Tips for Helping Underweight Kids (and Their Parents)

Parents of underweight kids who really don’t eat enough deserve better help than they often get. Still, most of the time when people say to me that their child is skinny and a very picky eater, the child does not need to eat more. When kids do need to catch up on weight growth, slower is better than faster. Even though we are eager to get them back on the curve, for long term health it’s generally best just to be moving in that direction.

Before focusing on trying to pack on the calories, be sure

1. They really are underweight (for their height)
2. It’s not for medical reasons that need to be addressed

Remember, the goal is to add calories, while still preparing them for long term healthy eating patterns — this means doing it without processed white flour or added sweeteners or fried foods.

Fats have the highest calories. Add fat (olive oil, peanut butter, avocado, cheese, butter, etc.) to healthy foods (veggies, whole grains, lean protein sources — you can gradually wean back the added fats later, just like switching from whole milk to 2% to 1% to nonfat).

Liquid calories are less likely to fill you up — smoothies and shakes and juices are great for this. I prefer using real food ingredients, not a chemistry set (like you might find in some manufactured versions). e.g. Whole fat dairy or soy. Add an oil. Add fruits. Maybe peanut butter. (note: getting rid of unnecessary calories in drinks is one of the best ways to help overweight kids. Liquid calories sneak in.)

When eating is restricted, I recommend a multivitamin, multi-mineral supplement, with DHA, as spackle to fill in any nutrient gaps.

Periactin, an allergy medicine, can be a potent appetite stimulant. It can be a godsend, helping kids with no appetite suddenly start eating 3 meals a day. For kids in the first 2 1/2 or 3 years of life – when long term flavor preferences are forming, and kids need multiple experiences with a wide variety of whole foods — I’d try the medicine sooner rather than later. These are precious months for food experiences, and should not be wasted.