Tips for Helping Underweight Kids (and Their Parents)

Tips for Helping Underweight Kids (and Their Parents)

Parents of kids who really don’t eat enough deserve better help than they often get. Still, most of the time when people say to me that their child is skinny and a very picky eater, the child does not need to eat more. When kids do need to catch up on weight growth, slower is better than faster. Even though we are eager to get them back on the curve, for long term health it’s generally best just to be moving in that direction.

Before focusing on trying to pack on the calories, be sure

  1. They really are underweight (for their height)
  2. It’s not for medical reasons that need to be addressed

Remember, the goal is to add calories, while still preparing them for long term healthy eating patterns — this means doing it without processed white flour or added sweeteners or fried foods.

Fats have the highest calories. Add fat (olive oil, peanut butter, avocado, cheese, butter, etc.) to healthy foods (veggies, whole grains, lean protein sources — you can gradually wean back the added fats later, just like switching from whole milk to 2% to 1% to nonfat).

Liquid calories are less likely to fill you up — smoothies and shakes and juices are great for this. I prefer using real food ingredients, not a chemistry set (like you might find in some manufactured versions). e.g. Whole fat dairy or soy. Add an oil. Add fruits. Maybe peanut butter. (note: getting rid of unnecessary calories in drinks is one of the best ways to help overweight kids. Liquid calories sneak in.)

When eating is restricted, I recommend a multivitamin, multi-mineral supplement, with DHA, as spackle to fill in any nutrient gaps.

Periactin, an allergy medicine, can be a potent appetite stimulant. It can be a godsend, helping kids with no appetite suddenly start eating 3 meals a day. For kids in the first 2 1/2 or 3 years of life – when long term flavor preferences are forming, and kids need multiple experiences with a wide variety of whole foods — I’d try the medicine sooner rather than later. These are precious months for food experiences, and should not be wasted.

Dr. Alan Greene

Dr. Greene is the founder of (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. Alba bovay

    I am not joking when I say my 3.5 year old boy is afraid of food. He has weighed only 29 lbs for the last 8 months. Lately it has gotten worse. We have tried Periactin and it works but my child’s behavior becomes intolerable on this medicine. We live a somewhat healthy lifestyle; eating whole wheats, fresh fruits and vegetables, lean protein-rich meals, etc. My boy will only eat/drink milk products sometimes. His calories amount to no more than 600 daily average. We are going to see the pediatrician but are there any other suggestions? This is so stressful. We literally chase him around the house offering food. At this point we just want him to take in a few more calories.

    • Hi Alba,

      I’m so sorry you and your son are going through this. There is help! Feeding specialists can work with him to determine why this is happening and give you tools to help him over come his fears.

      You will need to find someone who is local to you, but consider reaching out directly to Melanie Potock, MA, CCC-SLP, Coauthor of Raising a Healthy, Happy Eater: A Parent’s Handbook A Stage-by-Stage Guide to Setting Your Child on the Path to Adventurous Eating and founder of & and / or Beth Bader is the coauthor with Ali Benjamin of the acclaimed book, The Cleaner Plate Club.

      Hope that helps,

  2. Shan

    Is periactin available over the counter? I would like to purchase it for my 36 month old daughter. She should be 3 November. She does not have appetite from the time she was a baby. She is underweight and grows slowly. However she hates eating, especially things with calories. Plus she prefers to drink than eat and she doesn’t like to drink milky products. Is periactin available in Jamaica?


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