Feeding an Underweight Child

by brenda on

Note: I wrote this post before we were on GAPS or knew about whole, real food.

My son Isaac was born 3 months premature and has had a lot of feeding and weight gain issues because of being born so early.  We have researched a lot on the topic of weight gain, we’ve been to a lot of doctors, and we’ve tried many different foods.  The following is a compilation of ideas I have to share with you; after all we’ve been through with Isaac.

Think about the foods that low-fat dieters would tell you not to eat.  Feed these to your child, while trying to limit sugar to avoid starting dangerous habits.

Good examples of foods to feed your child– full fat yogurt, sour cream, butter, whipping cream, cream cheese, cheddar cheese, meat, mayonnaise, olive oil, etc.

Think of things that your child eats that you might be able to add some of these things to–like if they enjoy mashed potatoes, add whipping cream and butter (and sour cream?).  If they eat a bowl of cereal, use a little whipping cream in place of some of the milk.   Give your child milkshakes with full-fat ice cream and whipping cream (and whipped cream on top).

The highest calorie ice cream I have found is the Godiva Ice Cream.  Ben & Jerry’s ice cream contains pretty high amounts of calories, also.

We get the LaCreme or Custard Style yogurt for Isaac, and he loves it.  The strawberry LaCreme yogurt is nice and creamy (it also doesn’t have any chunks, which is great for those kids who have aversions to different textures)!

Remember that the earlier you introduce new foods and textures, the more likely it is that your child will actually tolerate them later.

Isaac enjoys pizza a lot.  We put lots of pepperoni, Canadian bacon and sausage on it.  He likes the meat.  He especially loves pizza if he can help prepare it.  You can make pizza on an English muffin at home, and then set it under the broiler or in the toaster oven.

While feeding your underweight child a lot of protein and high calories is great, make sure not to accidentally put them on a low-carbohydrate diet!  My son, for example, loves meats and cheeses and could eat an entire meal consisting of only meat and cheese—but I have to make sure to throw some crackers in there, or some toast or something, otherwise he will be more likely to lose weight!  Fiber (from fruits, vegetables and breads) is also important for your child’s GI system!

When we buy crackers or cookies we make sure not to waste our money on low calorie ones.  We get Chicken in a Biscuit crackers or the Cheese-its with 4 cheeses.  They have the most calories.  Try using cheese whiz on top to see if your child will like it!  Also, shortbread cookies (like Lorna Doone’s) are made with lots of butter (shortbread is pretty simple to make at home, too).  You can get Nutella to spread on top (call it “frosting”!).  You could also spread peanut butter.

Peanut butter is pretty high in calories!  I found some “pbj subs” at Grocery Outlet in the frozen aisle, and Isaac loved them.  They were little “sub” sandwiches with peanut butter and jelly, and the bread was made with crushed up peanuts in it (so they contained about 500 calories each!!!).  I wish I could find those again!  Try to find them if you can!

I feed Isaac those Pillsbury Breakfast Strudels.  They’re pretty high calorie, and it’s something he will eat.  Make sure to get the ones with lots of meat in them (bacon AND sausage…then they’re higher in calories!).

You can fatten up macaroni and cheese pretty easily.  Use whipping cream instead of milk, use lots of butter, and add real cheddar cheese, and those jarred nacho cheese toppings.  There are some homemade macaroni recipes (baked) that are even higher calories.

Fry things in olive oil.  It’s really high in calories!  We used to mix olive oil, cereal and formula into Isaac’s pureed baby foods.  A nurse told me once to fry Cheerios in a little olive oil, instead of just giving him plain Cheerios like you would any other baby.  You could make a trail mix with fried Cheerios, peanuts, and maybe some M & Ms.

I’m not sure about peanut oil.  It might have high calories, too, and it’s pretty cheap for a large quantity of oil.  (I am allergic to peanuts, so we don’t have that in our home).  You could just compare the bottles at WinCo or wherever and check how many calories are in a Tablespoon.

Does your child like meatloaf?  You can make meatloaf with a high-calorie sauce on top.

If your child enjoys eggs, you can do a lot with that!  Make scrambled eggs extra cheesy, make breafast burritos, etc.  You can make devilled eggs with high-calorie ingredients–mayonnaise, cheese, etc.

Dip everything you can in some sort of high-calorie “dip”.  We say “dip dip” with Isaac.  He LOVES ranch dressing.  We give it to him in a small bowl with a spoon, and then give him chicken nuggets, for example, and he will eat the ranch dressing by itself with the spoon.  Hey, more calories! J

Make pudding at home with whipping cream in place of some or all of the milk.  Let your child help you mix this.

Make really high-calorie “frosting” out of cream cheese, butter, whipping cream, and a chocolate pudding mix and spread it onto graham crackers (or Lorna Doone cookies!).

If your child has issues with sticky or wet textures, start doing “food play” with him or her.  Once a day or once a week (or as often as you can), put your child in their high chair and give them no utensils, but lots of toys (that can get dirty and be washed), along with some pudding (smear it around the tray), apple sauce, sprinkles, etc.  Let your child have fun getting sticky.  At first they won’t touch it.  Show them by example, how fun it is to play in the pudding.  This gets kind of messy, but it’s perfect just before bath-time!!

Remember that whatever your child can help you make, they will enjoy eating even more.  About once a week or so, Isaac helps me make German Pancakes, and then he likes watching them rise in the oven, and then he will eat them.  They have butter on them, and powdered sugar (textures he probably would not normally touch), but because he helped make them (and probably because they are so good), he enjoys eating them and asks for “more.”

Teach your child as much language about food and eating as you can.  Give them power words—“All done,” “Wash,” “Clean up,” “Finished,” “Spoon,” “Fork,” “Napkin,” etc.  A child who can’t stand eating or being in the high chair will appreciate such words.  To teach them these words and make them feel more comfortable with eating, you will have to show them how much power these words have.  This means that the first time they use the words “All done,” you allow them to be finished.  Later on, after they’ve got the words down (and are more comfortable with eating), be firm and say “no, you’re not finished yet” or something like that.  Sign language is a great way to teach your child to communicate, also.  Or make up some little cards with pictures and laminate them.  Let your child choose which picture he or she wants (“More” “All done,” etc.).

There are several different high calorie supplemental drinks out on the market.  Pediasure is the most popular.  It contains 290 calories per can.  We have used this on Isaac for several months and he did not gain much weight.  It is also incredibly expensive (about $2 per 8 oz), but note that the cheapest place to get it is at Wal-Mart.  They also sell a Parent’s Choice brand of the same basic drink, which is much cheaper.  Another brand of supplemental drinks is Nestle Peptamin Jr.  This is an unflavored drink, and Isaac does not like it much.  You can try adding some chocolate syrup or something to add some flavor to it!  Carnatian Instant Breakfast is by far the cheapest route to go.  You can mix it with whole milk, or part whole milk and part whipping cream (go light on the whipping cream or your child may vomit!  I recommend 1 to 2 oz of whipping cream to 6 or 7 oz of whole milk.)  At one time we were mixing 2 oz of whipping cream, 6 oz of whole milk, 1 packet of Carnatian Instant Breakfast, and 3 scoops of formula.  Isaac gained a little bit of weight during this time (at a faster pace than usual), but he was also vomiting a lot (probably because the large amounts of calories were tough on his tummy).  The drink we are using now is called NuBasics Plus, and it’s made by Nestle.  It’s the adult form of the drink, but it’s about $1 per can through Kaiser Permanente’s cafeteria (you have to buy an entire case of it, which I think is 25 cans).  It contains 375 calories per 8 oz.  Please ask your doctor about any drink supplements you plan to put your child on!  Playing with mixtures can be dangerous.  Your child could be getting too much protein or calcium, or something like that.  PLEASE check with your doctor on all of this (you will probably hear me say that a lot on this topic).  Also, make sure to ask if you can get a sample can or two of Pediasure or NuBasics or Peptamin (or whatever they have at your doctor’s office).

Most doctors will allow you to go in for a weight check without making an appointment or paying a co-payment.  Don’t expect to see the doctor during one of these visits, just plan to run in, check your child’s weight (on a toddler or baby they will need to be undressed completely), and then head out.  Watch your child’s weight carefully.

If you feel as though you’ve been trying really hard, feeding your child high-calorie foods and nothing is happening, keep a feeding log for 3 days to a week and then make an appointment to show it to your doctor.  (If you go to see your doctor without having a feeding log, he or she will probably send you home, ask you to write up a feeding log, and then have you come back in a month or so–creating a feeding log up front will save you time and make things happen quicker for your child!)  Your doctor may send you in to see a Nutritionist, or a Speech and Feeding Therapist, or some other type of specialist.  It is your right to ask that you be referred to another doctor or specialist.  If your doctor does not refer you, do not be afraid to see another primary care physician.

Isaac has seen several Nutritionists, 4 different Primary Care Physicians, 2 Speech and Feeding Therapists, 2 Genetics Doctors, 2 Endocrinologists, 1 GI Doctor, etc.  He was followed by a group called a “Feeding Clinic” (which is quite helpful—ask your doctor about this!).  A “Feeding Clinic” involves a Doctor, a Speech Therapist, a Nutritionist and sometimes a Social Worker.  They all ask you lots of questions about what your child eats, then they go out of the room and talk to each other (usually leaving you alone with the Social Worker so that they can quiz you about how you’re feeling with the weight gain issues and what your support system is like), and then they all come back and give you advice.  The types of advice they’ve given us for Isaac include: “Try these foods…” (and a list of foods), “See this Speech Therapist Weekly _______”, or “Go get him tested for this _______ Genetic disease.”  These clinics are EXTREMELY helpful!!

If your young child (age 3 or under) has feeding issues, speech issues, or any other issues with his or her development, they may qualify for your school district’s (free) Early Intervention program.  Call your school district for more information.

Pay attention to issues like vomiting, texture aversion, potential reflux (does your child seem uncomfortable after he or she eats?), constipation, greasy or wet stools, excessive sweating, or a child who is asking for water a lot.  Let your doctor know if your child has any of these issues, because they could mean something or could lead to further testing.

I hope that all of this information helps you!  If you have any further questions, please feel free to e-mail me at Brenda AT SeriousMoms. com (take out spaces and replace AT with @).  Good luck!

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