Does your child need increased calories? 3 common mistakes you may be making
Have you been told that your child needs more calories?
If so, I am sure you are worried about their eating and growth and may have a feeling of panic of how to do this.
In my practice I see many clients who need increased calories. Some of the reasons for this include, decreased appetite due to medication needed to treat ADHD, a caloric deficit due to increased sports activity, restricted food intake due to picky eating, multiple food allergies, a new vegetarian, or a child with a medical problem that may limit their intake.
By the time families have gotten to me, they are usually at the end of their rope. They state, “I have tried everything. I have read many things and it is not working.” Many also lament the fact that they feel their child’s eating has become unhealthy due to trying to get calories into them.
While it may be true that some products used for weight gain, like nutrition shakes, may be higher in sugar it does not mean everything you give them is higher in sugar or unhealthy.
In my years of practice I see 3 common mistakes that parents and other family member make when they try to feed kids increased calories.
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What are the 3 common mistakes?
#1- Feed them whatever they want
When a child needs more calories because they have been identified to have poor weight gain or be underweight, it is encouraged that parents and caregivers not restrict their food, this does not mean that a large portion of your groceries come from the candy and cookie aisle. Many kids do enjoy sweets, as science show they have more of a taste for that when they are younger, but choose the sweets wisely. Offer sweetened foods that have other nutrition benefits. For example, chocolate milk has added sugar, but it also has 8 grams of protein, 300 mg of calcium, and 100 IU of vitamin D, and other nutrients like phosphorus and potassium, therefore this would be better than offering chocolate cookies or brownies. This does not mean they would have chocolate milk for every meal, but if this is the only way a child will drink milk then giving it 1 time a day will give an extra 150-200 calories (depending on the brand).
#2- Feed them whenever they want
Allowing a child to graze on food throughout the day with no schedule will certainly backfire if you are trying to provide more calories. When I see kids that are doing this, they are either filling up on beverages between meals or consuming small amounts of high carbohydrate snacks. When kids are not on an eating schedule, and allowed to graze, it does not allow them to feel hungry for meals and snacks. Therefore, they constantly have something in their belly that prevents them from being hungry for meals and consuming larger portions.
#3- Making everything as high calorie as possible
I will admit at the beginning of my career I may have given this advice, but through my years of practice I have learned that it is much better to make small changes. I have seen families trying to mix heavy whipping cream and butter into everything. While this does result in giving more calories, I have seen people easily giving 4 tablespoons of heavy whipping cream and 4 tablespoons of butter through out the day and that equals 600 calories that are all coming from fat. Using this much fat to increase calories can result in children having increased symptoms of reflux due to the high fat content and having a decreased appetite.
So how do parents provide increased calories to their kids?
Establish a meal and snack schedule- Offer at least 3 meals and 2 snacks to your child on a schedule (younger kids may need 3 snacks). This does not mean you have to eat at the same time every day but, allow at least 2 hours between meals and snacks with no grazing in between. This will allow your child to be hungry for meals and snacks and lead them to consume more food.
One meal at a time- Look at how your child eats throughout the day and see how you can do something simple with each meal. For example, if they always have a banana or an apple every day, offer it with peanut butter (1 tablespoon has about 100 calories).
Use higher calorie drinks or nutrition shakes wisely- There are many ways to increase the calories in what a child drinks. Multiple ready to drink pediatric shakes (like Pediasure) are on the market to try. I recommend including these drinks as follows:
· Start by giving only one 8 ounce serving per day
· Offer it as a snack rather than a meal
· Look for a supplement that provides about 240 calories and 8 grams of protein.
I have seen that many children only have crackers or pretzels for a snack and offering 4-8 ounces of a supplement will help increase the nutrition and calories of that snack without decreasing their appetite for meals.
Many times, children may tire of these supplements. Find a food combination that will provide the same calories and offer them a choice of the drink or the food. It is important that older children feel that they have some choice in how they get their calories.
Here are food combinations that equal 240 calories:
· 8 ounces of whole milk + 1 medium banana
· 1 slice of cheese and a serving of woven wheat crackers
· ½ cup taco chips and 1 packet of guacamole
· ½ of a peanut butter and jelly sandwich and 1 cup of grapes
Use foods that are naturally higher in calories- When you are looking at the food groups all contain foods that are high in calories. For example, the fruit group has bananas, the vegetable group has sweet potatoes, the dairy group has whole milk yogurt, the grain group has oatmeal, and the meat/protein group has items like beef. Avocados are also a food that is naturally high in calories.
Providing high calories does not equal lower nutrition. However, as you can see it may require eating larger volumes of food, which is why some children do better with some high calories supplement shakes. They may find it easier to drink than eat the calories. Also, consuming more food, may mean a high grocery bill and some of the high calorie supplement drinks can be covered by insurance since it is part of the treatment for a medical condition.