My son Chester has been small his whole life. He’s four and a half years old, and at every doctor’s appointment, he’s measured smaller than normal. He’s developmentally a little bit behind others, but he’s smart as a whip and a very social child. Because his growth has been consistent over the years, there’s not been a lot of concern from his pediatrician. Until now.
For some reason, possibly to do with having four little boys to wrangle, a baby to take care of, and postnatal depression to deal with, we missed taking Chester to his four year appointment. I’d been meaning to do so, but it had slipped through the cracks. Since he wasn’t ill or anything, we’d kind of put it off.
But a few weeks ago, I took him with me to the baby’s 15-month well check, and I brought it up with my doctor that I was concerned at his growth. Even though he’d always been small, I felt that he was slowing down a lot. She agreed to measure him and see, and she suggested I bring him back in for a proper evaluation (AND to catch up on his immunizations, which I’d forgotten they get at 4 years). She was going on maternity leave, so I made the appointment with her colleague.
Fast forward to this week. I took Chester in for his four year well check, only six months later than I’d meant to. I brought up his growth, and she immediately checked his chart and saw what I meant. She explained that with kids, she likes to see a growth of about 5 lbs and 2 inches every year. For Chester, in the last TWO and a HALF years, he had only put on 7 lbs and 3 inches. His growth was actually on a downward slope now.
This wasn’t a huge surprise. After all, there is only 6 lbs between him and his 17 month old brother. He only wears 3T clothes, but he can still fit comfortably into some 2T pieces. He is a tiny kid, which he makes up for with a HUGE personality.
After discussing things with the doctor, and after a thorough examination, she also noted that his tonsils are absolutely huge. The biggest she’s ever seen in a kid, she said. She explained that we needed to get his tonsils removed because she believes that he’s not eating as much nor getting the quality of sleep he needs for good growth. We’ve been referred to a pediatric ENT to look into surgery, and we’re hopeful that it will mean we can turn around his growth.
In the meantime, we’ve been instructed to try and get his weight up as quickly as possible, knowing that he may lose weight after surgery. She wants to see a five pound growth between now and July, when we bring the baby in for his 18 month appointment. She gave us lots of great tips for how to help him gain weight in a healthy way.
Since I know that others may face these same types of challenges, I decided to share these tips here so others can use them.
General Tips for Healthy Weight Gain in Children
- Don’t let children skip meals
- Don’t stick to set meal times. Let them eat several times per day with smaller portions
- Encourage one or two healthy snacks each day
- Avoid eating junk food with empty calories. These low-nutrient foods and drinks are counter productive
- Eat high-nutrient foods that are energy dense and high in calories.
- Don’t allow sugary drinks like diet soda or fruit drinks
- Try not to let them drink with their meals. This fills them up faster and doesn’t allow them to eat what they need
Best Foods for Healthy Weight Gain in Children
A child who needs help gaining weight will need to eat high-calorie foods that are nutrient- and energy-dense, not simply junk food. Foods with a good amount of protein and fat are ideal.
Try these to begin:
- Whole milk
- Real whole milk cheeses
- Yogurt (Greek is great – stay away from sugary snack yogurts)
- Eggs (cook them any way your child likes)
- Peanut Butter (other nut butters are great, too!)
- Cereal with whole milk (keep away from super sugary cereals)
- Orange juice
- Dried fruits
- Seeds and Nuts
Try making a list of the foods your child likes and find healthy versions of them. Let them snack on fruits and veggies any time they like, but include a variety of foods in their daily meals.
Should You Use Supplements to Help Kids Gain Weight?
I asked my doctor if it would be good to supplement his diet with caloric meal replacement shakes or other types of food replacements, and she was adamant that it was not the best way to do it. She suggested instead adding other nutrient dense foods to the foods he is already eating.
For instance, adding mayonnaise to a boiled egg to make egg salad. This adds a healthy fat to his meal, which also boosts the calorie count. Other foods you can supplement include:
- Powdered milk – this can be added to a regular glass of milk to boost calories. Or you can add it to oatmeal, pudding, cereal or even water. It boosts the calories by about 30 – 60!
- Cheese – add a serving of cheese to your child’s meal for extra calories.
- Peanut butter – Add a tablespoon to their morning oatmeal or even to a banana, and you can pack on an extra 100 calories!
- Avocados – a healthy fat that will give them energy
- Sour cream – you can hide this in all sorts of things if they won’t eat it by itself
- Mayonnaise – a creamy companion to all sorts of things – tuna, eggs, even mac & cheese!
- You can also add things like margarine, wheat germ, honey, salad dressing and even instant breakfast mix to help your child grow
Other Tips for Getting Your Child to Eat
Sometimes a child simply isn’t gaining weight because they are not eating well enough. There can be many reasons for this. They may be bored and get distracted easily. They could be a picky eater. They may eat too slowly and let their food get cold and unappealing. Whatever the cause, there are some things parents can do to help.
- Eat together as a family. Sometimes we are busy and don’t sit down together to eat, and this can cause a child to be distracted. Sit down together, using meal time as a chance to interact.
- Don’t rush. Let everyone eat at their own pace without trying to get them to finish more quickly.
- Put down your phone. Make sure you are not distracted in any way so you can create the atmosphere for your child to have a happy meal time.
- Don’t force them. Make a small variety of foods and let your child(ren) eat whatever they like. Don’t try and force them into eating what they’re not interested in.
- Use praise. When they eat, make sure you praise them for doing so. Don’t worry so much about what they don’t eat, and instead focus on how well they’ve done. Positive reinforcement will go a lot farther than punishment.
The bottom line is that there are many reasons a child may be underweight and need a little boost. Always speak to your doctor about any concerns you have, and make sure you rule out other issues before embarking on a weight gain plan.
Hopefully we will be able to get in to see a Pediatric ENT soon, and we’ll have a better idea of our next steps for Chester. Until then, we’re helping him gain weight by offering up his favorite foods and doing our best to help him get his calories in.