Nutrition Tips for Underweight Kids from a Pediatric RD

Nutrition Tips for Underweight Kids from a Pediatric RD

Article By: Dominica Dieffenbach, RDN

Dominica is a Registered Dietitian and mom of 2 kiddos currently specializing in the special needs pediatric population. She has over 15 years of experience as an RD, working with a wide variety of patients to provide them with individualized medical nutrition therapy and education.

With so much focus these days on childhood obesity, we can sometimes forget that many children struggle to gain weight appropriately or maintain a healthy weight. Adequate growth is most critical during the first 5 years of a child's life but remains important through adolescence. A child or teen is considered underweight if their Body Mass Index (BMI), which is a measurement of their weight compared to their height on the CDC Growth Charts, is less than the 5th percentile. Every child grows at their own rate, so it's important to ensure they are following their own individualized growth curves and not decreasing percentiles.

Adequate nutrition and reaching a healthy weight will allow kiddos’ rapidly growing brains to get the necessary nutrients and create a strong skeletal system, support a healthy immune system, and ensure proper hormonal development. Many children who are underweight are also at risk of vitamin and mineral deficiencies and would benefit from a high-quality supplement such as the Renzo’s Picky Eater Multi.

1) What are some factors that make it difficult for a child to gain weight?

Below are a variety of factors that would make it difficult for a child to gain weight at the velocity they should:

  • Premature birth: Babies born early often have higher growth needs throughout infancy and childhood compared to those born full term.
  • Limited diets: Food allergies, feeding difficulties, a specialized diet for a medical condition, and picky eating can all be contributors for a kid not taking in enough calories, thereby causing them to be underweight.
  • Medications: Prescriptions used to treat ADHD can suppress appetite and make it hard for children to eat enough simply because they aren’t hungry.
  • Increased activity: Children who have a high energy expenditure due to sports participation or hyperactivity could be at risk for poor weight gain if they don’t consume extra calories to make up what they are burning.
  • Food insecurity: Children in families with inadequate access to safe and healthy foods are more likely to be underweight. Encouraging participation in programs such as WIC, Summer Meal Programs, and SNAP (Supplemental Nutrition Assistance Program) should be encouraged.

2) What are some strategies to help underweight kiddos properly gain weight?

In general, a child who needs help to gain weight should eat high calorie foods, that are energy-dense and healthy, rather than low nutrient foods such as ice cream and chips (wouldn’t that be nice!) — which do have the calories but lack nutrients. Some good foods to include would be full-fat dairy, nuts and nut butters, canned coconut milk, bananas, avocados, and olive oil.

  • Kids who graze and nibble all day overall end up eating less. Try to offer a meal or snack every 2-3 hours without anything in between so their appetite can build.
  • Aim for planned family meals and snacks at the table, free from distractions and screens. A picky eater will be more willing to try new foods if they see everyone eating the same thing.
  • Avoid juice/soda and sweetened drinks between and with meals — these fill up kids' tummies without providing any nutrients and can make kids feel full even though they haven’t eaten.

    3) What are some high calorie meal & snack ideas for kids?

    • Smoothie made with coconut milk, banana, avocado, and peanut butter
    • Frozen toaster waffle topped with almond butter and sliced fruit
    • Whole milk plain Greek yogurt topped with granola and berries
    • Scrambled eggs made with heavy cream and avocado toast

    Renzo's Vitamins provides general recommendations, not to be construed as medical advice.

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