To add extra calories or not?

DS just doesn’t seem to gain weight. He can be a picky eater as he’s averse to certain textures and just wont touch those foods. What he does like to eat he eats well.

About 5 weeks ago he was having a review at a Feeding clinic where he was weighed and measured. He’s 5 %ile for height and under 3 %ile for weight. While it’s not dropped too much, he’s not gaining either. They suggested adding polyjoule(?) – extra calories – to his diet. I’ve been hanging off on this as I’m in two minds and I don’t really know which way to go.

Firstly, and maybe irrationally, I don’t want to start bad eating habits, which I know so long as we offer a wide variety of fresh healthy foods, adding the extra calories shouldn’t equate to bad eating habits, so then secondly, is it creating a weight that may not be what DS is genetically made for?

He’s a happy little man. He’s had a few health issues such as constant ear infections for a couple of months, which did affect his appetite, but he’s had grommets in for 2 months now and things have changed there. Is it bad for his long term health and development to be so low on the weight range, should I meddle, or let things go naturally?

I would add some healthy items that have higher levels of energy - for example nuts and seeds. You don't need to go unhealthy to increase his calories.

I know a friend who had to use Polyjule with her DS for a medical condition. I think it is not unhealthy and if you continue to offer a wide variety of healthy foods, then you won't be setting him up with bad food habits.

Recently DS1 lost 400g over 3 weeks and was looking particularly skinny, and genetically he's a slim child. So i decided to add toddler milk to his diet (he used to have cows milk) and I now offer a wider variety of foods at each meal. I also make an effort to have higher calorie foods too, like Kryalss said. I give him nuts, sausages, cheerios, full fat cheese, homemade muesli bars. And homemade iceblocks (with fruit and cream in them) between meals. He's definately chubbed back out to his normal level of skinny-ness over the past fortnight.

But I don't let it stress me too much. They won't let themselves starve.

Polyjule can be added to anything so water milk and food. We used it for DD2 but she couldnt tolerate it so she is now on pediasure as a drink

You could always see a dietician about natural ways to increase calorie intake. Nuts and seeds are great, lots of full fat dairy, milk, yoghurts cheese. Avocado. Banana and yoghurt smoothies are calorie dense and healthy. Good luck

It's a tough one CeCe. In some respects if he is following a curve albeit at the 3rd percentile than shouldn't that be okay? It would be more worrying if he wasn't following a curve. Is his development okay? I think that could be a guide as well.

The advantage of trying to get his weight up a bit is that if he became unwell he would have a bit of room for movement with weight loss.

Our paediatric dietician told me that weight gain slows up in the second year but it is also a time when you can get some catch up weight through dietary modifications. My DS is 9 months and isn't holding a curve on the weight charts, and his height is disproportional to his height. We have to add extra calories to his food and she recommends in the second year that he have formula (I"m EE and won't go past 12 months) instead of regular milk to drink.

I'm not sure I've been much help, but I do understand your dilemma.

It's a tough one CeCe. In some respects if he is following a curve albeit at the 3rd percentile than shouldn't that be okay? It would be more worrying if he wasn't following a curve. Is his development okay? I think that could be a guide as well.

The advantage of trying to get his weight up a bit is that if he became unwell he would have a bit of room for movement with weight loss.

Our paediatric dietician told me that weight gain slows up in the second year but it is also a time when you can get some catch up weight through dietary modifications. My DS is 9 months and isn't holding a curve on the weight charts, and his height is disproportional to his height. We have to add extra calories to his food and she recommends in the second year that he have formula (I"m EE and won't go past 12 months) instead of regular milk to drink.

I'm not sure I've been much help, but I do understand your dilemma.

Thanks all.

Part of the feeding clinic is with a dietician who gave me a list of things to add to DS diet to increase calories, but try as I might I'm fighting against DS's aversions to soft, mushy food. He wont eat soft fruits, such as bananas. The dietician suggested peanut butter, but DS wont have a bar of it, as with avocado. The last couple of days we've been trying him with fruit smoothies and so far, so good; he's even tolerating banana in it, unlike the banana custard I made for him. The issue is when I try to increase the amount he's eating, he then starts to equalise himself and will eat less of the next meal.

I may get some polyjoule, or similar, just give it a go and see how it pans out. DS has low muscle tone so developmentally he's a little behind with gross motor skills, but otherwise is a very happy little man.