Very skinny boy

[bobstersmum]

Ds has just turned 5 and has had a few days of being very poorly with a virus and ear infection, he hardly ate for 3 days and was sick and in this short time he has become skin and bone. He is very slim anyway but this has made me realise that if he were ever poorly for much longer he'd be at risk of getting really dangerously thin. He has some sensory issues so is a very picky eater but on the whole doesn't eat too badly.
Is there anything I can do to help him fatten up a little? I did think of those paediasure shake things but I doubt he'd be willing to have those and they're so expensive!

We had the same issue with our DS who was very premature. Those shakes prescribed by the doctor did not go down well! So we did little swaps- the opposite of dieting. For example Jersey gold top milk instead of blue top, Rolo yoghurts (highest calorie yoghurts at the time) instead of petit filous. It works without them noticing!

Oooh Tronk, can you still buy gold top milk! I will look for that because he loves his milk, and I will try those rolo things too. I will have a think what other things I can swap. Thank you

My ds is too slim for his height and the dietician has always said to cover his vegetables in butter, fry everything, lots of oven chips, and calorific puddings for both meals. Basically, the opposite of a healthy diet for other children (which has taken school several years to really get to grips with!) Ds has three snacks a day too (and again, flapjack, toast etc, not just fruit.)

Does he like chocolate milk? We used chocolate flavoured meal replacement and passed them off as chocolate milkshakes. You can also add some cream to the milk before mixing the shakes.

DS is only 2.5 but was premature and in the very low centiles for weight.

I used to:

• add a spoon of double cream to weetabix
• add smooth peanut butter in porridge (sugar free)
• avocado and banana smoothies with full fat Greek yoghurt
• extra butter in his mash/toast etc
• Curry and rice (he loves rice)
• Milkybar do some puddings that are very calorific, he only gets these if he’s very skinny after a bout of tonsillitis

He still gets quite thin when he’s poorly but he’s doing much better now

The pediasure shakes are grim, with a consistency like phlegm.

You might be better off making your own shakes. Also homemade icecream.

Does he like the fat fluffy pancakes - when dd2 was losing weight (after a period of illness), she ate a lot of these made with extra eggs with Greek yoghurt and fruits or grated chocolate and peanut butter.

Before doing anything else I'd weigh and measure him and calculate his BMI on the NHS calculator. Just to be absolutely certain he's underweight - judging by eye can be pretty inaccurate.

Milkshakes made with Nesquick and full fat milk with a spoon of double cream in.

Nutella.

Lots of butter on toast before jam or peanut butter etc.

Ice cream.

Cheese toasties made with a lot of thick cheese slices.

Hot chocolate made with half boiling water, half full fat milk (or cream) and lots of mini marshmallows.

Anything with eggs - scrambled eggs on buttered crumpets.

Crumpets with a lot of butter.

My eldest has cystic fibrosis, and the above advice was exactly the advice we were given. Taste the Difference milk in Sainsbury's is the equivalent of gold top. Full fat everything, crisps and chocolate for snacks whenever he wants them.

DS1 was prem and off the bottom of the centile charts for a while (period of illness saw to that). We were advised to:
add some cream to porridge, cereals, mash (as well as butter), curry, anything really, so long as it goes!
use butter and cheese spread (Philadelphia) in sandwiches - we used to do either or
Butter and some grated cheese on veg, in fact put grated cheese on lots of meals (which he loved!)
Give puddings, with custard

This was all recommended by the dietician

We used Build Up shakes - I think Nestlé did them?

As a toddler my dd needed to get her weight up as it was dropping rapidly due to a medical condition. We used to give her really nutritionally rich foods, and things like porridge with cream in it, and plenty of the foods as described above, peanut butter, buttery mash, desserts like waffle and ice cream, obviously also tried to give healthy balance with veg and fruits. She wasn't keen on stews with rich meat or dumplings but that'd be good?
Basically rip up the rule book on childhood diet, it is written for normal weight and overweight children!

Some really good advice here thanks everyone. He is under a consultant for another issue and last visit in Nov they said his weight was low but not worryingly so, but this last few days has really affected him. I shall weigh him in the morning and go from there, it can't harm him to bulk up a little though as he's very active and he does look so much healthier when he has a little more weight on.

You can see every bone in my DS1's body and face, and he eats minute portions, but because he is a live-wire of energy, and rarely gets ill, I wouldn't even think of carrying out any of the recommendations on here without further medical advice OP - many of the PPs here have indicated that their DCs have medical problems requiring dietetic input, which is where they've got their advice from. From what you've said, yours doesn't. Definitely don't feed your child a diet recommended for a child with cystic fibrosis - that's a WHOLE different ball park.

If his energy levels are fine, he's not sleeping excessively and he's back to his normal levels of activity, I wouldn't be using gold too, cream or excess butter. Just carry on with a well-balanced diet. Some children are just naturally slim, and really don't need to be developing a taste for added saturated fats unnecessarily.

*gold top

I am not sure about that @elphaba the OP has said he is under medical observation and his weight loss is connected to a recent illness. What is worse, a few extra helpings of butter, or allowing an already underweight child to slip further? I don't think a few extra calories will hurt in the circumstances

My ds has always been super thin, on the NHS bmi he’s normally around the 1st - 3rd centimetres over time and he looks very thin, to the point of bruising if he lies in hard floors.

I’ve done all the above fatty tricks, he eats tons but he’s just that shape it seems. He’s super healthy luckily and over the last 8yrs I’ve started to ignore it. At swimming though he attracts comments about his weight (you can see the entire rib cave and pelvis, not just some ribs).

The only bit that worries me is with the comments if others it’s almost becoming an identity, being noticed as tall and super slim, and he likes it. I worry he would be reluctant to put on weight if he started to naturally.

Oh yes I forgot about eggs too!

ILoveDolly She hasn't said what he's under medical observation for. He was weighed, but that could have been a routine thing, that was mentioned in passing.

I'm always wary about people wanting to 'fatten' children up, based purely on what they look like. The idea of a chubby child being a healthy one has yet to die a death fully in our society. He's not a prem baby, nor has the OP indicated that he has a metabolic disorder, which is the type of dietary adjustments she's having recommended.

It's normal and healthy to see a child's bones, as long as their activity and behaviour are age-appropriate.

We make hot chocolate and add a couple of spoonfuls of milk powder as well as full fat milk- it adds extra protein and vitamins and they can't notice really. Or ds likes milkshake with peanut butter blended in.

Those nut bars you can get are good, or blitz nuts, dates and cocoa powder up and roll into balls.

Yes I get what you are saying, but I am not talking about fattening up normally thin kids, just trying to regain a healthy weight in an already small child. My kids are all super thin naturally and generally that's not a concern of course not, its just if you have an underweight child they are going to get too weak if weight has dropped off, a few extra bits in the short term would be ok? Obviously a "feeding" has to have a specific aim and reason...

Elphaba - one of my DCs is just inside healthy weight. If ill then it would be very easy for them to drop outside it after a period of time and be underweight. Short-term extra calories added in those circumstances is not a bad thing - preferably without telling the child, so they aren't really aware of it, so they can't ask for it specially in future or develop a relationship with it or the attention given to it.

Hi, he's under observation for some very large lymph nodes in his neck (only one side) that haven't budged since they were spotted in early October. At his consultation because at the time he was well in himself they decided to leave him and see if they went down, he had full blood tests done and apparently all was OK, they did say if he started to become regularly ill or generally unwell they would scan him. He's been ok up to now but as you can imagine I do worry that he could have something underlying and just want to keep him topped up so to speak so that he doesn't go too far under if he has another bout soon.

The important thing is to keep him eating whatever he wants. DS1 had a bout of flu which led to him being diagnosed, he lived on chocolates from the Christmas tree for a fortnight.