Mohave County WIC

Nutrition for your Underweight Child

 

By the end of this lesson you will:

Understand the importance of recording weights and heights of a child
Identify two causes for undernutrition in children
List two weight gain strategies for you child
Recognize the food groups and number of servings for your child

 

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Activity 1:   Why do you think your child is underweight? (optional)

 

Should I monitor my child's weight and height?

Childhood is a time of growth both physically and mentally.  After infancy, growth in children slows down and occurs in spurts.  Weight and height measurements plotted on a growth chart are used to determine the growth pattern of a child compared to other children with typical growth patterns.

On one of your visits to WIC, you may have heard the term "percentile" and wondered what the word actually means.  Percentile is the ranking of a child among 100 other children of the same age and sex.  If a child is in the 50th percentile for weight or height for age, this means that 50 children will weigh more or be taller than this child and 50 children will weigh less or be shorter than this child.

 

Assessing Growth:
Growth is a good indicator of a child's nutritional status.  A child's growth is assessed by a health professional to determine if the child is keeping up with his or her growth pattern.
Children who are between the 25th and 75th percentiles are considered to be growing appropriately.  Children who are between the 10th to 25th percentiles may also be growing appropriately but their food intake needs to be evaluated.  Children who are less than the 10th percentile may also be growing appropriately but are considered to be at risk for growth failure and need to be closely evaluated.

 

What are some causes for undernutrition in children?
Too much Juice: Too much juice in the diet often replaces milk and other important food groups because the child has become too full. Juices often contain more sugar and less vitamins than fresh, canned, or frozen fruits.
Low-fat diets: Some parents become concerned about heart disease and obesity and may decide to offer their children only non-fat or low-fat food products such as skim milk, or they may decide to reduce calories.  It is recommended that kids under 2 years of age not be put on a low-fat diet or eating plan as they need adequate fat for growth and brain development.  Fat is important for storing energy, protecting and insulating the body and absorbing fat-soluble vitamins in the body.
No breakfast: Children who skip breakfast eat less calories and nutrients than those children who eat breakfast.  If there is little time for preparing breakfast, choose foods that are easily prepared or are ready-to-eat such as yogurt, fruit bars, milk and leftovers. 
Diets that restrict food groups or diets that are inadequate: A vegan diet consists of only plant foods and may not provide the recommended amount of calories, vitamins and minerals required for growth.  A vegan diet requires careful planning to ensure children receive nutrients from other sources of food.  see also Vegetarian Diet in our list of lessons!

 

Weight Gain Strategies:
Childhood is a time when eating behavior changes.  Since the child is not growing as fast as when he/she was an infant, his/her appetite has decreased.  Since less food is being taken in, parents or caregivers should offer nutrient dense foods and energy dense foods.  

What makes a food nutrient dense?  A food is nutrient dense if the vitamin and mineral content is more than its energy or calorie content such as lean meats, beans, oranges, carrots, broccoli, whole-wheat bread, and whole-grain breakfast cereals.  

Energy dense foods contribute more calories than they do nutrients such as chips, sodas, cookies and ice cream.  Remember to balance healthy nutrient dense foods with energy dense foods.  Here are some examples of weight gain strategies:

Provide small frequent meals with nutrient dense foods and energy dense foods and drinks.
Add fat to foods such as margarine on mashed potatoes and toast, mayonnaise and cheese on sandwiches.
Offer whole (not reduced) fat products such as whole milk, cottage cheese, cheese, creamed soups, pudding and yogurt.
Add calories to foods such as canned fruit in heavy syrup and vegetables with cheese sauce.

 

Activity 2:

1. List 2 causes of undernutrition.
a.
b.

 

2. List 2 weight gain strategies.
a.
b.

 

3. Which of the following are Nutrient Dense foods? (choose all that apply)
chocolate chip cookies
banana
special K cereal
potato chips
skittles
carrots

 

 

How Much and What Kinds of Food Should I Offer My Child?
The Food Guide Pyramid developed by the United States Department of Agriculture (USDA), is a guide for daily food choices for children over 2 years old through adulthood.  The food Guide Pyramid recommendations ensure adequate calories and nutrients needed for growth and development.  It encourages a healthy diet that provides a variety of foods, balance of foods from major food groups, and moderate intake of food.

The Food Guide Pyramid recommends:

Grains provide carbohydrates which is the primary source of energy and is the largest food section of the pyramid.  We need to consume  6-11 servings per day.

Fruits and Vegetables provide vitamins and minerals for healthy skin, hair and vision.  They are also a good source of fiber which helps reduce cholesterol.  It is recommended that we eat 2-3 servings of fruit which includes 1 piece of fruit or melon wedge, 3/4 cup of juice, 1/2 cup of canned fruit and 1/4 cup of dried fruit.  The recommended number of vegetables is 3-4 servings which including 1/2 cup of chopped raw or cooked vegetables or 1 cup of raw leafy vegetables.

Milk group provides calcium fro bone growth and maintenance.  The recommendations for this food group is 2-3 servings which includes 1 cup of milk or 2 ounces of cheese.

Meat group provides protein for building muscle and other important functions in the body.  It is recommended that we eat 2-3 servings from this group which includes 2 to 3 ounces cooked lean meat, poultry or fish, 1/2 cup cooked dry beans, 1 egg or 2 tablespoons of peanut butter*. *Peanut butter may cause choking in 2-3 year old children.  Always watch children during meals and snacks. 

Fat and sweets provide additional calories and should be used sparingly so that they don't replace more nutritious foods needed for growth and good health. Fat is needed in a child's diet and should not be restricted.

Child-Size Servings
Serving sizes for children should be appropriate for their age and energy needs.  As a rule of thumb, children ages 4 to 6 years should consume the minimum number of servings from the Food Guide Pyramid.  Children 2 to 3 years old need smaller servings which is approximately 2/3 of a regular serving size.  Offer selections in small portions and allow children to ask for more to satisfy their hunger.  Huge servings may overwhelm the child.  Offer 3 meals and 2 snacks a day at regular times.  

 

Make Eating an Enjoyable Experience

Parents are responsible for providing a safe and enjoyable environment during meal times which would include:

Offering a variety of nutritious foods

Offering foods that are safe for the child

Offer serving sizes that are appropriate

Eating meals at the table and at regular times

Serving as good role models when choosing foods to eat

Not pressuring or bribing the child to eat

Avoid arguing or negative behaviors during meals

Parents are also responsible for what your child is offered to eat, where, and when it is presented.

 

Children also have responsibilities:

They decide how much food to eat

They decides whether he/she eats at all

 

Food Can be Fun
Be creative when preparing foods.  You and your child can invent new snack ideas.  Involve your child when preparing nutritious meals and snacks and teach them the importance of healthy eating.  Children's food preferences change over time so let them to experiment without added stress.  Offer a variety of foods and let them exercise their independence and choose the foods they like!

 

For information on "Picky Eaters", click here!

 

Now let's review!

Activity 3:

1. Children in what percentile are growing appropriately?
Greater (>) than the 90th percentile
Less (<) than the 5th percentile
Between the 25th and the 75th percentile

 

2. Why is it necessary to understand the importance of recording weights and heights of a child ?

 

3. Should children eat the same number of servings as an adult? Why?

To print out a handout on tips to increase your child's calories, click here!

 

Which WIC Office do you go to?

Bullhead City
Kingman
Lake Havasu City

Where are you taking today's lesson?

        

Congratulations!!!

 

You have completed the lesson on “Nutrition for the Underweight child”.  If you have any questions or comments, please e-mail one of our nutritionists.  We’ll be glad to answer any of your questions.

In Kingman you may contact a Nutritionist at kngnutr@co.mohave.az.us
In Bullhead City you may contact a Nutritionist at bhcnutr@co.mohave.az.us
In Lake Havasu City you may contact a Nutritionist at lhcnutr@co.mohave.az.us

* If you have an extra minute, please fill out our survey on the WIC home page (where you chose this class) so we can better serve you.  Thank You.

Answers:

Activity 2: 

 

1. Drinking a lot of juice throughout the day, low fat diets, skipping breakfast, eating non nutrient dense foods
2.
Provide small frequent meals with nutrient dense foods and energy dense foods and drinks.
Use high calorie, weight gain supplements such as Pedisure under a physicians recommendation.
Add fat to food such as margarine on mashed potatoes and toast, mayonnaise and cheese on sandwiches.
Offer whole (not reduced) fat products such as whole milk, cottage cheese, cheese, creamed soups, pudding and yogurt.
Add calories to foods such as conned fruit in heavy syrup and vegetables with cheese sauce.

3. Bananas, Special K, and Carrots are nutrient dense foods.

Activity 3: 

 

 

 

1. Children who are between the 25th and 75th percentiles are considered to be growth appropriately. 
2. Children who are between the 25th and 75th percentiles are considered to be growth appropriately.  Children who are between the 10th to 25th percentiles may also be growing appropriately but their food intake needs to be evaluated.  Children who are less than the 10th percentile may also be growing appropriately but are considered to be at risk for growth failure and need to be closely evaluated.
3. Serving sizes for children should be appropriate for their age and energy needs.  As a rule of thumb, children ages 4 to 6 years should consume the minimum number of servings from the Food Guide Pyramid.  Children 2 to 3 years old need smaller servings which is approximately 2/3 of a regular serving size.  Offer selections in small portions and allow children to ask for more to satisfy their hunger; huge portions may overwhelm the child.  Offer 3 meals and 2 snacks a day at regular times.  

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Revised: August 25, 2004
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