Underweight child, would you be concerned?

[Lagerdrink]

DS is 8 and a half and weighs 20 kg. He's about 130 cm tall, which puts him in the underweight category for his age/height/sex.

Obviously this isn't a completely new thing, he started dropping down the weight centiles shortly after birth (birth weight was bang average) and has always been light and skinny. Previously doctors have said if he keeps on the same curve then it's OK and both us parents were skinny children, so we haven't been too worried. But we weigh him periodically (few times a year) just to see and it seems like he's barely putting on any weight at all now. We don't keep records or anything so don't remember exactly, but I don't think he's gained more than a few grams in half a year. He has got taller, though.

To see him he does look very skinny. He's generally a very energetic boy with what seems to me a normal appetite, not massive but not very small either. His diet's not restricted and he'll eat most things. He has been noticeably sicklier than normal this school year with a few days off almost every month for fevers. Very minor illnesses but it's the frequency that has started to concern me. He also looks a little pale to me but I could be imagining this.

I've booked an appointment with a paediatrician because I'm not sure it can be dismissed any more as just a naturally skinny child. Would you be worried if this was your child?

I probably wouldn't be worried by the skinniness itself, but combined with his being a bit prone to getting poorly at the moment, it does seem quite sensible to speak with a doctor about it, as you already have plans too.
I still think that 'worried' would be putting it too strongly -- you are just being sensible and making sure that you have a chance to talk things through and spot problems early if they do exist.

Ds was like this and often poorly. We were under the hospital. He was not picky at all but never really loved food and ate for fuel and now more. The advice was to give high calorie every thing so cream, butter added into foods like mash, milkshakes etc. everything he ate was as calorie dense as it could be. We also gave multi vitamins. As he got older his health got better and he slowly ate more. He is now 19 still very slim and very active but is also very food conscious and understands how to fuel his body to do what he needs it to do. I would definitely check their are no underlying health issues but having lots of infections certainly does not helps so that is worth trying to sort out.

We do try to give him high calorie food as far possible. He always has the full fat versions of everything and we don't stint on cream/butter/oil etc. But tbh if the food is richer he just eats less of it so I'm not sure how effective it is!

Hard to say. My 5 year old is 15.5kg so 20kg at 8 would seem possible. However my just turned 3 year old is 18kg, which makes her seem huge and your boy tiny.

if he's eating well and has lots of energy, I would say just put extra butter on his toast, more cheese etc, squeeze in any extra calories.

Mine has really grown since I started giving him extra butter and a large bowl of full fat Greek yoghurt with a little honey most nights

Being skinny would not concern me seen in isolation. DS2 is very skinny, but that’s just how he is built. He is still skinny at 19 thought he eats a lot. I think we are also not used to see peoples ribs anymore so think of it as unhealthily skinny when it’s isn’t necessarily so.

We do the Greek yoghurt for supper thing as well!

It's not his physique that worries me, it's the fact that he seems to have stopped putting on weight and that in combination with that his general health seems worse 🙁

My son is in his twenties now but he's always been underweight. We did get blood tests when he was younger but they showed no issues. You're right to get everything checked but my son is over 6 foot now and is still skinny - he eats well but never puts any weight on. I think some people are just naturally skinny.

Could he be iron deficient or anaemic OP? Vitamin D? In your position I would want it investigated if his general health is worsening.

I just don't know. He does take a Vitamin D tablet daily and has full fat milk fortified with D so theoretically should be OK there. No iron supplements but he has red meat at least weekly. I don't know if that's enough.

Perhaps it's just been a run of bad luck with bugs going round and he's naturally eaten less when he's ill and somehow not made it up properly.

I'm glad people don't think it's silly to have made the appointment though. Hopefully they'll be able to get to the bottom of it if there is an issue beyond him just being a skinny boy.

It was the growing in height but not in weight that was flagged for us. In a year no weight was put on but height grew. I do agree with that some dc are naturally very slim but for me when linked with low level poor health then it needs looking at. I know ds was not eating enough at that time so it was good to have it monitored and to have support. They get full quickly when they eat little so it is a vicious circle.

Keep a food diary for a couple weeks, before the appointment. Also note down his weight & height now.

Making the appointment sounds sensible, definitely the right thing to do, even though the most likely outcome is they'll discover he's fine!

I agree with everyone else that you shouldn’t worry and he’s probably just a skinny kid, but it’s sensible to have him checked.

Iron sources possibly need upping? But the dr is bound to order blood tests which will check all that.

Does he eat most of his lunch at school (especially if it's a school dinner, as they're not exactly large)? Some children are more focused on going out to play football and will just eat a few mouthfuls and they're out, or don't like school dinners compared to home cooking.

I'd be concerned. It's not very common for children to be underweight, I worked with children and even the ones who looked really thin were in the healthy weight range. I'd be pushing for tests to get to the bottom of it with the paediatrician.

this happened to a kid in my DD’s class - it turns out he’d become coeliac! The doctor thought it was triggered by a bug he’d had.

My child is underweight, but also low height and low BMI. She has other health issues but the issue with weight gain (even with food supplements for people at risk of malnutrition 😢) mend that she's being investigated by gastro and endocrinology.

I think it's sensible to get him checked out.

I’ve always worried about which health habits I pass on to my children. When I had kids, I started educating myself more, and my stance now is that my job is to make healthy food available to them and then let them choose how much to eat.

We’ve found that now they’re pretty clued up on their bodies’ needs, so if we try to push too much, they actually end up eating less. Giving them autonomy around food has made a big difference in helping them build a healthy relationship with eating.

We don't really push our children to eat, except that they must eat some of the vegetables (and if it's something they hate tomatoes, cucumber or carrots are always available as an alternative). DS eats as much as he chooses to eat and we aren't forcing him to eat more. I don't think he has an unhealthy relationship with food at all.

I've always been right at the very bottom of the healthy weight category myself, so I know it's mostly genetic and he'll likely be a slight build all his life, but to be in the underweight category is actually a really low weight. Everyone wants to see their child growing properly.

I must admit this occurred to me, only because I also know a few people who discovered they had coeliac disease in childhood and it explained a lot of problems they'd been having with weight and health. But when I looked it up he didn't have any of the other symptoms (no general digestive problems). But who knows, maybe there is some kind of intolerance going on.