Low weight older children

If you’re concerned that your child is underweight or not growing normally, consult your GP. Low weight can occur for a number of reasons.

The GP will weigh and measure your child, and talk to you about what your child is eating. If there is a possible problem with your child’s diet, your GP can provide nutritional advice that will help bring them up to a healthy weight.

Paediatric dietitian Jacqui Lowden, from the Manchester Children’s Hospital, explains basic child nutrition and what to do if your child is underweight.

A healthy, balanced diet
All children need the energy (calories) and nutrients that come from a varied and balanced diet.

If your child is underweight, it might seem tempting to fill them up with high calorie but unhealthy food such as sweets, cake, chocolate and fried fatty foods. If he or she is to gain weight in a healthy way, it has to be done through a balanced diet.

Once they reach age five, you can start to make your child’s diet similar to that of a healthy, balanced adult diet. (Children under five need a diet higher in fat and lower in fibre.) That means three meals a day and healthy snacks.

A balanced diet means:

• Starchy carbohydrates such as pasta, rice and potatoes should form the basis of every meal.
• Lean proteins such as lean meat, fish, pulses, beans and eggs.
• Five portions of fruit and vegetables a day.
• A low intake of saturated fats (found in biscuits, cakes and pies).
• A low intake of animal fats (found in processed meats such as sausages and bacon).
• Grill or bake instead of frying.
• Don't give them fizzy drinks. Give diluted juice instead or simply water.
• Give chocolate, sweets and cake only occasionally. It's best to give them at the end of meals, to help avoid tooth decay.

Meals at home
“This is a good time to sit down and think about how your family eats,” says Lowden. “Do you take time for proper meals or do you rely on snack meals and quick fixes? If so, that might be part of the reason your child isn’t consuming enough calories.”

Make time for a proper breakfast and dinner and eat together as a family. Make mealtime a fun part of the day. When possible, cook for yourself instead of using ready meals. That way you know exactly what is in your food.

To help your child gain weight, increase their servings of healthy carbohydrates such as brown rice, wholemeal pasta and potatoes.

Lunch
During the week, your child will eat lunch at school. It’s impossible to monitor exactly what your child eats away from home, but you can help your child make healthy choices.

• Talk to your child about the importance of a healthy and balanced diet.
• Give your child a packed lunch or pre-paid school dinners, instead of giving money that your child can spend on food.
• Talk to your school to find out what its healthy eating policy is.

Packed lunches are a great way to provide a nutritionally balanced lunch. A good packed lunch should include carbohydrates, protein, calcium and a portion of fruit and vegetables.

• Sandwiches with a filling of lean meat, tuna, eggs, or cheese  provide carbohydrates and protein.
• A quiche or pasta salad are tasty alternatives to sandwiches.
• A milkshake, yoghurt or piece of cheese will provide a serving of calcium.
• Cut vegetables into small segments to make them easier to eat. Dried fruit counts as one portion of fruit.
• Don’t forget a drink: water, milk or fruit juice is best.

Snacks
If your child isn’t consuming enough calories, you can help to boost their daily intake by providing healthy snacks.

Younger children in particular will need snacks between meals because their stomachs are not large enough to allow them to consume all the calories they need in three meals.

On school days, you can provide a healthy snack for your child to eat at morning break.

Great snack ideas include:

• Dried fruit.
• Small sandwiches with a protein filling, such as cheese or eggs.
• Cheese and crackers, or cheese on wholemeal or brown bread.
• Yoghurt, as it contains protein and calcium.
• Breakfast cereal with milk is a great bedtime snack.
• Other energy-dense foods such as bananas and avocados.

Be active
Physical activity burns calories your child has consumed. But even if your child is underweight, it's still important that they're physically active.

Physical activity helps them develop strong, healthy bones and muscles. It’s a crucial part of the way they learn about themselves and the world. And best of all, it’s great fun.

Children over five should do at least 60 minutes of at least moderate intensity physical activity each day. But the amount of physical activity your child should undertake may be different if your child is underweight. Your GP, practice nurse or school health visitor can advise you on this. For more information, read Getting active with your child (see Useful links).

Monitor progress
If you provide a healthy diet using these guidelines, you should see your child’s weight and growth improve.Make sure to go back to your GP to check that weight gain is happening as it should.