“My child is so skinny.” “My child will not eat anything nutritious; they survive on soda and biscuits.” “My child throws up whenever I force them to finish their meal.” These and more are the challenges parents raising underweight picky eaters understand too well.
Donna Ndamira has been struggling for the past five years with a daughter who has suffered from anaemia simply because she refuses to eat anything that is not junk. Five-year-old Theresa is happiest eating fries and soda. At three she was hospitalised with severe anaemia so, Ndarama started being very cautious about her feeding.
Dr Edward Mugisha, a paediatrician at Kabarole Hospital, says: “A lot of children are naturally thin. They follow a fairly steady growth curve. If you are concerned about their size, it is prudent to see a paediatrician who will measure them using objective tools and confirm whether they are healthy or not.”
According to Dr Mugisha, children grow a lot during their first 12 months, gaining as much as seven kilogrammes. Between one and five years, children gain about two kilogrammes a year. After that, weight gain slows down, with most children steadily picking up a couple of kilogrammes each year until puberty. “So do not rely on your eyes, a child can look small in size when their BMI is healthy and that is what matters most,” he explains.
Dr Joe Opio, a paediatrician, cautions parents against forcing their children to eat. “Give them nutritious foods, and make mealtimes enjoyable. It may not seem like your child is eating much, but over the course of a day or a week, it is probably more than you think. Keep in mind that children have small stomachs, and some can only manage a few bites at a time. Because of this, they need to eat more often,” Opio explains.
He urges parents to leave a variety of nutritious snacks such as yoghurt, peanut butter, smoothies, carrot sticks in rooms other than the kitchen where children can easily access them.
Grace Nansamba, a mother, says involving her son in planning the menu and shopping the food makes him more interested in it. “I explain the role of each food to him, offering alternatives to each type and asking him to choose which ones we should buy. He is always looking forward to tasting them,” Nansamba explains.
Dr Opio observes: “As much as you want the child to eat extra calories, it is unhealthy to do so with fatty foods. Instead, go for protein-rich foods such as dairy and offer foods rich in healthy fats such as nuts and avocados, among others,” he advises.
Wean your child off junk especially if they are underweight because the nutritional value of foods still matters since they eat so little. Serve one food that you know they like with every meal. Cut back on liquids such as juice and replace these with whole milk or water at meals.
Underweight leads to anaemia and fatigue, and has been linked to poor attention and difficult behaviour in children. Low body mass in children can also delay puberty. If your daughter is below the 15th percentile for body weight and has not started showing signs of puberty or menstruating by age 15, consult your paediatrician for further examination.