What else can I add to DD’s diet to help her gain weight?

[Queijo]

Dd has always been on the cusp of being underweight, no matter what she eats. She’s 7 now and recently had a growth spurt so is tall, but very, very slim. I’ve got her a referral to the hospital, but in the mean time what else can I do?

Breakfast is usually dippy egg, butter and seedy bread soldiers with full fat greek yogurt, honey and frozen fruit. Or avocado on toast, or nut butter on toast. Lots of things on toast!

Lunch is a school hot lunch. At home she’ll have wraps with full fat cream cheese and smoked mackerel or salmon, then hummus, pitta or breadsticks on the sides, nuts and some fruit

Dinner is usually pasta with a creamy sauce, a fatty cut of meat with fortified mash, veggies in butter anything I can sneak some cream/butter/cheese into really.

Snacks she has nuts, crisps, chocolate, pastries, basically anything high calorie.

She the slimmest in her class by far and she’s noticed now, and I don’t want it to become more of an issue.

@Queijo there is a huge laundry list of potential symptoms and I think as a child, I don't think I had typical gastro symptoms. Being tired and low energy was what struck me in your post. There are great resources online - coeliac UK are great.

Interesting you mention tonsillitis, ds is waiting for a tonsillectomy after 15+ bouts of that and strep a in 2 years. So I fully get the worries when they stop eating 😅

Paediasure is on amazon subscribe and save, either the small or big tub is alternatively on offer. Boots often has 3 for 2. Yes it adds up, if she's underweight, the gp might prescribe? Ours hasn't, but I haven't asked.

If it helps, I can always see ds's spine. He's actually at the healthiest weight he's ever been since accepting mac n cheese to his food list.

She’s 4’3” and hovers around 3 stone.

Brilliant, thank you I will have a look at that.

I agree with this.

I was tall and extremely underweight as a child. Yet I ate like a horse. I was referred to my GP age 10 but nothing further. I also did a lot of sport. Once I started work in an office I gradually started to put weight on. Now I am overweight can’t seem to loose weight and I have an under active thyroid, I am anaemic, gluten intolerant and pre-diabetic.

My teenage son is also very tall and is struggling to put on any weight. He also eats like a horse but doesn’t put any weight on.

I would continue to do what your doing don’t beat yourself up and maybe offer slightly more food say hot chocolate and a mix of healthy and unhealthy snacks but I wouldn’t go mad until after her hospital appointment.

Slender and very active family here and as children we were all given a large chocolate milkshake in the evening and I've done the same with my children who have followed suit. They're adults now and still have a milkshake every day!

My weight can sometimes dip so I have a cheese omelette mid morning which helps.

She sounds slim but not hugely under weight tbh, though it depends whether she's almost 8 or just gone 7. By my calculations, she's somewhere from 5th -7th centile?

My nearly 7yo is a kilo less.

I also have a child that is very underweight (with a lot of effort she can make the 1st centile). She is prescribed calorific squash, has gold top milk, and a LOT of treats. She has a dietician, paediatricians (for other things but they keep an eye on her weight), and endocrinology keep an eye on her.

The advice to us is to prioritise calories at the expense of 'healthy' and top up with vitamins if needed. Its probably not a great long term solution though...

This is sound advice.

Feeding her up now could result in confounding test results.

You could be looking at celiac or type II diabetes, among other issues.

Hot chocolate/chocolate milk

Pecan pie

Peanut butter

Ice cream smoothie

The thing is too much fat is satiating. You want to do the opposite of what people are advised to do to lose weight (obviously avoid junk food and high processed food) so drink your calories and add plenty of high sugar and starch. So fruit smoothies with banana and apple juice. Homemade lemonade or milk shakes, hot chocolate etc. look like you do ok on the carbs front otherwise. Is there a family history of being very slim as children?

I would keep a food diary ahead of the paeds appointment and try to not to make drastic changes as long as their weight is stable and not actively loosing weight. Give them as much information for them to help you.
It could be a food allergy as well as coeliacs. Difficulty with weight gain can be a symptom. The delayed food allergy symptoms can be ambiguous

I too would wait for the referral, they can advise.
Having said that, the diet you list sounds like the kind of high fat/protein recommended for adults who wish to feel full on fewer calories. If she does need to gain weight then add snacks which are high in carbs. The kind of food adults avoid as it doesn’t fill them up for long. So white bread toast with jam as an example.
Whatever you do don’t start excluding things like wheat/gluten, as if she is tested for coeliac she might then get a false negative.

Sounds thyroid related or low iron perhaps

Are you yourself really slim op?

Custard made with cream, butter on everything, jacket potatoes with butter & tons of cheese. Will she eat fried food? Go back to cooking everything in either butter, dripping or lard. Lots of bread, pasta, rice & potatoes, make flapjacks, cakes with buttercream or fresh cream. Angel Delight made with whole milk, tinned fruits in syrup, smoothies & milkshakes, fakeaway KFC Krushems made with condensed milk, ice cream, & then either white chocolate chips, bashed up Oreo biscuits or Maltesers.