Q & A: My Child is Underweight

My pediatrician says my child is underweight. He suggests supplementing with formula or pediasure. What should I do?


The growth and development of infants and children is complex, intricate, and most importantly, individual. Each child has a unique genetic makeup and this, combined with unique environmental and social circumstances, helps dictate how a child grows. It is too simplistic to take a child’s weight and conclusively say that that measurement alone makes for a healthy or unhealthy child. There are lots of children who plot on a chart as underweight but are otherwise perfectly healthy, just as there are children who plot on a chart as a healthy weight but have many health issues.

Firstly, make sure your health professional is using the appropriate growth chart for your child, otherwise s/he may look, falsely, under- or overweight. Your baby’s gender and type of milk consumed are large determinants of growth. We know that boys and girls grow differently and breastfed and formula fed babies grow in different ways. The World Health Organization (WHO) has developed growth charts for health professionals to use in tracking a breastfed child’s physical growth and development, yet most pediatricians use a standard formula fed chart regardless of the type of milk consumed. The WHO charts are available online and you can print them off and take them to your pediatrician if needed.

Secondly, you need to consider your child’s diet as a whole, to help determine overall health and wellness. Children who eat high sugar, high fat, processed convenience foods and drink juice tend to weight more than children who do not eat these foods. I have not only professional experience with this issue, but personal as well. My 20 month old son has consistently been in the 5th-15th percentile for weight (yet height and head circumference and all milestones are normal). However, he was (and still is) breastfed, does not eat dairy, wheat, or sugar, and gets outside exercise for at least 2-3 hours a day. In only considering only his weight as a number on a chart he appears underweight, but considering his lifestyle as a whole, he is strong and healthy.

If after the above two considerations you feel your child is truly underweight and this brings with it health issues and you want to supplement, consider carefully the formula and pediasure options. Formulas are not a natural food to the human digestive system and make create digestive problems or health issues for your child. They are high in sugar, chemicals, and artificially created ingredients. They can increase caloric intake because of fat and calorie content, but it’s not a healthy way to increase fat and calories to support a healthy weight gain. The same applies to supplemental drinks like pediasure. The second and third ingredients listed are sugars, closely followed by the most allergenic proteins, and unhealthy oils. Also included are synthetic vitamins and colours, some known to have a relationship to learning problems. Children are sure to gain weight drinking a supplemental beverage that contains almost as much sugar per serving as soda pop but it’s certainly not a healthy weight gain.

In summary, if your child is underweight and this lower weight brings with it health concerns, consider increasing healthy fats and calories with foods like avocado, nuts and nut butters, seeds, animal meats, and fish oil supplements. Find a qualified health professional who can create an individualized food plan for your child.

Have a question for Dr. Carly? Email her.

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