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In a world where much attention is given to prevention and treatment of childhood obesity, the thin child lurks in the corner, causing his parent to sprout grey hairs and plead for her to eat.  From toddlers to teens, the thin child who appears to barely eat, or eek out the average growth every year, is just as much a concern to a parent as the child who overeats.

If your child is thin and you are worried about whether she is getting enough nutrition, here are some guidelines to help calm your fears and feed your child:

Check the growth chart:  Children show us that they are thriving through normal growth and development and this is demonstrated on the Center for Disease Control growth charts.  Your pediatrician graphs your child’s weight and length/height routinely at well visits.  Children who are growing normally will grow predictably on their personal channel of growth. Children who are not gaining weight appropriately may demonstrate a flattening of their growth curve or show a decrease from their usual growth channel percentile.  The growth chart is a good indicator of your child’s overall nutritional status.  If your child appears to be maintaining his usual, predictable pattern on the curve, you can rest assured that your child is getting adequate calories for normal growth.

Consider an age-appropriate multivitamin:  Children who are thin may be selective or fussy eaters and may not be getting adequate amounts of needed vitamins and minerals.  If your child eliminates a major food group (dairy, fruit, vegetable, grains, proteins), consumes more processed foods than whole, natural foods, or is having difficulty gaining weight, a multivitamin may be a prudent addition to her daily diet.

Make every bite count:  Be sure to add fat, such as butter and/or oils, to vegetables. Adding sauces such as cheese or hollandaise, and topping with sour cream or shredded cheese can help boost calories as well. Dip fresh fruit into yogurt, fruit dips, or peanut butter. Dress your pasta: rinse and toss with olive oil, then add butter, cheese or sauce. Choose 2% or whole milk instead of skim or 1% low fat milk. Reconstitute soups and prepare oatmeal with milk instead of water. Boost baked goods such as muffins, cookies, or pancakes with an extra egg or dry milk powder. Every bite of food and every gulp of liquid can make a contribution to your child’s ability to gain weight and grow.

Incorporate a pre-bedtime snack:  Smoothies, milkshakes, instant breakfast drinks or peanut butter toast are good snacks that pack extra protein and calories before sleeping.

Stick to a schedule:  Eating meals and snacks on a consistent basis can help drive the cycle of hunger and promote adequate nutrient intake. Aim to offer meals and snacks every 3-4 hours.

Stay active:  While it may seem that physical activity would promote weight loss, it actually helps children (and adults) to build and sustain the hunger cycle.

Don’t plead, beg, or threaten your child to eat:  These actions set up a negative dynamic around food and eating for you and your child. These are controlling behaviors and may backfire in the long run, as research points out that pleading and disciplining a child to eat may lead to being pickier. Provide ample opportunity and nutritious, acceptable foods on a regular schedule and allow your child to control whether and how much she will eat.

Some children are naturally thin and some are thin due to suboptimal or inadequate nutrition.  Always seek further assistance from a Registered Dietitian or your pediatrician if you are concerned about your child’s weight.