.P.S. to come take my baby away. My mother thought it sounded like she was accusing me of Munchausin's by Proxy. One of the traits of Munchausin's is frequent changes of doctors - so now, even though I felt extremely uncomfortable with this doctor, I was afraid to switch. Luckily, we had another insurance change early the next year, and I took advantage of it to change doctors. A year later, at her next physical, I asked the nes doctor about her weight, and she said that while it was at the bottom of the charts, it was consistent, and she wasn't concerned.
At 19 and 15, they are both fine now, though my son is on the short side (the endocrinologist calculated that his final height would be 5'10", plus or minus two inches. She was wrong on this count, too - he is only about 5'5".
Here is my thought - doctor's try to find something wrong when they see something that does not fit a pattern they are used to . . . There may not be something wrong - there might just be something different. If your daughter is happy and developing as she should, if she interacts socially and is not withdrawn - I would not worry too much. . . .
That aside - The one food I remember them recommending to me as a good high calorie source of fat and protein is peanut butter. The other thing you can do is split eggs with her - give her the yolks, and take the whites for yourself. Also be sure she is getting at least 24 oz of whole milk every day (unless you're still nursing) - maybe try Pediasure . . . (it was too rich for my 4 month old baby who was used to breast milk, but your 16 month old may like it)
Good luck! I've been there - it's not fun, and it's not easy - but I have come through the other side - it doesn't last forever!
B.