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How do you handle underweight kids?


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All my girls have always been slim. My babies never had rolls of chub to squeeze (some were thinner than others). My oldest two (10 and 8) have lately been losing weight. I have been telling them that they need to eat all the food I put on their plates (which makes me cringe) because they are losing weight. My second dd is particularly thin. She weighs 42 lbs. and she will be nine in April. Medically, she suffers from migraines (and currently takes medication that helps a ton), but we can't find any other health issues. She is just very, very thin. Her losing weight scares me because she doesn't have anything to lose! She is active and acts normal. I will ask about this issue again at her physical in April.

 

We don't eat HFCS except for an occasional candy treat. We eat homemade cookies or ice cream maybe 1-2 times a week.

 

To give you an idea about our genetics, dh is about 50 lbs. overweight and his mom was obese prior to bariatric surgery. His dad is 20 lbs. overweight. I am a healthy weight. The only time I was 10-15 lbs. heavier than I like to be was when my thyroid wasn't working. My mom has gone back and forth between healthy weight and 50-70 lbs. overweight. My dad is a healthy weight.

 

How do I help them eat extra calories in a healthy way?

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I was a toothpick until 7th grade. Way underweight. No health issues, just that way. Had a small appetite, and was very active.

So- underweight isn't necesarrily a problem on its own.

However, if they are purposefully dieting at that age and already thin, then that screams eating disorder and needs to be dealt with, with a therapist, asap.

I don't mean just loosing weight because they happen to not be hungry, but actually talking about "being fat", etc, etc.

Just remember that the average weight for a kid that age is just that - average. There will be many way above and way under the average number.

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Skinny is fine. Losing weight probably not fine. Is it possible that your 8yo's migraine meds are affecting her appetite or causing the weight loss in some other way?

 

You can pack a lot of calories into smoothies if you make them with full fat coconut milk or cream. If you're worried about protein intake too, add some protein powder. I'm partial to this one because it doesn't have a milky aftertaste and it doesn't have a ton of additives: Jay Robb Vanilla Whey Isolate. Nuts and nut butters are also high calorie, as are full fat dairy products.

 

(If you need reassurance that saturated fat won't give them heart disease, I can PM you with references.)

Edited by jplain
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All my kids are skinny minnies and off-the-curves small. I had consultations with two different pediatric nutritionists with my oldest two. The basic gist of both was to feed "energy dense" foods- nuts and nut butters, avocados, full fat dairy, dried fruits, fatty fish like salmon, putting olive oil on veggies, etc.

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They do snack a lot. I keep fruits and veggies, cheese, and assorted crackers available for snacks. My oldest likes nuts. My second dd doesn't really like nuts or cheese. I need to find something with fat in it that she will willingly eat!

 

I am not worried about any eating disorders. They eat when they are hungry and stop when they are full. That would be great except for the fact that they are losing weight.

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Have a nutrition day. Print out a food pyramid. Have everyone measure all the food you eat for one day, and mark what categories they are in. Figure out if you are really eating a full balanced diet, or if there are places you can fill in.

Sometimes when one tries to be nutritionally consciencious, they can eliminate "bad foods" yet not reach their caloric need for each day.

My youngest drinks juice at most meals. I do it to keep her caloric intake up. There was a time when I was feeding her an avocado daily to increase calories for her, using real food.

Also, you might be surprised at some serving sizes. A serving size of peas is a lot more peas than we usually eat for a serving, same with baked beans.

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Great ideas! I think a day/week to learn about nutritional needs and keeping a food journal would help all of us. Does anyone have a book or website they recommend on not only caloric needs for age/height/weight but percentages of calories from different foods?

 

I just used a calculator for determining caloric needs of children based on age, height, weight, and activity level. It said my 8yo needs over 1600 calories and my 10yo needs over 2,000. That sounds high to me, but I don't know if it really is.

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Laura-My 9 year old (ten in April) SON weighs less than that. But, dh and I were both small when we were young, and ds has a lung disorder. I actually feed my kids a LOT of snacks that are high in good fats-olives, avocados, hummus with lots of olive oil, almond butter, nuts. They also drink whole milk, eat a lot of full fat cottage cheese, cheese, peanut butter. I add cream and olive oil to lots of things. Granted, *I* gained more weight from these techniques than the kids.:glare:

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My middle son is underweight to the point of causing health problems. He is on a special diet high in proteins, good fats, high calorie, etc. and a weight training program to help him lose muscle because he was getting weak, having migraines, etc. He's managed to gain four lbs. and with the problems he has, that's a really good weight gain. It has taken four months.

 

He is one three large meals per day and three mini-meals and practically feels like we are force feeding him. But, he also understands he has a health problem and must do this. We are very careful not to give him much in grains and nothing sweet except some honey and occasionally, his favorite fruit - strawberries. He adores fruit so we allow him as much citrus and low sugar fruits as he would like - such as apples, avocados as long as he keeps his protein and fat count up. He eats lots of green vegetables but we don't allow squash so that he won't try to fill up on that and not eat more of other things. He snacks on macademeas, peanuts, cheese, yogurt - which I make from whole milk to get the fat content up - etc. and when I make baked goods for him, it's with honey and the oils are butter and coconut oil! He likes shrimp and so I make a shrimp and bay scallop scampi with butter and lemon juice on a very regular basis for his lunches. But, though high in essential fatty acids, I have to load that meal with other things too because it is otherwise too low in calories. Usually there is a serving of salmon to go with it (so not a cheap meal), plus green vegetables, plus a glass of milk, a slice of cheese, and some apples with peanut butter or something similar. I end up making two meals at every meal...one for him and one for the rest of us, or I make a meal for us and add ons to make it a higher fat and calorie count for him.

 

A couple of times dh has made homemade ice cream using whole milk and honey (very, very yummy) and I've blended it with milk and strawberries for him. He loved that.

 

Faith

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I have a height/weight chart in front of me b/c we just took our ds to the dr for a physical. Your daughter falls right on the border for her weight and age. I agree that I would talk to your dr and rule out any medical concern. Also one thing the dr pointed out to me was that my ds looks extremely thin because he is in the 90th % for height and only in the 50% for weight. He is very tall. Is your dc tall? If not then she may be proportional for her weight. It isn't normal to expect someone who is petite to be the same weight as say my ds who is very tall (which is a family trait).

 

I would be concerned about losing weight. Do your dc eat snacks? I would try to plan nutrient dense foods during the day and even some high fat things that will "stick to their ribs" so to speak. My concern with my dc is that if he gets sick he has no fat reserves at.all and it wipes him out.

 

What about nut butters (peanut, almond, cashew even the hazelnut spread with chocolate) things like that with crackers or even with fruit. Like apples dipped in peanut butter. Also I would make sure they are getting healthy balance of fat/protein/carbs. I can tell when my ds have been eating too many carbs and not balancing with protein and fat because they are hungry all the time. Another great high healthy fat would be guacamole which is super easy to make and it could be served with veggies as a dip if you wanted to avoid chips. I would try to feed them several times a day. Like breakfast, snack, lunch, snack, dinner and snack before bed. They wouldn't need to eat a lot but I would make sure they were getting several mini meals of high quality nutrient dense food.

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Dh and I are both tall. He is 6'5" and his dad is 6'10". I'm 5'7" and my parents are 5'8" and 6'3". My dad has a slim build, though. It looks like my oldest will be tall, but my second will probably be short.

 

Ok, so focusing on protein and good fats seems like a manageable goal to start with. I only buy full fat dairy. I need to figure out which cheeses and nuts my 8yo will eat. I mostly buy cheddar. Ooh, she might like nut butter if she can dip carrots in it. She would probably like cream smoothies, too.

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We struggle too. I used fitday to keep diet records for the pediatrician last year. I had to enter some things but it calculated calories pretty well as well as percent of calories for fats/proteins/carbs. My kids are younger but the calorie counts you found sound right to me based on what I was told last year when we were investigating failure to thrive (yet again). I will say that sometimes you'll see calorie needs per existing weight and/or activity level. You're dealing with an average. Still, with small kids, they generally want me to shoot for those averages.

 

I try to do calorie dense as lots of people have mentioned. You get the most "bang for your buck" per calorie with fats but kids need carbs for energy too and protein of course. You want balance. Also, some kids are better in calorie intake as grazers. I have one who is better with multiple small meals and snacks and the other seems to be wired to eat three big meals. Overall I bet the smaller kids are better with lots of meals/snacks.

 

I do encourage my very tiny guy to eat more. When I don't he falls off the growth scale. I'm going to be honest here...I think it would be bother me a lot less if he was a girl assuming there were no health related issues. Some kids are just genetically small, you know?

Edited by sbgrace
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Nuts help a little. I loosened up a little on sweet snacks (biscuits/cookies) too, but didn't see much change with that. I don't require that the boys finish their food, but there are no sweet things/snacks if the main meal is not eaten.

 

Calvin has just crept onto the bottom of the BMI chart - mostly I think he has started to put on muscle.

 

I'm 5'4" and could do with losing ten pounds. Husband is 5'6" and is also a few pounds overweight. One of my elder brothers is 6'2" and very slim - I suspect that Calvin has those genes.

 

Laura

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I was kind of like that as a girl. Looking back at pictures around age 7-10 I had ribs sticking out most of the time. Around puberty I put on a fair amount of weight and then slimmed down to normal-thin by high school.

 

My son is looking to be the same way - not fat rolls as a baby, been near the same weight for 2 years now and ribs showing most of the time now. He's super tall, but not too thin by the charts because he's pretty ridiculously muscular for a kid his age. It makes him look like he's 6ish instead of 4. I'm not really worried but I make sure he eats things that are calorie and/or nutrient dense - avocado, cheese, olives, nut butters, meat, fruit and veggies etc. I try to minimize filler food like crackers and such.

 

Definitely discuss with their doctor though just to rule out any problems.

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Great ideas! I think a day/week to learn about nutritional needs and keeping a food journal would help all of us. Does anyone have a book or website they recommend on not only caloric needs for age/height/weight but percentages of calories from different foods?

 

I just used a calculator for determining caloric needs of children based on age, height, weight, and activity level. It said my 8yo needs over 1600 calories and my 10yo needs over 2,000. That sounds high to me, but I don't know if it really is.

 

If they are very active, then yes, I would think this could be accurate. Higher activity level requires higher caloric need.

Think about this: I can eat the same diet from teens through my 40s, but if my activity level decreases, my caloric needs will also decrease, thus why I would then gain weight. :glare:

Try to keep your tracking/monitoring simple. The easier it is, the easier it will be to track/monitor.

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I was underweight until I had my first baby. Pelvic bones sticking out and all (and yes, my dh even commented on it). I TRIED so hard to put on weight, but it didn't work. I was constantly reminded of how skinny I was by my mom and stepdad and forced to eat everything on my plate (sometimes it made me hate food more than like it). I do have one daughter that is very tiny (combination of my skinny genes and one branch of her daddy's short relatives...though her dad is tall). She has a ton of energy though and I know it's just 1) her metabolism (she also prefers to eat like a bird, but she does eat and she obviously is healthy) and 2) her age...things could change either at puberty, adulthood, or even motherhood...or even middle age, which is when my mother FINALLY put on some weight.

 

Just keep up with her doctor, see if her meds are causing any issues, and keep feeding her healthy.

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My kids are all skinny, too. We eat full-fat yogurt with ground flax seed, nuts, seeds, and cheese. I also make sure that they eat often. We have three meals and two snacks every day.

 

ETA: I never force my kids to eat anything. We have certain food available for each meal and they can eat as much or as little of that food as they want. Snack portions are determined by me.

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We're currently trying to put weight on ds12 - the suggestions given to us were to put peanut butter on everything that walks :p , get him to drink as much of those 'boost' style drinks as he will (he doesn't like them that much, so we bribe LOL), and use full fat everything. When I make his mac & cheese, for instance, I use cream instead of milk. Extra butter on ALL of his veggies/potatoes/pasta/whatever. I found a yoghurt at one of the stores here that is WAY higher in everything than most - that's the one that I buy for him. Calories, calories, calories. Chocolate milk (has a few more cals than regular). Juice - he's rarely given water because there's nothing in it. Juice, milk, boost - those are his main drinks. Nuts to snack on, nuts IN things. I make peanut butter oatmeal cookies with extra nuts on top and choco chips inside 'em. Highest cal cookie I could come up with LOL ...his bread is the thick grain filled stuff (dh and dd14 refuse to eat that - they only want white or 60%ww. Ds12 has his own, the higher cal stuff.)

 

Basically, we were told to sneak the calories in anywhere and everywhere. It's working - he's come up a few pounds. :)

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Growth spurts will also make a child look underweight if they suddenly grow taller but not heavier. My 15yo ds is 5'7" and weighs 100 pounds. His dad is the same height and weighs 160. You can imagine the difference when they stand next to each other. :001_smile: Both my kids snack constantly. Dd will put on pounds while her brother will not.

 

I'm not minimizing your concern, but I do think most kids eventually level out if there is no underlying medical condition. Skinny kids often become overweight adults, and vice versa.

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All my kids are skinny minnies and off-the-curves small. I had consultations with two different pediatric nutritionists with my oldest two. The basic gist of both was to feed "energy dense" foods- nuts and nut butters, avocados, full fat dairy, dried fruits, fatty fish like salmon, putting olive oil on veggies, etc.

 

these are my kids, too, and the recommendations I received. Make every calorie count.

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Activity levels and metabolism have more impact than the charts reflect. The charts are averages, after all.

 

Just for comparisons sake, here's an article on what Michael Phelps eats.

 

http://www.dietsinreview.com/diets/michael-phelps-diet/

 

The dining hall at West Point served an average of 7000 calories a day. (No, I didn't gain weight. And I bought candy and ice cream on top of that. Yes, I was "active." )

 

1600-2000 doesn't sound high to me, especially if they're losing weight on it. I would be losing weight on that too. My dc eat a lot more than that. Dd drinks about 5,000 calories in milk alone (more than a half gallon a day.)

 

Sometimes when one tries to be nutritionally consciencious, they can eliminate "bad foods" yet not reach their caloric need for each day.
:iagree: Some of the snacks (carrot sticks??) in previous posts looks remarkably similar to the snacks recommended on threads for helping their dc to lose weight. My dc don't replace the "sweets" with healthier food in the same amounts - they just say they're not hungry. Sometimes just getting enough calories is more important than not eating sugar. If they aren't eating the nuts, peanut butter, avocados, cheeses, etc; you're fighting a losing battle.

 

There are recipes out there that combine the vegies and the high calorie fats (especially ones from restaurants.) It does "sneak" the high calorie stuff in where they won't notice it.

 

http://www.foodnetwork.com/recipes/emeril-lagasse/carrot-souffle-recipe/index.html

 

I do encourage my very tiny guy to eat more. When I don't he falls off the growth scale.
I heard of a guy who came to the US as an adult (mid-twenties) and grew several inches. He had stopped growing years earlier, but finally, had enough to eat.
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Some of the snacks (carrot sticks??) in previous posts looks remarkably similar to the snacks recommended on threads for helping their dc to lose weight.

 

I have my kids dip carrot sticks in organic ranch dressing. 2 Tbsp. of Annie's Naturals Cowgirl Ranch has 110 kcal and 11 g. fat. It does have a bit of cane sugar but I'm not going to sweat 2 g. worth per serving, KWIM?

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My skinny ds can get migraines when he forgets to eat! Point out to dd that unless she wants a migraine, EAT! He is about 5' 8" and weighs....110 (if that). Doctor says he is healthy and will probably live a loooong time!

 

She may do better learning to graze, with frequent small meals, than trying to eat a big plate of food three times a day.

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Mine have all gone through periods of being "too thin." My youngest was hit the hardest, and he was passing out often last year. We needed to get some body fat on him. We eat really healthy and he is very active. I added Ovaltine in whole milk at bed and in the morning, and I switched him to full fat dairy products. That has helped a lot.

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I barely registered on the weight charts growing up and weighed no more than 90 until I was almost 30. My girls are on the low end of the weight charts, but two different pediatricians have told me it doesn't matter as long as they keep growing and are following the curve. Some people are just smaller than others. I do understand your concern that they're actually losing weight, though. Have they been tested for any allergies, celiac disease, etc?

Edited by WordGirl
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You can add protein powder to things too, if you want.

 

Ok, I would not do this. Excess protein can cause kidney issues. We know a disproportionate number of guys who have kidney stones after being on a health kick and using lots of protein powder. It is a topic of discussion in certain body building mags.

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I have small kids as well. Although ds finally gained weight after we cut out gluten. They are still not very big, my daughter has been petite from birth, everyone always referred to her as a little doll. I am trying to get them to grow a bit as well. I have been trying to add fat to everything, good fat of course. I should do smoothies every day, they love those, plenty of fat and calories from coco milk as well. We just add fruit and a bit of raw honey. Those on dairy could do cream.

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