How can I increase DD's calories healthily

[HelloCheekyCat]

DD has annual appointments due to a health condition and she is always weighed & height measured.
She is on the 25th centile for weight and 75th for height, today the doctor has suggested increasing DD's weight by increasing her calories.
Given the chance DD would want to eat loads more chocolate and crisps but clearly she would need to eat healthier food, but what would/should that be?
Also do we actually need to do anything be because she's always been similar proportions but her weight hasn't increased as much since the last appointment in the same proportion as her height

Full fat dairy - cheese, a glass of milk, creamy sauces, butter on bread etc.
Oats - make flapjacks with as dark chocolate as she'll eat and honey to minimise refined sugars
Nuts either whole (depending on age) or nut butters

Make every mouthful as calorie dense as possible. @hittheball’s ideas are on the right lines, full fat milk, cream and cheese etc, also nut butters. Add double cream to scrambled eggs and cook in butter etc, that sort of thing. Smoothies (with milk and nut butter) along with small dense snacks x2 a day morning and afternoon and maybe even evening too alongside 3 meals.

My dd was between 75th and 85th percentile height and 10th to 15th percentile weight throughout childhood. i believe had arfid too but ever diagnosed, and was also a slow eater so feels full quickly.

I have got used to her being very slender; it does run in the family!

I found it extremely difficult to get dd to eat more food at mealtimes as her tummy filled up so easily.

She also hated “rich” food so lacing everything with cream was a no-no. She loved things like plain pasta dripping with good quality melted butter and grated cheddar. Milkshake (admittedly not healthy but the full fat milk was good!).

She liked things like shepherds pie so it was easy to make buttery mash.

Home made fruit loaf toasted with a smear butter on.

my DD (16) is on above the 91st centile for height but between 25th and 50th for weight. This has always been the case. Is your DD healthy, does she have energy, a good appetite, and a balanced diet? if so I wouldn't worry we are all different, some of us are shorter and stockier some are tall and slim.

Thank you for all the suggestions.
I'm going to be really awkward now and say that DD can't tolerate too much dairy 😳 she used to have a pancake for breakfast everyday and when she cut it out she instantly stopped getting stomach aches/issues.
She does.love cheese though and has pasta regularly so that's an easy one. The doctor also recommended eggs but she said she doesn't want them too often (she does like a cooked breakfast at the weekend though & will have one scrambled then).
She does like peanut butter but doesn't really eat it so I'll try to incorporate that

How old is she OP?

look at what body builders eat to bulk up and everything that people on diets avoid! Full fat dairy, lean protein, eggs, oily fish, avocado, nuts.
Do small things like putting butter as well as jam on toast, add mayo to sandwiches, grated cheese on top of pasta etc.

Eggs aren't calorific though so I'm surprised.

Nut butters if she likes have lots of calories and good fats, balanced out with apple for fibre and nutrition.

Smoothies can work (home made) bananas , full fat milk, or you can use oat, you can also add Greek yoghurt, nut butters, banana, berries etc , nice in sunder of your freezer the fruit before blending, also nuts to snack on. Proper snacks toasted granary bread with nut butter or cream cheese, crumpets with butter and a cup of milk, greek yogurt with nuts fruit and honey. DS has a fast metabolism and is tall so I get it. I have to work to add calories, he is fine with dairy though so adding cream and cheese to things helps but I'm sure you can use non dairy versions

Does she usually clean her plate, or leave a fair bit?

If she cleans the plate then focus on very slowly increasing portion sizes adding an extra spoon or two of volume a week.

If she tends to not finish then focus on making food more calorie dense.

Smoothies are a great way and full fat everything really so cream in mash potatoes, in porridge etc. full fat milk in a cheese sauce. Nut butters are good too and icecream. Avacados and bananas. It takes time for them to be able to eat more as they feel full quickly so do little and often. Honestly if they are concerned then unhealthy calories are also ok. Ds was under the consultant for a few years for weight and in the end his go to was sausage rolls! I just let him. He is still skinny and struggles to gain weight but is very active and eats a healthy diet with the add in of malt loaf etc. he also still fifs eating big portions difficult. He is not a picky eater but does not love food really.

Mine was the same, she still finds it hard to put on weight. I used to grind up nuts and seeds (healthy fats and protein) and stir them into porridge, weetabix, yogurt etc. Also olive oil drizzled over absolutely everything and not skimped on when cooking.

Lots of omelettes with plenty of cheese, polenta with melted cheese, nut butters not only on bread but also cooked with (eg. Satay style sauces, or rice with tahini and lemon), dips made with avocado etc.

we didn’t overdo the dairy as we’re all slightly lactose intolerant, it was mainly cheese and yogurt. You don’t need to rely on dairy as the only calorific option, there are plenty of others and most are healthier long term.

Dd has eating issues due to autism and physcal health issues (according to dietian) is 3rd percentile for weight 50th percentile for height. She also isnt good with dairy. But will tolerate butter and custard.
We were advised to add in a couple of snacks per day. This might be a piece of fruit with a small sweet treat (even at 17 wont eat lots of unhealthy food) or crumble and custard (loves mixed berrys), crackers with butter or hummus, veg sticks and breadsticks. It was also suggested a calorific drink everyday but dd will only drink water (and most calorific drinks are dairy based).
If you have a main meal just add an extra spoon of the most calorific bit eg pasta or rice.
The dietian always says not to make it a big issue and just being mindful of adding in a spoonful every meal will add calories. Dd has two snacks and 3 meals so it adds up.

Do people usually put jam on toast without butter?! That's appalling! 🤣

What's she like beyond her height and weight? Is she constantly tired or lethargic? Does she do as much activity as other children her age? Can she keep up in a group of peers? Does she function well at school? Does she drink enough water, and use the toilet regularly? Is she hungry constantly, or often says she isn't? Is she generally happy with her size? You haven't said how old she is, but if she's otherwise healthy, and her diet hasn't significantly changed from previous, then I wouldn't be to worried tbh. I know several people who grew out, then up, then out, then up, so their weight would increase a little, and they'd then grow a few inches and be rather skinny for a few months, before putting some weight on again. It's possible similar is happening here.

If not, look at what she needs to improve - for tiredness, you may want iron and B-vitamins; for bowel stuff try fibre, fruit and increase water intake; for energy you want more slow release carbs. Can swap things on her plate already for more nutrition-rich version (in what she needed), or add stuff in.
If it's just the weight, and you agree that it's just needed increased in terms of calories, try;

• adding in a snack (as other have said, smoothies are great), maybe after school or before bed, or mid-morning through the hols.
• adding one extra thing to each meal (so serving garlic bread with all pasta, tortilla chips with chilli, Yorkshire puddings with all roasts, extra veg with other dinners, bread with lots of dinners, a portion of fruit or a cereal bar with breakfast, one extra item in packed lunch)
• changing a snack for a higher calorie or healthier version (kids yoghurt for greek yoghurt, ice lollies for frozen smoothie lollies, crisps for chips or pretzels or veg sticks with a dip, biscuits for cheese and crackers etc).
• adding dessert to some days a week. (If you can do homemade, and get some ingredients with fruit/veg in too!)

If she's not eating full meals, but is eating lots of snacks with low nutritional value, then considering cutting these out so she eats meal, and see how you get on!

Again thank you everyone!
To answer a few questions:
She's 14
We had a quick chat when she got home from school about the suggestions made earlier and she has said she doesn't want to put weight on 😞 she made a comment over the holidays that she didn't want to have her tummy out so I think she's starting to be more body/image conscious. So any increase in food will be more stealthy which should be fairly easy.

She does have enough energy, can walk miles because she always walked just over a mile to primary school. Although she does moan about being tired during the week but it's because she gets up at 6am and 9am would be her preference 😆

She has butter on toast for breakfast but I use a diary free spread so I can easily swap that for real butter.

She doesn't have much appetite when she's on her period and will sometimes skip breakfast if she sleeps in at the weekend which I don't think helps.

She eats a lot of fruit, and drinks probably a litre of water a day.

DH only has jam on toast 😱

Some children/people are naturally tall and slim. A difference of 25th to 75th doesn't sound too bad to me.
What is her BMI? Is it within the healthy range or is she actually underweight?

I've just checked her BMI frim.memory of her measurements and it is bang in the middle.of the healthy range, the doctor showed us the progression and she was happy with it

It sounds like she doesn’t need to gain weight just maintain her BMI? One of my DDs was 75th height 25th weight from 10 months to 16ish when she suddenly became more womanly due to puberty. Very fit just an athletic build.

ermm yeah, I don’t put butter / spread on toast or bread if there’s another condiment going on too…..

Fair play. To me jam always goes with butter. Peanut butter doesn't have butter though! As long as you enjoy it x