Underweight kids

All parents worry about their children as they grow and develop. We hear a lot about kids being overweight these days – but some parents struggle with underweight children.

Before worrying too much about your thin child, keep in mind that growth charts are based on averages. The focus should always be on helping your child stay healthy overall while instilling positive eating and exercise habits.

Never Miss a Beat!

Get Healthy Tips Sent to Your Phone!

Message and data rates may apply. Text the word STOP to opt out and HELP for help. Click here to view the privacy and terms.

What’s a “Normal” Weight for Kids?

When considering the recommended weight for children, most doctors use body mass index (BMI) or this growth chart from the Centers for Disease Control and Prevention (CDC). A child who falls below the 5th percentile is considered underweight.

For example, a 6-year-old who weighs about 36 to 37 pounds is in the 5th percentile. A 10-year-old who weighs 55 pounds falls into the 5th percentile. At the 5th percentile, thresholds for girls and boys are mostly the same.

These numbers do not account for height. Only your doctor can give you a better idea of where your child falls on these charts by including stature. If your child is underweight, talk to your doctor about your child’s overall health and nutrition. Look for any nutritional deficiencies (anemia, lacking calcium or vitamin D), medication side effects, or unhealthy behaviors that may cause your child to not gain weight.

Keep in mind that children’s metabolisms will vary, so two children eating the same diet may have different body types.

What Can I Do to Help My Child Gain Weight?

Although your first inclination may be to try to fatten up your child, remember that he or she will go through many growth spurts and changes over the years. Rather than focus on your child’s size, which may create unhealthy feelings, encourage the whole family to develop healthy habits. Talk to your child about nutrition, and how eating the right foods makes our bodies stronger.

Healthy eating habits

First, take inventory of your child’s current eating habits:

  • What are they getting too much of? Too little of?
  • What will they eat or not eat?

Then develop an eating schedule based on your child’s needs and habits. He or she may not be able to sit down and eat a lot at once. Instead, offer multiple, nutrient-dense snacks throughout the day with three modest-sized meals.

It might help to keep a log of what your child eats and how frequently they are active. The log can help you get an idea of how many calories your child may need to consume to gain or maintain their weight.

At younger ages, small increases to good nutrient consumption can make for better growth than in adults. You can consider adding meals to your child’s daily consumption if they really need to add weight.

Making nutrient-rich snacks in advance so they’re ready to take on the go also will give your child a healthy way to eat more often throughout the day.

Make calories count

Here are some ideas for making the most out of the calories your child consumes:

  • Provide nuts, seeds, cheese, fruit, and whole-grain bread or crackers for snacks.
  • Offer strawberries with vanilla yogurtfor dipping after school.
  • Spread peanut butter on a whole-grain tortilla, top with banana slices and wrap it up for breakfast on the go.
  • Add milk or dry milk to prepared foods to add protein and calories.
  • At dinner, serve lean meats or seafood with vegetables and whole grains.
  • If your child has a hard time eating more, try a nutritious shake or smoothie.

Stealthy healthy foods

For a picky eater, you may need to be a little sneakier.

Pureeing vegetables and adding them to sauces is an easy way to add nutrition under the radar. For example, if your child only eats macaroni and cheese, here are a few healthy stir-ins to try:

  • Steam and puree cauliflower, butternut squash, or yellow squash; mix into the cheese sauce. Start with small amount, adding more vegetable into the sauce each time.
  • Add a puree of canned navy beans, chickpeas, or white beans. Rinse, drain, and puree beans (save a bit of the bean water to thin puree, if needed). Add puree to cheese sauce.

If your child loves snacks:

  • Bake your own muffins and cookies to include ingredients with more power, such as ground flax seed or wheat germ. Mix in dark chocolate mini-morsels to make it a treat.
  • Look for oatmeal cookie recipes that include fruit purees to boost nutritional value.
  • Mix up a protein shake or fruit smoothie. Add healthy greens, fruits, or juices to make a tasty snack they’ll enjoy.

Exercises for kids

As you focus on food, don’t overlook exercise. More movement can build your child’s appetite and muscle mass. Take lessons, ride a bike, or play games in the yard. Make a point to help your child get at least 30 minutes of exercise each day.

Be sure to follow up exercise with proper nutritional and fluid replacement for the energy burned. This can help your child maintain a healthy weight by creating good habits with calorie replenishment.

Genetics also plays a role in being thin, and your child may have a higher-than-normal metabolism. By focusing on your child’s health rather than on their build, you’ll help your child stay strong with a positive body image.

Editor's Note: This article was originally published on , and was last reviewed on .

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.