We are frequently asked this question by both parents and care providers: How do I help an underweight child gain weight with foods that are higher in calories?
As a pediatric dietitian and a parent of a child who is underweight, I have faced similar challenges working through this situation with my son. Some of the more notable obstacles I encountered were related to finding higher calorie foods that my son would actually eat, and practical, inexpensive choices. And when I found good options, I realized that I needed a strategy to keep my son’s high calorie foods separate from the other family members who were not underweight.
For example, I knew how to make the highest calorie cookies, but if my son did not eat them I had to figure out what to do with the rest of the batch (my other family members did not need the high calorie cookies). They would just get thrown away, which I hated doing.
It was also important to me to find options that did not have a large upfront cost and came in reasonably-sized packages so that I did not feel bad about wasting food from the failed product or experiment. The following are some ideas of different foods that can be used to help improve your child’s weight gain. The list is quite extensive so we created a PDF that you can download below.
Aside from the foods listed on the PDF, you can also incorporate supplements in your child’s diet to increase calories, such as Pediasure, Boost Kids Essentials, or Organic Pediasmart. If your child has a milk allergy, Soy Bright Beginnings and Organic Pediasmart Soy are also available.
I recommend starting with one or two of these supplements per day as the overuse can cause your child to lose interest in eating. I gave my son a pediatric supplement while we worked on increasing his daily calories and eating a wider variety of foods. He had about four ounces of it at snack time because he got more calories from the supplement than from the few crackers or pieces of fruit he would eat.
After reviewing the high calorie food list, here are some additional tips to help you increase your child’s calories:
Make food for the child that needs extra calories without giving it to the whole family. Some ideas to accomplish this are adding extra oil and butter to one serving of pasta, using extra nut butter on your child’s bread, serving whole milk to your underweight child with meals, and adding extra cream and maple syrup to oatmeal.
Purchase small packages and individual servings. This will help you avoid food waste while you’re experimenting with different types of foods.
Young children have smaller tummies and therefore are not able to eat a large volume of food. In this case you will want to choose foods on this list that will have the most calories in a small volume. For example hummus is 25 calories per tablespoon, but cream cheese is 50 calories per tablespoon and peanut butter is 100 calories per tablespoon. Therefore if your child eats only small amounts and you’re looking for a good dip to have with celery, serve it with cream cheese or peanut butter.
Balancing a healthy diet with high calories foods. Many families feel like their child is not eating healthy when calories are increased. There are ways to make the diet balanced by using the foods listed on the high calorie foods PDF. For example, if your family is having grilled chicken for dinner you can offer a high calorie side item with it, such as sweet potato fries and steamed broccoli and melt butter on the portion for the child who needs the extra calories.
If your child has never been diagnosed as being underweight but you are concerned, discuss it with your pediatrician. He or she can review the growth history and determine if there is reason for concern. If it is recommended that your child needs to eats more calories, consider a referral to a registered dietitian.