Some children would rather talk and move than eat. They tend to be “built like a stick.” But that does not mean that they are underweight. As our children are still growing, it is sometimes difficult to tell if they are just thin or underweight.
A child who is approximately 2 to 4 kg below the standard weight for age range is considered underweight. Doctors use the body mass index (BMI) measurements to assess a child’s physical weight. The BMI takes the height, weight, gender and age into consideration.
A survey conducted by the Singapore Nutrition and Dietetics Association and Abbott (2018) of 1,002 parents with children between the ages of two and six, revealed that about 42 percent of the parents expressed concern over whether their child weighed less or was shorter than other children in the same age group.
“A child’s size matters to parents and may give rise to anxiety, especially when comparisons are being made with the child’s peers,” says Associate Professor Fabian Yap, the head and senior consultant at the endocrinology service of the department of paediatrics at KK Women’s and Children’s Hospital. This is why children’s growth should be monitored to reassure parents that their child is growing at the expected annual height and weight increments.
What are the causes for your child to be underweight?
There are many reasons that result in underweight children. Poor weight gain in young children can be caused by acute or chronic illness such as the common cold and respiratory infection.
Fussy eaters with poor appetite, over-dependence on milk and poor feeding habits such as allowing children to run around while spoon-feeding them at mealtimes can result in an underweight child. Imposing a restricted diet on a child can also cause some children to be underweight.
Dr Janice Wong, a paediatrician and specialist in neurology, neurorehabilitation and neurodevelopment at Thomson Paediatric Centre, shares that Singaporean parents are not sure how to assess growth. “A child’s development is not related to size, as he can be small-or big-boned. It is the nutrition that he gets that matters,” she noted.
She adds that “as long as the child stays within the growth curve, he is fine. If his weight drops too much too soon or if he is off the charts, then he is not fine. It’s important for parents to know about normal growth so they can seek help when needed.”
What can parents can do?
Want to ensure that your child is eating well and gaining weight in a healthy way?
Implement these healthy eating and feeding habits.
1. Encourage Self-Feeding
Help your child develop healthy eating habits. Always eat meals or snacks at the dining table. Provide plenty of vegetables, fruits, and whole-grain products and choose lean meats, poultry, fish, lentils, and beans for protein.
Encourage your family to drink lots of water. Limit sugar-sweetened beverages like juices or soft-drinks. Avoid consuming products with too much sugar and saturated fat.
2. Make Favourite Dishes Tastier
Some of the favourite meals for children include pasta, mac-and-cheese, pizza and French fries. If your child is underweight, include more milk-based meals/snacks like cereal with milk or carbohydrates like pasta, mashed, baked or oven-roasted potatoes.
Add dry milk powder to foods like mashed potatoes, cream soup and shakes to boost calories, protein and calcium. Make shakes and smoothies with fruit, 100 percent juice and yogurt or milk.
3. Recognise Your Child’s Feeding Patterns
Work with your child’s appetite. Some children prefer smaller portions but eat more regularly throughout the day, while others enjoy three meals in a day. For your underweight child, drink lots of juice and low-fat milk and eat nuts, seeds and avocados because they are healthy fat sources to help your child gain weight.
4. Make Mealtimes Enjoyable
Children tend to eat more when they enjoy their meals. Involving them in the preparation of the meals may motivate them to eat the meals they helped prepare. Allowing them to have control over their portions also encourages them to eat rather than “fuss” over their food intake.
5. Encourage Active Outdoor Play
It goes without saying that exercises are good for your child’s physical health. It will also get your kids hungry and ready to eat.
Incorporate at least 60 minutes of moderate-intensity physical activity most days of the week, preferably daily. Do 20 to 30 minutes of physical activities just before mealtimes.
Bring your toddlers downstairs to the playground or field for walks, tag-games or kick a ball. Go swimming if there is a pool available. On rainy days, put on the music and dance with your child or skip rope.
Consult a doctor or dietitian to get to the root of the cause of your child’s underweight issues. This is to ensure you are meting out the right treatment to help your child gain weight.
Tell us what you do to help your underweight child grow healthily.