Question from Sarah:
Hi, I have a 7 year old boy who is extremely thin, all skin and bones. Right now he is only 46.2 pounds. He hasn’t gained any weight in over a year. His height is normal. His appetite is pretty good, although he can be picky with vegetables, etc. We had him tested over a year for food allergies, and he is intolerant to gluten, eggs, and dairy. But even with a strict diet, he still hasn’t been able to gain any weight. He is also pale with bags under his eyes. Hes very active, plays soccer and martial arts. Although because of his thin frame, he does get hurt easily. His blood test showed normal iron, vitamin D and CBC. I’m not sure what other tests if any I should be doing for him. The pediatricians I see keep saying its better to be skinny than obese, but i still feel there must be some other underlying issue with him.
Thanks for your help!
Answer from: Keith-Thomas Ayoob, EdD, RD, FAND, our contributing Nutritionist. If you want to learn more, please follow Keith’s twitter @KeithAyoob
If his height is average and his weight is about 46 pounds, then his weight is within normal limits for his height. His diet is more limited due to his allergies, and avoiding gluten, eggs, and dairy knocks out foods that can supply a good amount of calories. His pediatrician has looked at his lab work and doesn’t feel that further evaluation is needed, and that’s great news. If he’s growing normally, and he hasn’t gained weight in a year, remember that he also instituted a new and more restricted diet at about the same time as his weight stabilized. Focus on high-calorie, nutritious foods he is able to tolerate. Make him smoothies with soy milk, peanut butter and fresh fruit. Consider trying soy yogurt and soy cheese. Spread nut butters on gluten-free bread and crackers, and nuts and dried fruit are loaded with good healthy nutrition and high in calories. Make a home-made granola with the grains he tolerates, along with nuts, dried fruit, etc. that he can eat with soy milk. Granola is usually way-high in calories from the nuts and oil it contains. He can also keep trail mix (make your own or buy ready-made but check labels for any possible allergens) in his book bag as a go-to snack when he’s away from home as well. These hints should help get him on his way to appropriate weight gain that keeps up with his growth.
Keith-Thomas Ayoob, EdD, RD, FAND
Associate Clinical Professor
Department of Pediatrics
Albert Einstein College of Medicine
1165 Morris Park Ave. 4th Floor
Bronx, NY 10461
718-430-3970 ext. 6412