“Your child looks too puny. Don’t you feed him anything?”
“He is 3? I honestly thought he must be 2!”
“She looks so thin! Are you trying to make her size 0?”

Familiar? For many of us, any discussion on our little one’s weight is a sensitive one. Since height and weight are the most visible evidences of growth, we are bombarded with comments, feed backs and often unwelcome but sometimes helpful advises on these two parameters from all and sundry. This is especially difficult for the mothers because many at times the implicit message is that the mother is not taking care of the child’s diet well. Even if it is not hinted, many of us end up feeling quite defensive about it. Or worse, we start feeling guilty that we are not doing enough.
Ok, first of all, it doesn’t matter what others think and say. That said, you also need to ensure your child has a healthy weight, to ensure that your child is developing all his organs in a healthy normal way. The good news is that by educating yourself and carefully planning your child’s diet, you can help him gain enough weight to be not classified under “underweight”!

How Can I Tell If My Toddler Is Underweight?

If your child is underweight or not is determined by many factors and not the weight alone. So if your child weighs less that the same aged child in the next house, do not panic yet. The best way to tell if your child is underweight is by asking his doctor. Your child’s hospital records would show his height and weight measurements taken during various visits to the hospital for vaccination shots. With these numbers, your child’s doctor can plot a growth chart for your child (many hospitals would give you these charts as well). Your doctor will see if your child has stop growing at the pace he used to grow before. He will also consider other factors such as hereditary, eating habits, calorie intake, BMI, gender and age.
You can do all the above at home as well. There are many “growth calculators” available online. However, be aware that many of these calculators use Caucasian babies as the base range – and we Indians are genetically smaller than Caucasians. So while these online tools give you an indication on where your child stands, it is not the gospel truth.

Developing A Healthy Attitude To Food In Your Toddler

As parents, the first step for you is to focus less on the weighing scale and more on the nutrients that your child is having. A diet of French fries, Oreo shake and burger might increase your child’s weight. But it will not give him essential macro- and micro-nutrients such as vitamins, minerals, protein, carbohydrates and fats. These nutrients are required to build a healthy body with strong bones and robust organs. So do not become obsessed with the weight, rather focus on ensuring the calories that your child intakes come from healthy foods.
As for kids, they generally develop the same attitude to food as the adults around them. If the family members have a healthy attitude towards food, eat meals on proper time, eat together and eat healthy, chances are that the child would imbibe the same qualities. Some tips for ensuring your child has good food habits:

1. Do not offer food as reward: especially junk ones – as a reward for doing something right. This would make them turn to food for comfort
2. Make meal times fun and interactive: Do not have/give food while watching TV (although it is very tempting to!). Small kids might get too distracted to eat
3. Give them plenty of exercise: Yes, we know you want to increase their weight, not reduce. But more exercise means more hunger and that means more eating!
4. Serve variety: If your child is still very young, introduce a wide variety of food as early as possible
5. Be calm: Do not scold them if they do not finish all items on their plate. Your child should not associate food to criticism and negativity

What Should I Feed My Underweight Toddler?

1. Give your child full fat milk and curd, not skimmed or toned ones
2. If you are breast feeding, ensure you feed long enough for your child to get the thicker and more filling hind milk
3. Add full fat cream to the dishes like soups
4. Cook your child’s Kichdi or Pulao in ghee, preferably homemade one. Coconut oil is also great to be used for cooking
5. For fussy eaters, get them to have smoothies. Add full-fat cream or coconut milk as base. Do not add sugar. Or make simple milk or rice puddings for them
6. Mashed potatoes are another tasty, healthy and weight-gain-friendly food. You can make it tastier with cheese and cream
7. Snack them on nuts and dry fruits. You can make trail mix or granola balls with them (mix nuts and dry fruits with peanut butter and honey; roll them, refrigerate them and give them to kids as snacks)
8. Apart from these, you can beef up calories in your child’s normal food with some smart cooking. E.g. Cook your child’s soup in milk instead of water; or, add extra grated cheese on his toast; or powder mixed nuts and sprinkle them on just about anything!
9. Do not feed him sugary or fat-laden foods as a shortcut to weight gain. This will curb their hunger and they will not have space to eat healthy nutrient-rich food
10. Do not put them on a high-fiber diet as they are very filling and your child might end up not getting a balanced diet
11. Limit the liquid intake. Some kids drink so much fluids – in the form of milk, juices or water – that their tiny stomach holds no place for solid foods. 2 cups of milk and 1 cup of juice would do for a day. Do not let them drink water during a meal
12. Ask your doctors about supplements. Your doctor might prescribe a high-calorie health drink to compensate for the calories your child is not getting from his diet. However, store-brought processed drink powders are not the best health options; so try the other options above before you think of a health drink

What If My Toddler Doesn’t Gain Weight Despite My Best Efforts?

You would most certainly be monitoring your child’s weight grain closely. If your child has reached a healthy weight, then you might want to talk his doctor about readjusting the diet. However, if the child is not gaining weight, despite you doing all the tricks in the books, explore the following options:

• Is the child taking enough calories?: If yes, then you need to work with his doctor to understand any underlying medical reason such as below.
  • • Worms: Toddlers are usually asked to take de-worming medicines once or twice a year. If your child has not taken it, then worm infection in tummy can make them lose weight
    • Illness: If your child has recently had fever or other illness like diarrhea or vomiting, then his body cannot absorb nutrients in food easily, causing them to lose weight fast

  (While the above two examples are not harmful and the child, once treated for these, will start gaining weight normally again, there are more serious chronic conditions that can lead to underweight as well. Discuss with your child’s doctor)

• Is your child refusing to eat?:
  • If yes, see if there is a psychological reason behind his refusal to eat
  • If no, find out if your child is intolerant or mildly allergic to any food that you usually give that causes discomfort in him

  Hold on mommies and daddies! With some smart meal and snack planning and lot of coaxing, your little one will be in the healthy weight range soon. Be patient!