How to help DS gain weight

[Sprogonthetyne]

He's 7, he was a relatively big baby/toddler and in clothes a couple of sizes above his age. Since about 4 he only seems to have grown upwards, he's quite tall but has gotten gradually skinnyer. I've been tracking his hight & weight on the NHS calculator, and last week it came out at 4th percentile, down from 7 in the summer.

He is autistic, and does have a restrictive diet, but he has a reasonable range, with things he'll eat in all the main food groups. The main problem is the portion size, I think he struggles with the sensory change from hungry to full, so will still only eat toddler size meals.

Today's food

Breakfast- 2 slices butter malt loaf, small yogurt & easy peel orange

Lunch - half peanut butter sandwich, half apple & crisps

Tea - cheese & bacon pasta - maybe 2 table spoons

Snacks across day - cucumber, caramel wafer bar, cup of milk

That's all he will have and would happily eat less if I didn't push him. He gets snacks on request and within reason, can choose what he wants (as long as it isn't constant sweets)

Any suggestions? I'm getting worried as he's starting to look to thin & it's getting difficult to buy trousers with long enough legs that stay up.

It's not much protein. If he has small portions then you need to make them count. EG buy top of the range peanut butter and put it on thinly sliced bread.

It's hard to know what to suggest to add to his diet. Would he have some seems on his yogurt for example. Would he have eggs or beans for breakfast?

What centile is his height on?

I agree more protein and fats.

What snacks would he eat that are heavier in calories?

Would he have avocado?

One of my DD's had to have Complan to supplement her diet.

I have this same thing.. I do add cream to porridge, cups of milk offered reasonably often (doesn't have much of it so can't just give one full cup), cheese cubes/baby bells etc.. snacks of nuts/edamame beans/eggs/avocado/seeds? Mine certainly won't eat all of them but he likes edamame beans which has been a winner.. it depends on what will/won't be eaten as to what can be recommended I suppose, do you have a list at all?

Still haven't got him up a percentile but was pleased at the last weigh that he hadn't gone down!

Thanks for replying. Eggs and beans he won't have, but he does eat some meat, fish & nuts. He wouldn't eat seeds in yogurt but does sometimes eat pumpkin seeds by themselves. Only problem is he picks them up one at a time, so it takes forever to get a reasonable amount in, so usually he's got board before eating more them a t-spoons worth.

He wouldn't eat seeds in yogurt but does sometimes eat pumpkin seeds by themselves. Only problem is he picks them up one at a time, so it takes forever to get a reasonable amount in, so usually he's got board before eating more them a t-spoons worth.

Put them in a bag or a container and he can haven them instead of crisps for example or when he's watching TV and time isn't an issue.

He's 135.5cm, which I think is 98 percentile for his age. He weighs 25kg

Would he have a milkshake as a snack? Easy to make and you can add in extra skimmed milk powder to boost protein, ice cream, banana etc all help boost calories?

Bigger portions? My four year old would eat double those amounts given though he is 90th percentile for weight and 98th for height. In age 6 clothes

Sorry missed your last but what about more frequent meals?

He does have (if I'm honest, most) snacks in front of the TV, but he very much lives in the moment, so if he stops eating for a minute, because there's a good bit of his program he wants to focus on, he entirely forgets the snack exists so really finishes anything.

Does he have full fat dairy? Buy double cream and add it into as many things as possible. For example yoghurt, mash, pasta, custard etc. If he will eat mash, add an egg, butter, cheese and cream. High fat dairy is good as it has a high calorie count per portion. The fats in dairy also carry valuable fats soluble vitamins.

He likes the idea of milkshake, and gets excited about having it, I guess because it's a stereotypical treat, but once he has it he will have one mouthful and put it down.

Usually if given the chance of drinks he will ask for water, though for the last few weeks we have been insisting he has at least one cup of milk a day.

My DS very similar. Now at 18 still eats less than 15yo sister! (she's a slim size 8). I have to find ways and means of getting high cal into him, let alone a fruit/veg.

Greek yoghurt and granola (he used to eat at 7, sadly not anymore)
Macaroni cheese made with cream
Porridge made with cream
Flapjacks with loads of butter
Fruit cake / Christmas pudding
He has a thing about cheese and chorizo at the moment so wraps with that melted inside
Pancakes and maple syrup
Apple crumble and custard
Chocolate cake made with grated courgettes

My DS is 8, 23 kilos and 134 cm. Yes skinny - and indeed lighter than yours - but hugely active and huge and diverse appetite.

I won’t list what he eats - but my main point is that kids are sometimes also just built a certain way and have different metabolic rates. My husband looked exactly like DS does now.

Try to improve his diet sure but I’m not all that certain you can necessarily change his weight and stature all that much…?

I would allow open access to cakes, biscuits and crisps as these are ideal foods for weight gain.

Does he like puddings? Start introducing a daily pudding after dinner.

Double cream can be just about added to anything, soups, scrambled eggs, porridge, pasta sauce, curries etc

I think you would be better looking at the charts that were in the back of the red book and plotting height and weight separately
UK-WHO growth charts - 2-18 years | RCPCH

You could ask your GP for a paediatric dietitian referral or you may have a community based feeding team you can be referred to

25kg puts him at 75th centile for weight?
OK, so his height makes the BMI result very low, but he is clearly eating plenty and putting on weight.

My oldest typically sits at 9th centile on the BMI thing - with height around 50th. He's still there, and getting close to GCSE's. He eats masses. It's just the way he's built.
Yes, trousers are a nightmare - getting better now he can wear small men's. For the first time in his life he can wear jogging bottoms XS men's with the waist not being 5 inches too big.

I'd keep going as you are.
Maybe offer a high calorie pudding some times - fruit crumble and custard or ice-cream style puddings here.

My DS is on the 25th centile for weight - he’s tracked this exact centile since he was born. However he is over 75th for height which creates his lanky look. He was always a banana baby and I recall obsessing crazily over his leanness when I was breastfeeding. Now I know this is who he is. Doesn’t stop family from
commenting about needing to feed him up.

DS eats like a king, bless him. Copious amounts of adult sized portions of fish meat salads and all sorts of adventurous tastes. Wakes at 530 does a ton of sport and clubs and nothing moves him Upwards of 25th centile for weight.

So focus on improving his nutrition and appetite sure. A curiosity for food sure. But I don’t know if you really can alter childrens centiles and the underlying ”build” in any way or even if it would be good for them

I agree that this is likely his body habitus and he's eating well for asd in terms of food so just keep going. No need for lots of cakes etc,
Do ask for a dietician referral for advice as they can have some great tips.

(Mother of asd boy on 0.4 centile who is improving now he's 10)

I would also caution against providing free and flowing supplies of sweets and cakes and fillers just to make him look like the kid you want him to look like. It’s his lifelong eating habits and nutrition that is the focus here - so providing access to an array of flavours and foods, cooking and shopping together, watching food programmes, exploring different foods - learning about food groups - all that is what’s possibly better than cakes sweets and biscuits galore