How to Help Children Gain Weight

While much attention is given to the increasing number of overweight children, many still struggle to gain weight. However, the solution isn't as simple as letting underweight children eat all the junk food they desire. Instead, a combination of changing eating habits, selecting high-calorie nutritious foods, and subtly adding extra calories to meals is the best approach to help children gain weight. If you are concerned that your child may be underweight, always consult a healthcare professional as the first step.

Look deeper into the causes. Some children, much like certain adults, naturally have a slim body type and find it challenging to gain weight. Nonetheless, it's essential to explore other possible reasons behind a child's difficulty in gaining weight.

• Children are often "picky eaters", but if your child shows little interest in food, it could indicate a medical or psychological issue. Hormonal or metabolic conditions, such as diabetes or an overactive thyroid, can sometimes hinder weight gain.
• Digestive issues or other conditions may make eating uncomfortable, and undiagnosed food allergies could also be a contributing factor.
• Certain medications may reduce appetite, so this possibility should be considered if your child is on any medication.
• Unfortunately, even pre-adolescent children can develop eating disorders due to peer influence or other factors.
• Your child may simply be very active, burning more calories than they are consuming.

Consult your child's doctor. If your child is still receiving regular check-ups, your pediatrician can provide guidance on whether gaining weight would be beneficial for your child. Don't hesitate to raise the topic if you're unsure.

• As previously mentioned, allergies, unfamiliar foods, digestive issues, and various other medical conditions can sometimes contribute to a child being underweight. Your child's doctor can help identify and treat these issues.
• That said, the most common issues can often be addressed with changes you and your child can make at home. However, professional medical advice is always helpful.

Follow special advice for infants. Addressing weight gain issues in infants is different from older children. While serious causes are rare, the main issues usually lie with feeding methods, milk supply, or gastrointestinal problems.

• Always seek your doctor’s advice if you're worried that your infant might be underweight. The doctor may recommend tests or refer you to a feeding specialist (to observe feeding techniques) or a pediatric gastroenterologist.
• Treatment methods will vary depending on the infant's specific needs, but might include: supplementing breast milk with formula (if the breast milk supply is insufficient), feeding more frequently and for longer periods, as long as the baby wants (avoid rigid schedules), switching formula brands (if the baby is allergic or to increase calorie content), or introducing solid foods earlier than the usual six-month mark. In some cases, the doctor may prescribe acid reflux medication for the baby.
• Weight gain during the first year is critical for long-term health, so underweight issues should be addressed with appropriate medical advice. Underweight infants can gain weight effectively without long-term issues when properly managed.

Feed your underweight child more often. In many cases, the issue is not what the child eats, but how much they eat. Young children have smaller stomachs and need to eat more frequently than adults.

• Your child may need to eat five or six smaller meals along with snacks each day.
• Whenever your underweight child feels hungry, offer them food immediately.

Make mealtime a special occasion. While offering snacks to your child is important, make regular mealtimes an important and enjoyable part of their day. Teach them that eating is not only necessary but fun.

• If mealtimes become stressful for your child—such as eating only when told to or being punished for not finishing food—they are less likely to develop a healthy relationship with food.
• Make mealtime a consistent routine. Turn off the TV. Treat eating and enjoying food as an activity to focus on and cherish.

Set a good example. While your child may need to gain a few pounds, you can still benefit from making healthier choices to shed a few pounds yourself. In this case, your eating habits should align with what you believe is best. Eating a variety of nutrient-dense foods is essential for underweight, overweight, and average children alike.

• Children learn by observing. If you frequently try new foods and make healthy choices, such as prioritizing fruits, vegetables, and whole grains, your child will be more likely to adopt these habits too.
• Consider less nutritious foods as rare treats that are beneficial for both you and your child, regardless of whether you're trying to gain or lose weight.

Encourage regular exercise. Like healthy eating, regular physical activity typically helps with weight loss rather than weight gain. However, when combined with smart eating, it can play a role in weight gain.

• Especially for older children, building muscle mass helps with gaining weight, and it's always healthier than adding fat.
• Exercise often stimulates appetite, so try encouraging your child to be active before mealtime and see if it helps.

Avoid unhealthy options. It's true that sugary treats, cookies, soda, and fast food are calorie-dense and can help with weight gain. However, the potential health costs (including diabetes or heart disease in children) far outweigh any minimal benefits these foods provide.

• Calorie-rich but nutrient-poor foods like sugary drinks are not the solution for healthy weight gain. The best options are foods that are both calorie-dense and nutrient-rich, as they help with weight gain while providing necessary vitamins and minerals.
• Don't tell your child they need to "gain weight" or "put some meat on those bones." Instead, explain that both you and your child need to choose and enjoy more healthy foods together.

Prepare plenty of nutritious foods. Variety is important not only because it provides necessary nutrients but also because it makes mealtime more enjoyable. If mealtime feels like a chore or is boring, your child will be less likely to enjoy eating.

• A calorie-dense and nutrient-rich diet should include starches (pasta, bread, grains); at least five servings of fruits and vegetables per day; protein (meat, fish, eggs, beans); and dairy products (milk, cheese, etc.).
• All children under two should consume full-fat dairy products, and your child's doctor may recommend continuing this even after the age of two to support weight gain.
• While fiber is crucial in a healthy diet, you may not want to give your child too much if they're trying to gain weight. Too many whole grains or brown rice may cause your child to feel overly full for longer periods.

Use Healthy Fats. We often assume that fats are unhealthy, but that's not always the case. In fact, many plant-based fats are essential in a balanced diet. Healthy fats are also excellent for weight gain because they provide 9 calories per gram, compared to only 4 calories from carbohydrates or proteins.

• Flaxseed oil and coconut oil are great options and can be added to various foods. Flaxseed oil has a neutral taste, making it easy to blend into dishes without altering the flavor, while coconut oil adds a sweet touch to everything from stir-fries to smoothies.
• Olives and olive oil are also excellent choices.
• Nuts and seeds, such as almonds and cashews, are rich sources of healthy fats.
• Butter can also be added to many dishes, offering a creamy texture while providing beneficial fats.

Choose Smart Snacks. If a child needs to gain weight, they should be encouraged to have snacks frequently. However, the choice of snacks matters—opt for nutritious options instead of those with little to no calories.

• Focus on high-calorie, nutrient-rich snacks that are easy to prepare and consume. Examples include peanut butter and jelly on whole grain bread, mixed nuts and dried fruits, apples with cheese, or turkey slices wrapped in butter.
• For special treats, offer whole grain muffins, oatmeal bars, and yogurt instead of sugary cakes, cookies, or ice cream.

Monitor What and When Your Child Drinks. Proper hydration is important for children, but too many drinks can fill them up and decrease their appetite for food.

• Calorie-free drinks like soda provide no nutritional value, while excessive sugar in fruit juices can harm teeth and overall health when consumed in large amounts.
• Water is always a good choice, but for a child needing to gain weight, try offering whole milk, smoothies, or fortified drinks like PediaSure or Ensure. Consult your pediatrician for the best options.
• Offer drinks after meals, not before, and only give enough to ensure your child feels comfortable and not overly full. This helps prevent them from feeling too “full” from liquids.

Make Milk Your Friend. Incorporating dairy products like milk and cheese into meals can be a fantastic way to increase both calories and nutrition.

• Smoothies and milkshakes are great ways to add calories, with fresh fruit boosting their nutritional value.
• Cheese can be melted or sprinkled on various dishes, from scrambled eggs to salads to steamed vegetables.
• Try using milk instead of water in canned soups, and add sour cream, cream cheese, or fruit and veggies into yogurt.
• If your child is allergic to dairy or if you prefer non-dairy alternatives, soy milk or almond milk can also provide high-calorie, nutritious options, with tofu being a great addition to smoothies.

Incorporate Peanut Butter. As long as there are no allergies, peanut butter is an excellent addition to your child's meals, offering a wealth of calories and protein.

• Spread peanut butter on whole grain bread, bananas, apples, celery, granola bars, or pretzels.
• It can also be blended into smoothies or milkshakes, and used as a 'paste' between two pancakes or French toast slices.
• If allergic to peanuts, almond butter is a great alternative, and flax seeds and flaxseed oil also offer a substantial amount of calories and nutrients.

Take Small Steps to Increase Calories. Adding or swapping ingredients can subtly increase the calorie content of your child's food. For example, try:

• Cooking pasta and rice in chicken broth instead of water.
• Offer dried fruits as they are more calorie-dense and don’t make children feel full from water content like fresh fruits do.
• Mix flaxseed oil, which has a mild taste, into various dishes, from salad dressings to peanut butter and banana smoothies.
• Incorporate cooked beef or chicken into pasta, pizza, porridge, stews, scrambled eggs, and macaroni and cheese.

Explore High-Calorie Cooking Techniques. There are countless recipes online to help children gain weight healthily. For instance, the online guide from UC-Davis Medical Center (http://www.ucdmc.ucdavis.edu/cancer/pedresource/pedres_docs/HowHelpChildGainWeight.pdf) provides easy-to-make meals for kids, such as fruit dips and 'milkshakes.'

• It also explains how to create super-high-calorie milk by adding two tablespoons of powdered milk to each cup of whole or low-fat milk.
• Another helpful article includes a menu for 'energy balls,' meals made from dried fruits, nuts, and other nutritious ingredients that store well and are perfect for quick snacks when kids are hungry.

• Avoid using sugary or fatty foods and drinks—such as chips, pastries, candy bars, and soda—to boost your child's calorie intake. While these foods may help with weight gain, they can harm teeth, disrupt metabolism, and negatively impact muscle, brain, and heart development. They can also worsen existing health conditions like diabetes.
• If you are concerned about your child not gaining weight or losing weight, consult a doctor immediately, especially if there has been a significant change or if your child is ill.