After reading our article “Skinny Kids: How do you know your child is malnourished?” ZisBoomBah reader and mom blogger Sarah Varney of Joys of Single Motherhood wrote to us, sharing that she is beginning to experience an issue regarding her preteen son. At 12 years old, Sarah’s son weighs only 61 pounds.
“He was drinking Ensure once a day, and that was working,” Sarah writes. “But then he got tired of the taste.” And who can blame the growing boy? What’s making it even more challenging for Sarah to ensure his son gets the nutrition he needs to be healthy and succeed in school, is that “he doesn’t ‘feel hungry’ — almost ever.” The single mom writes that her son is also a picky eater. “And it’s getting worse instead of better. I’m beginning to worry,” she says. Sarah has turned to the ZisBoomBah community, seeking other moms faced with similar issues and to ask for any suggestions.
To offer Sarah and so many other parents faced with underweight children who, at the same time, are picky eaters, we turned to our trusted child nutrition expert Dr. Keith-Thomas Ayoob, EdD, RD, FADA. Here is what he responded:
Expert advice by Dr. Keith-Thomas Ayoob
- Self-esteem issues can accompany the preteen age. It’s often a rough time for kids.
- While Ensure is complete nutrition, it should never be a goal for a kid who is fully able to eat regular table food. The extra 250 calories once a day are simply not enough to make up for the calories a preteen picky eater might be missing elsewhere. Any supplement drink should be in addition to regular food, not instead of it.
- Some kids — albeit very few — are telling the truth when they say they don’t feel hungry. Any emotional turmoil, including depression or anxiety, and self-esteem issues, can lower a child’s appetite. To rule out emotional problems or underlying medical issues, talk to your child’s health care providers.
- Tell your child that sometimes we eat because we like to, but sometimes it’s because we need to.
- Have him list his favorite foods in each food group: favorite fruits, veggies, meat, dairy, grains. Aim for at least three in each category. This gives you something to work with. Have these foods around as often as you can.
- Find out when he’s most hungry, even if he’s still not really hungry. Give the biggest meal with the most calories then. Start each meal with the high-cal foods, so if he fills up early, he’s still eaten a fair amount of calories.
- Don’t be afraid to add some fat to his veggies and pasta. The rules for him are different right now than for most other kids. Use oil whenever you can, but also add cheese to make veggies higher in calories and protein.
Read: “Skinny Kids: Boost meals for healthy weight gain“
- Snacks and desserts aren’t throw-away calories.
- Get him involved with making his own shakes and smoothies. Add in some peanut butter, full-fat Greek yogurt or even high-cal ice cream. Snack on some homemade trail mix with favorite nuts and dried fruits. If he makes the combo he likes himself, he’s more likely to eat it. He can have it in his backpack for whenever he’s hungry.
Read: “Grab-and-Go Snacks: Homemade Trail Mix Recipes Kids Can Make“
- Instead of the Ensure, try whole-milk chocolate milk or let him make his own flavors with some extracts and honey or sugar. Orange extract and a sweetener makes a drinkable “creamsicle.”
- Set a goal of gaining 10 pounds over the next 3 or 4 months. If he has a phone, get him an app to track his calories. Start with an aim for 2500 calories daily and have him track his progress.
- Physical activity is a mood booster and can even help normalize a child’s appetite and direct those calories to the right places.
- Above all, tell your child every day what he is doing right. Kids need praise and positive reinforcement, especially at that age.
- Reinforce that none of this is about appearance, it’s about his health.