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How To Increase Calories In Your Underweight Child’s Diet

How To Increase Calories In Your Underweight Child’s Diet

How Do I Help My Underweight Child Gain Weight?

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, I have faced similar challenges working through this situation with my son when he was younger. 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 did not need to follow a high calorie diet.

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 didn’t feel bad about wasting food from the failed product or experiment.

HIGHER CALORIE FOODS TO TRY 

Foods high in calories and protein can help your child gain weight. At the bottom of this article is a chart with calorie and protein boosting foods, along with associated calories/protein and suggested uses. These will give you some ideas of different foods that can be used to help improve your child’s weight gain.

USING SUPPLEMENTS IN YOUR CHILD’S DIET

In addition to the foods listed in the chart below, you can also incorporate supplements in your child’s diet to increase calories. Examples include:

  • PediaSure®
  • Boost® Kid Essentials(TM)
  • PediaSmart® Organic Beverages
  • Orgain® Kids
  • And for kids with a milk allergy, Bright BeginningsTM Soy Pediatric Drink and PediaSmart® Organic Pea Protein 

These beverages are ready to drink and typically have about 200 calories for every 8 ounces. They also contain protein and are supplemented with vitamins and minerals. 

I recommend starting with one or two of these supplements per day as 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 4 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.

In some cases these supplements can be covered by the Women, Infants, and Children (WIC) program or insurance. 

Some of the foods in the chart below can also be used to make a shake that can supplement a child’s diet.

TIPS TO HELP INCREASE YOUR CHILD’S CALORIES

After reviewing the Calorie and Protein Boosters chart below, combine food choices with these tips to help increase your success with upping your child’s calorie intake:

  • Make food for the child that needs extra calories without giving it to the whole family. Add extra oil and butter to one serving of pasta, use extra nut butter on your child’s bread, serve whole milk with meals, or add 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. Choose foods from the chart 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.
  • Do not allow them to eat whatever or whenever they want. This is common advice for parents when their child is underweight. In the world of child nutrition, parents are encouraged to practice what is called the “Division of Responsibility.” This means the parent’s role in feeding is to determine what a child is offered, when it is offered, and where it is offered. It is the child’s job to decide if they will eat it and how much they will eat.It is not optimal for a child to have unlimited access to food as a way to address being underweight. This can result in constant snacking and grazing, which actually can lead to a child never being able to take a larger volume of food because they are always a little full. Following the Division of Responsibility encourages structure to eating. Typically children need to be offered 3 meals and 2-3 snacks per day. Generally, snacking should be discouraged 1-2 hours before a meal or snack time. This allows the child to come to the meal hungry and consume a larger volume of food.
  • Balance a healthy diet with high calorie foods. Many families feel like their child is not eating healthy when calories are increased. You can make the diet balanced by using the foods listed in the Calorie and Protein Boosters chart. For example, if your family is having grilled chicken for dinner, offer a high calorie side item with it, such as sweet potato fries and steamed broccoli. Then 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 eat more calories, consider a referral to a registered dietitian. 

In the Cincinnati area, your child can be seen by a registered dietitian in the Cincinnati Children’s Outpatient Nutrition Clinic. If your family is outside of Greater Cincinnati, I suggest using the Find an Expert feature from the Academy of Nutrition and Dietetics to find a pediatric dietitian in your area.

CALORIE AND PROTEIN BOOSTERS

Food Calories / Protein per serving Uses
Oils (canola, safflower, olive, or coconut) 40 calories/teaspoon 0 protein Use in salad dressings, toss with pasta or cooked vegetables, and use in baked goods.
Butter (can use either dairy or soy butter) 35 calories/teaspoon 0 protein Spread on toast or bread, melt onto vegetables and pasta, and use in various baking recipes.
Nuts (calories per ounce)

  • Almonds, Peanuts, Cashews, and Pistachios: 160-170 calories
  • Walnuts: 185 calories
  • Macadamia and Pecans: 200 calories

Use in baked goods, sprinkle on yogurt and cereal, trail mix, salads, and stir fry.
Whole nuts can be a choking hazard to children less than 3 years of age.
Nut and Seed butter (peanut, almond, cashew, and sunflower seed) Per tablespoon: 100 calories 3-4 grams protein Use as a dip for fruits or vegetables, spread on crackers or toast, stir into hot cereals. Some brands of sunflower seed butter are nut free.
Eggs 80 calories per egg 6 grams protein Use as breakfast food, add to baked goods, and when hard boiled can be eaten as a snack.
Hummus or other bean dip Per tablespoon: 25 calories 1-2 grams Use as dip for vegetables or a sandwich spread
Cheese Calories per ounce

  • Cheddar, Swiss, Provolone, Muenster, Colby, and Goat Cheese: 100-110 calories
  • Mozzarella and Feta- 75-85 calories; 7 grams of protein (4 grams of protein in feta cheese)

Use as toppings for sandwiches and soups, melt into casseroles, sprinkle on vegetables, or as a snack.
Heavy Whipping Cream 45 calories/tablespoon 0 grams protein Use as some of the liquid in hot cereal, add to milkshakes, smoothies, and other beverages. Use in casseroles, potatoes, rice, or noodles.
Whole Milk Yogurt At least 140 calories/cup 6 grams of protein Use as a snack, dip with fruit, or mixed into a smoothie.
Cream Cheese 50 calories/tablespoon 1 gram of protein Spread on bagels or toast or use in dips and sauces.
Sour Cream (Do not use reduced fat or fat free) 25 calorie per tablespoon 0 gram protein Top on potatoes, use in dips, and mix into casseroles or soups.
Sweet Potato

  • 165 calories with peel
  • 100 calories without peel

Use in soups, casseroles, and baked goods.
Peas Per 1/2 cup:

  • 65 calories
  • 4 grams of protein

Mix with rice, pasta, soups, and casseroles.
Avocado 240 calories/fruit 4 grams of protein Slice on sandwiches and salads, mash as a dip for chips and vegetables, and add to smoothies.
Banana 1 medium sized fruit 105 calories per banana 1 gram of protein Eat as a snack, mash to put in baked goods, blend into a smoothie or milkshake, and use as a topping for cold or hot cereal.
Flax seed 1 tablespoon 45 calories 2 grams of protein Add to salads, soups, baked goods, yogurt
Dried Fruits Calories per ounce

  • Cranberries: 40 calories
  • Raisins, Cherries, and Blueberries: 85-95 calories
  • Apricots: 65 calories

Use in a trail mix, mix with yogurt, top a salad, add to cereal, or as a snack
Pure Maple Syrup 50 calories per tablespoon Use to top pancakes or waffles, use to flavor hot cereal, yogurt, or smoothie
Honey 65 calories per tablespoon 0 grams Use to sweeten milkshakes or smoothies, mix into hot cereal, and use as a dip for chicken. Do not give to children less than 1 year of age.
Canned Coconut Milk 25 calories per tablespoon Add to sauces, smoothies/shakes, and soups. Do not use the light or fat free versions.
Wheat Germ 25 calories per tablespoon 2 grams protein

ADDITIONAL OPTIONS

Food Calories / Protein per serving Uses
Ice Cream 130-250 calories per 1/2 cup 2-4 grams protein Milkshakes, topping for pancakes, waffles, or as a snack
Instant breakfast (1 packet) 130 calories
5 grams protein
Mix with 8 oz. of whole milk Add to hot chocolate, pudding, milkshakes
Sweetened condensed milk Per tablespoon 60 calories,
1.5 grams protein
Add to pudding, milkshakes, pies
Salad dressing Per tablespoon 80-100 calories Add to salad, raw or cooked vegetables as a dip
Mayonnaise Per teaspoon 45 calories Use on sandwiches, in cold salads or as a dip
Jelly/jam Per tablespoon 55 calories Spread on toast, biscuits, muffins Use as an ice cream topping or in a milkshake.
Milk Powder, made from whole milk Per tablespoon 40 calories 2 grams of protein Add to milk, yogurt, pudding, mashed potatoes, etc.
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 For more information or to speak to one of our Pediatric Nutrition Specialists, contact our Nutrition Clinic

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