What Should I Do if My Child Is Underweight?

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publication 348-271
Healthy Weights for Healthy Kids:
What Should I Do if My Child Is Underweight?
Elena Serrano, Extension Specialist, Department of Human Nutrition, Foods, and Exercise, Virginia Tech
Kathryn Branstad, former graduate student, Virginia Tech
Being underweight is not the same as being thin or
slender. Some children have a naturally slight build
and maintain it with a well-balanced diet and physical activity. This is normal and healthy. However, true
underweight may be a sign of dietary, health, or emotional problems.
How do I know if my
child is underweight?
If a child has no interest in eating, it
could be a sign of anxiety, a food allergy
causing discomfort after meals, high
amounts of caffine, an excessive fear
of being overweight, or even an eating
disorder. In any case, it is extremely
important to work with your child’s
doctor or health professional to help determine what is
going on and how to address it.
Some children are
naturally small,
which is different
than underweight.
Weighing your child may not give you
enough information to determine if he
or she is underweight. If you are concerned that your child may be underweight, consult your child’s doctor. A physician or other
health professional can compare your child’s weight
and height to growth charts developed by the Centers
for Disease Control (CDC). A child is underweight if
his or her BMI-for-age-and-gender is less than the 5th
percentile. BMI, or body mass index, is defined as
weight divided by height times height (kg/m2).
What are some concerns
for underweight children?
weak or tired, and have trouble focusing and concentrating. He or she may have stunted growth or a delay in
the onset of puberty. It has been estimated that 12 million children live in food-insecure households, meaning that they have limited availability of nutritious and
safe foods.
What can I do to help my child?
If your doctor recommends weight gain, the main goal
will be to get your child to take in more calories. Continue
to promote physical activity as part of a normal routine. If
your child has been playing actively, have him or her rest
for at least 15 minutes before meal times.
What should my child eat?
Offer extra calories that are rich in important nutrients. Avoid letting your child fill
upon on empty calories, such as candy
and soft drinks, or high-fat foods from
fast-food restaurants. Begin by planning meals and snacks with calorie-dense foods from each food
group of the MyPyramid. Limit
snacking just before meal time,
There are several possible reasons for being underweight:
not consuming enough food, an
underlying illness, stress, obsessive exercise, lack of interest in
eating, or a sudden growth spurt. An
under-nourished child is more likely
to become sick. The child may feel
Produced by Communications and Marketing, College of Agriculture and Life Sciences,
Virginia Polytechnic Institute and State University, 2009
Virginia Cooperative Extension programs and employment are open to all, regardless of race, color, national origin, sex, religion,
age, disability, political beliefs, sexual orientation, or marital or family status. An equal opportunity/affirmative action employer.
Issued in furtherance of Cooperative Extension work, Virginia Polytechnic Institute and State University, Virginia State University,
and the U.S. Department of Agriculture cooperating. RIck D. Rudd, Interim Director, Virginia Cooperative Extension, Virginia
Tech, Blacksburg; Alma C. Hobbs, Administrator, 1890 Extension Program, Virginia State, Petersburg.
as this may curb appetite. Avoid caffine; promote
healthy drinks, such as water and milk. Tailor your food
choices to foods that your child enjoys and will eat.
give him or her plastic sandwich bags filled with snack
foods, such as granola bars, crackers, dried fruit (like
raisins), carrots, nuts, and jerky. At first, your child may
not be accustomed to eating so much. Offer positive
support for any positive changes. Realize that changes
may not take place overnight. Be patient.
Ideas for Foods from the Different Food
Grains: whole grain bread and bagels, granola bars,
pancakes, crackers, cornbread, pasta
How can I create a positive body
image in my underweight child?
Vegetables: baked French fries, sweet potatoes, peas,
corn, squash, broccoli
Remember that each child is unique. Each child’s
body shape is unique. Children come in different sizes,
shapes, and weights. They also grow at different rates.
Every body is a good body.
Fruit: canned fruit in syrup, dried fruits, fresh fruit
Milk: flavored milk, cheese, cottage
cheese, yogurt, pudding
foods for your
Do not weigh your child frequently. Home
should be a comfortable and accepting
place for children, not stressful. Your doctor may request regular visits to monitor
your child’s progress. You can use this
opportunity to obtain information about
your child’s weight. Also, be sensitive
about discussions focusing on weight.
Meat and Beans: eggs, peanut butter,
tuna fish, chicken, hamburgers, salmon,
nuts, bean soups, kidney beans, chick peas
(hummus). Nuts are a great source of protein and healthy fats, but may cause choking in young children; some children may be allergic
to them.
A healthy weight is a weight that can be maintained
healthfully, insuring that children are well nourished,
active, and have a positive attitude about their body and
Calorie-Dense Combinations:
eanut butter and jelly sandwich
Macaroni and cheese
Crackers with hummus
Fruit smoothies made with yogurt
Baked potato with broccoli and cheese
Beef and barley soup and cornbread
French toast or pancakes with ham and fruit
Where can I get more information?
If you have any questions or concerns about your child’s
weight, contact your physician or a registered dietitian.
They can work with you to determine if your child is
at a healthy weight and how to proceed if there are any
When preparing foods, provide heart-healthy sources
of added fat, such as vegetable oils in place of butter,
margarine, and sour cream. For example, make mashed
potatoes with vegetable oil. Any high-calorie supplement should come from your doctor or dietitian along
with a care plan.
Virginia Cooperative Extension offers educational and
cooking classes for parents, childcare providers, and
children on nutrition. Visit the Virginia Cooperative
Extension website at http://www.ext.vt.edu to locate
your nearest Extension Agent for more information on
food, nutrition, and health programs and resources.
How much should my child eat?
For more resources and information:
Encourage frequent eating and snacking. Six small
meals may be easier to eat than three larger meals. Your
child should eat as much as he or she can without feeling uncomfortable. Do not pressure your child to eat.
Rather, offer plentiful meals and snacks to your child
throughout the day. When your child goes to school,
Visit www.MyPyramid.gov to obtain an individualized
eating plan for everyone in your family. The website
also has links to other diet and physical information and
a webpage for kids which includes My Pyramid Blast
Off game and tips for families.

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