It seems we hear a lot more about overweight children, but not often about the other end of the spectrum: underweight children. Just as many kids fall in the lower percentiles for weight as fall in the high percentiles for weight.
My oldest son, Noah, was at a very low weight starting at about 9 months old, due to a medical condition that caused him to lose weight and a medication that affected his appetite. He fell between 5-10% on the weight growth charts, which meant we needed to take extra steps to encourage him to put on weight. However, he was also beginning to crawl and then walk at this point, meaning he was burning more calories with the increased mobility, which was working against us. We went over options with our pediatrician, and then when he was just over 1 year old, we met with a nutritionist to discuss suggestions and options.
His main source of milk was still breastmilk up until 12 months old, and occasionally formula in small amounts. The first suggestion was to try Pediasure, which is high in fats, calories, and nutrients. Unfortunately, he wasn’t the biggest fan of it, and it was expensive. So the nutritionist suggested we try Carnation Instant Breakfast, which adds calories and nutrients to cow’s milk, but no added fat. It is also much cheaper. By then he was over 1 year old and got the okay for whole milk, so we started mixing the Carnation into his whole milk (I was still nursing, but slowly weaning). He seemed to like this. We got into the habit of carrying milk along with us in a little cooler bag everywhere, to encourage him to drink the higher calorie milk as often as he was thirsty. He occasionally drank water, and very rarely did he drink juice.
At 9-12 months old, Noah was still primarily eating baby food purees, plus some finger foods. In addition to fruits and vegetables, we tried to encourage him to eat things like avocados, yogurt, egg yolks, and cheese. When meeting with the nutritionist, besides suggesting the Carnation, one of her main recommendations was to add butter to pretty much everything. So Noah got butter added to anything that it might taste good with, as well as things like peanut butter, mayonnaise, sour cream, and cheese. We discovered he really liked sour cream, so we gave him the full fat sour cream, adding a small dab to the end of his spoon often was enough to encourage him to take more bites. We were lucky that Noah wasn’t a particularly picky eater, he just ate very little, so adding these things, along with making nutritional choices from all of the food groups, worked well for him.
• A favorite baby food was mixing plain yogurt with boiled egg yolks, which contained lots of protein and fat
• Adding baby cereal to fruit and veggie purees is a good way to get additional calories and nutrients as well as to thicken it
• Smoothies with full fat yogurt are a great way to add the calories and still get the fruits and even veggies
• Start with whole grain bread and crackers, and add toppings such as cheese, dips, or peanut butter
• Encourage whole grain carbs such as pancakes, pasta, bagels, cornbread, and macaroni and cheese with added butter
• If there is a certain food your child really likes that seems to be helping to gain weight, serve it often, along with a variety of other foods
Now, at age 5 years old, Noah is at a healthy weight (he falls in the 25-50%). He continues to be very active and full of energy, but does finally eat bigger portions. We are still liberal with him when it comes to higher fat foods, but we stopped the Carnation by the time he was 3 years old and now he drinks 1% milk.
Keep in mind that it is important to consult with your doctor or a nutritionist to come up with a plan prior to starting any high-calorie diet.
Sarah is mother to Noah (5 1/2) and Kyle (2 1/2). She lives with her husband in Plymouth, Minnesota.