How can I help my skinny DD gain weight?

[Dustbunnies]

My DD has always been long and skinny. She was 5lb 3oz when she was born, with long, stick thin arms and legs. Now she's a very active, nearly 6 year old who does several sports (although less so at the moment obviously). She's also vegetarian by choice. She always refused to eat meat, even as a baby/toddler, and she made the decision to become an 'official' vegetarian in September last year, which we've respected, as we believe it's her choice.

She eats plenty, and asks for snacks as much as the next small child, but she does tend to go for fruit and veg over protein/carbs. In fact I really struggle to get her to eat any protein whatsoever. Tonight she stood on the bathroom scales and announced that she's 2st 9lbs. I'm pretty sure this is basically the same weight as when she was about 3! She's 3ft 10, so quite tall for her age.

How on earth can I fatten her up without resorting to feeding her nothing but cake?! Eating meat really isn't an option for her, she won't really even touch fish.

Sorry for the long post, I'm trying to avoid a drip feed!

She has healthy eating habits and I wouldn't exactly introduce junk to make her gain weight.
Does she need to? Does she look sick?
With summer coming you can try milkshakes and ice cream but what about then creating an habit for sugary and creamy food .
Make some quiche, have whipped cream when she has her strawberries or melted chocolate with the banana. Make pasta or creamy risottos.

Record what she eats on cronometer.com for 3 days, not so much for the calories, but for proteins. And if you are concerned , book a phonecall with the GP .

Is she actually underweight? Do you know her height?

Thanks for the replies. Yes she does look very thin, she's tall with long skinny arms legs, and her hip bones and ribs are quite visible.

We're quite a slim family so I didn't think much of it, but after putting her weight and height into the NHS BMI calculator tonight it says she's below the 1st percentile, so I'm starting to worry!

Avocado, nuts, nut butters, potatoes, extraolive oil and butter on her food, calorific smoothies, pasta dishes, pastries, pizza, double cream and fruit, banana bread, milk shakes.

If you plot that weight onto the girls weight chart red book style she is between the 2nd and 9th percentile and around the 50th for height. My children are of a similar build. I got the “underweight” letters from school. My teenager is now 5’4 and 5 stone, growing fast but it’s all upward and not outward. It’s OK to be smaller, if they are active and eat well, you are slim family so it doesn’t sound like a surprise. I’d read up on vegetarian children if you haven’t already, I’m sure there is good advice out there on making sure she has everything she needs.

In our society, being round and overweight is the normal and I have never understood this MN criteria of being able to see the ribs to determine if slim.
We do not come in the same shape. Some children are round, some are skinny. As long as she looks fine, not like a walking skeleton, grey skin, massive dark circles around the eye, I wouldn't necessarily worry.
Ignore for a second the number on the scale. How does she look.
Healthy and active?
My son does athletics and swimming at a state level (In Australia) and I spend hours watching events and meets . For the girls, the high jumpers are all long and thin, the butterfly swimmers are bulky and sturdy. Both type of girls are healthy.
What I am trying to say is don't take the body our of context. Anyone putting the weight for the high jumper in a chart would say they are underweight and for the swimmers that they are overweight, when in fact both are power machines, one flying in the air, the other flying over the water.

Don't worry based on a number on the scale, but trust your eyes. You didn't notice until you heard a number.

Under 1 centile is worrying though.

Milkshakes are a good idea or just drinking milk/babycinos

You can fortify full fat milk with milk powder to increase the protein in it

Add cream/cheese/butter to soup/mash/jackets etc. Cheese and yoghurts as snacks and some sweets things are also ok

Good regular eating pattern 3 meals and 3 snacks

Good luck

As PP said fill day everything.

Blue milk. Real butter. But butters etc.

I agree with PPs about making sure everything is full fat, adding extra oil and stuff and nuts. My DS is 12 and on the 3rd percentile for weight (can't remember height). He was only 5 lbs at birth and he's always been small. He's looking healthier as he's growing up, but it's a constant struggle to keep weight on him because of his ADHD meds

If both weight and height are below 1st they are in line .
So not an issue.

But keep a food diary for a week of everything she eats then get check with gp and get referral to community dietician for advice.
Typical advice would be full fat milk avocados good oils etc

My 4yo is very skinny and I give her avocado every day, load butter onto toast and potatoes etc, peanut butter on oatcakes. She is still a skinny little thing but I know he is getting plenty of good fats so I don't worry about it. Also saves me a fortune in clothes as they last forever because she doesn't fill them out 😂 she's always been around the 9th percentile though I'm not sure what she currently is

Thanks for the advice everyone.

She's always been very active and full of energy, so until now I honestly just didn't think much of it, other than to be secretly a tiny bit smug about having a kid so keen to eat fruit and veg! But seeing the numbers on the NHS website tonight shocked me a little bit, and made me realise that I could probably be doing more to make sure she gets enough protein in her diet. I've found some tasty looking kid's protein shake recipes using things like tofu and nut butters, so I think I'll do a shop tomorrow and stock up on some high protein and carby food for her, and give those a try.

If it wasn't obvious enough - she's my PFB, so I am prone to worrying!

@tumtitum - yes to the clothes thing! She can wear things forever as she only ever seems to get too tall for them, not too big!

Hi,
if she looks very underweight and the centile line has decreased over the years, then this may be classed as faltering growth and by no means should you assume that as long as she is “active and healthy”, all is fine. You mention it’s difficult to get any protein sources in her and that she tends to opt for fruits and vegetables mainly. Yes, kids are usually quite good at self regulating but some just don’t get enough energy and protein to maintain their growth trajectory. The vegetarian diet adds to the complexity. If you’re worried, OP, I’d ask the GP to refer to a paediatric dietitian who should be able to assess the adequacy of her diet for a healthy growth and give you some tips on how to fortify her diet based on her usual eating habits. Good luck .

You need to look at ways to add calories without volume. As mentioned above milk powder in milk is a classic example.
Does she eat eggs? If so make scrambled egg with an additional yolk for each eggs used and scramble in butter and cream, same for omelettes and eggy bread.
Make crumbles with chopped nuts and add ground nuts to pastry.
Add cream a spoonful of ground almonds to porridge. Finely Ground peanuts (do in the food processor) disappear in curries.
Olive oil or butter on veg.
If she’s snacking on veg serve with a dip, sour cream, hummus, guacamole etc

Unless there is a medical reason to take all those steps to fatten her up, I would be very cautious about going over the top. Gaining weight and losing weight is a metabolic process not just calories. It involves hormones such as insulin and IGF-1.
So call your GP and ask if there is cause for concern. If not, leave her alone. She enjoys fruit and veg, which is a gift for life. Artificially modifying a feeding pattern is not something to take lightly .

Unless she is ill, many of the steps suggested by posters are excessive without medical supervision be it a GP or dietician.

Are her height and weight accurate?
I have a slim (but not as slim as your DD - he bounces between 3rd and 6th centiles).
Honestly, he eats masses (has the nickname Hollow Legs within family friends), is full of energy, and not in any way fussy. He looks tiny compared to many of his more robust friends. If the numbers are correct, I'm surprised you haven't seen a discrepancy compared to her friends.
I'd check her height and weight over the next few weeks.
And, if you still need to, try to "upcarb" or "up protein" the snacks - fruit such as bananas, apples, pineapple, grapes. Add a small bit of cheese or a biscuit to the fruit. Dried fruit. Dips for veg sticks.

The fact she hasnt put in any weight in maybe 3 years would be ringing more alarm bells for me than the absolute numbers. If she has grown taller, she is dropping centiles.

Vegetarians don’t eat fish so don’t make her eat that. Add more cheese, full fat milk, nuts/nut butters, potatoes, pasta, bread.

Honestly, she's full of energy, you do NOT need to fatten her up! She's a healthy child, with healthy habits...don't go changing that!

I could be wrong but it seems quite unusual for such a young child to be so aware that she chooses to be vegetarian. Do the rest of your family eat meat/dairy?
The first things that spring to mind are oils, avocados, nuts, pulses and rice dishes. Plus good old chips and mashed potatoes with olive oil and garlic of course 😁
But at such a young age, you really need expert advice. A poor diet now could adversely affect her health in future.

If she has a healthy diet, a good appetite, growing properly and is rarely ill - I'd leave her be.

What centile is her height on if her weight is at the bottom?

2 of mine had much lower weight centiles compared to their height. The thinnest was 20th for weight and 80th for height she has a very narrow frame as do I and desire doing a lot of sport only got muscles after going through puberty at 14ish.

If you are both slim with narrow frames that could explain it.

Ensure she is eating full fat milk, yoghurts etc.

Get in touch with the school nurse (they will still be working) to discuss your concerns. She might be fine as she is.

If there is a genuine need to increase her calorie intake then look up recipes for 'enriched meals'. (I discovered these while caring for an elderly relative with virtually no appetite). It basically consists of ways of adding extra nutrients and calories to foods, without increasing portion size, or eating junky snack foods. Things such as adding cheese to mashed potato, thickening soups with cream etc.

Nobody would put a 6 year old on a diet to make them lose weight without doctor’s involvement. Yet the opposite principle, putting a child on a fattening diet is acceptable.
Food is not only calories. It triggers metabolic response on multiple levels and systems, including the brain. Excessive sugar and insulin is linked to depression so careful