Your Underweight Child
Is It More Than Underweight?

This article is all about the underweight child. Being underweight is not the same as being thin or slender. Some children have a naturally slim build and their parents tell me they eat a well-balanced diet and have plenty of energy to play. This is normal and healthy.

How do I know if my child is underweight?

Early Head Start nurses, or your pediatrician can weigh and measure your child. If your child’s weight for length is below the 5th percentile or BMI for age-and gender is less than the 5th percentile this may signal underweight. Most of all, talk to your pediatrician about your child’s growth.

What can I do to help my child?

If your pediatrician recommends weight gain then adding extra calories is the main way to do this.

It's possible that your child is drinking too much

Many toddlers I see are drinking all their calories. Once your child is past his first birthday and on whole milk, wean him to a cup. This may help them drink less milk. Remember: a child over one year of age only needs about 16 ounces or 2 cups of milk per day and about 4 ounces of juice per day. (They may also drink some water.) For some children straw drinking is a little easier than cup drinking at first.

What should my child eat to gain weight?

Offer extra calories that are rich in important nutrients. Avoid letting your child fill

upon on empty calories, such as candy and soft drinks. Foods that contain protein (like foods from the meat and dairy group) and fat (meat, dairy, and fat group) have more calories than foods that are only carbohydrates (fruits and vegetables and breads and cereals). This doesn’t mean we cut out the carbohydrates, we just balance them with protein and fat.

Here are some suggestions to add calories to your child’s diet.
  • Add small amounts of fat to your child’s diet. This could be a teaspoon of margarine, sour cream, cream cheese, salad dressing, or mayonnaise. When your child has a sandwich use a bit of mayonnaise. Add sour cream and butter to their potatoes. Spread some cream cheese on their toast instead of jelly or along with the jelly. Let them have a bit of their favorite salad dressing as a dip.

  • Use eggs. Eggs are a great source of protein. If your child doesn’t like eggs, think about how you can slip them into something they do like. For example, cooked pudding from the box, French toast, macaroni and cheese, and egg salad. You can also add an egg to either cooked noodle ramen or rice, a few peas and carrots and stir fry in a pan. This takes a lunch that was mostly carbs and adds protein and calories.

  • Use cheese. Cheese is both protein and fat. Melt a bit of cheese on your child’s vegetables. Add an extra slice of cheese to a grilled cheese. Let cheese be a snack for your child. Add cheese to scrambled eggs.

  • Use whole milk products. Whole milk has more calories than 2% or skim. Young children need these fat calories for good brain growth. Read the label when you buy yogurt or other milk products. Be sure it says Made from Whole Milk on the label.

  • Milkshakes or smoothies are great. Milkshakes and smoothies are a great way to add calories. Use whole milk. To really boost the calories try adding a packet of instant breakfast, or ice cream.

  • What about peanut butter? Children should be over 2 years of age before they are served peanut butter. Why? For two reasons:
  1. Peanut Butter is the number one food allergy in this country.
  2. Peanut Butter is a food that can cause a child to choke.
But having said that, I am a big fan of peanut butter for children over two that can tolerate it’s very thick texture. It is high in protein and high in fat; a great food for over two-year-old children.
  • Use non-fat powdered milk. Powdered milk can be added in small amounts to any food to add calories for children over 2 years of age. You can add 1 tablespoon to your child’s milk, on their cereal, when making macaroni and cheese, puddings, or anything you have to mix up.

  • No "skinny kid" comments. Do you know anyone that was underweight when they were a kid? It was a sensitive subject just like being overweight. Help your child understand that each child is unique. Each child's body shape is unique. Children come in different s, shapes, and weights. They also grow at different rates. Every body is a good body.
Cups without lids

Your toddler doesn’t need a spill proof cup. If you do use one, use it for only a short time. Don’t let your toddler walk around the house with a cup. Use a cup without a lid at meals and snacks. Put small amounts of milk or juice in the cup. Your toddler needs to practice using a cup. He will spill at times. Offer water in a cup if your toddler needs a drink between meals and snacks. If you must travel with a spill proof cup, put only water in it. Water will not ruin an appetite or cause cavities. Put your toddler to bed without a bottle or spill proof cup. Singing, reading or rocking your toddler may help at bedtime. Help your toddler learn to drink from a regular cup without a lid at meals and snacks!

Early Head Start 
Nutrition News

February 2007

From your nutritionist, Ann