Caloric supplementation for underweight children is an important issue, as proper nutrition for optimal growth and development is crucial during early years. Proper nutrition consists of providing adequate calories and nutrients to sustain a positive energy balance while providing healthy, nutritious choices in place of calorie-laden junk foods. Recommendations for increasing calories in pediatric diets depend on the age of child and feeding methods utilized.
Youngest Years
For a child receiving breastmilk, the use of a lactation consultant to aid the mother in proper latching technique, positioning, and techniques to increase milk supply may be beneficial. Assistive devices, such as a feeding cup or supplemental lactation device may also be beneficial. According to Dietitians of Canada, "Supplemental breastmilk, with or without formula has not been fully studied, however it is frequently used to supplement infants who are growth faltering." Both breastfed and bottle fed babies, including those requiring extra calories, should be introduced to solids at about 6 months of age. During this transition, especially for children who require extra nutrition, it is important to continue to receive adequate volumes of breastmilk or formula.
Older Infants and Toddlers
Strategies for toddlers and older infants include provision of high energy foods and possibly a nutrition supplement. Parents and caregivers should avoid forcing a child to eat as evidence shows this leads to future food refusal and does not help with weight gain. To help increase intake, adults can eat alongside children and consume the same foods. They can also offer foods in fun and interesting ways, such as shapes and different colors, and provide new foods along with older, familiar ones.
Energy Dense Foods
Unlike adults, younger children do not require lower calories or fat in their diets. Providing children with healthy fats, including whole milk and alternatives, margarine on toast in addition to peanut butter, sour cream in mashed potatoes, and extra canola or olive oil on salads are healthy suggestions for increasing calories. The addition of dry milk powder, honey, margarine, or cream to foods can also help to increase calories consumed.
Nutrient and Energy Dense Food Examples
Specific examples of nutrient and energy dense foods which kids tend to enjoy include, peanut butter and other nut butters, cheese, yogurt, dried fruit, milk, and juices. Examples of nutrient and energy dense meals include, macaroni and cheese, chicken nuggets and fries, and peanut butter toast. Snack suggestions for increasing calories for children include fruit with real whipped cream, yogurt parfait with fruit and nuts, fruit canned in syrup, and cheese and crackers. Additional ideas include homemade puddings or smoothies made with whole milk, and gelatin dessert made with fruit juice instead of water.
Pediatric Supplements
Nutrient and energy dense foods should be tried to increase calories before the addition of a supplement. If a supplement is required, there are several pediatric nutritional formulas available that meet the specific needs of children for growth and development. Examples include specialized protein and calorie powders and clear or milkshake consistency-like drinks from manufacturers such as Boost and Abbott.
References
- "Dietitians of Canada"; Pediatrics- Failure to Thrive (Growth Faltering): Key Practice Points; 2009
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