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Nutrition Guidelines for Underweight Children


Being underweight is not the same as being thin or slender. Some children have a naturally slight built and maintain it with a well-balanced diet and physical activity. This is normal and healthy. Some children are naturally small, which is different than underweight. However, true underweight may be a sign of dietary, health or emotional problems.

How do I know if my child is underweight?

  • 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.
  • Growth can be monitored by looking at your child’s weight for age and height for age and comparing these with international references. This can be done by plotting your child’s weight and height in the appropriate weight and height chart, for boys and girls, depending on your child’s gender.
  • Physicians will measure your child’s weight and height to determine if your child’s weight is within a healthy range. A physician will also consider your child’s age and growth patterns to determine whether your child is overweight. Assessing underweight in children is difficult because children grow in unpredictable spurts

What are some concerns for underweight children?

  • An under-nourished child is more likely to become sick. The child may feel weak or tired, and has trouble focusing and concentrating.
  • He or she may have stunted growth or a delay in the onset of puberty.
  • In any case, it is extremely important to work with your child’s doctor or health personnel worker to help determine what is going on and how to address it.

There are several possible reasons for being underweight. This includes:

  • Not consuming enough food compared to their recommended daily intake. The reduction in food intake usually occurs much earlier either a few weeks or months beforehand.
  • Underlying illness like worm infection.
  • Stress
  • Obsessive exercise
  • Lack of interest in eating. It could be a sign of anxiety, a food allergy causing discomfort after meals, high amounts of caffeine, an excessive fear of being overweight, or even an eating disorder.
  • A sudden growth spurt.

What can I do to help my underweight child?

If your doctor recommends weight gain, the main goal will be:

  • To get your child to take in more calories, begin by planning meals and snacks with high calorie foods with reference from each food group of The Malaysian Dietary Guidelines.
  • It is important that your child consumes sufficient amounts of protein, carbohydrates an fats to provide energy for activity, growth and development.
  • Continue to promote physical activity as part of a normal routine. If your child has been playing actively, have him or her rest for at least 15 minutes before meal times.
  • Avoid giving your child foods that are high in sugar such as candies, soft drinks or high-fat foods from fast-food restaurants.
  • Limit snacking just before mealtime, as this may curb appetite.
  • Avoid caffeine; promote healthiest drinks such as milk water juice.
  • Tailor your food choices to foods that your child enjoys and will eat .

What should my child eat?

Since less food is being taken in, parents or caregivers should offer high-calorie foods. When preparing foods, provide healthy sources of added fat, such as vegetable oils in place of butter and margarine.

Examples of preparing high-calorie foods:
Rice/ porridge Added with chicken/ meat/ oil/ margarine
Bread Added with margarine/ peanut butter/ cheese
Crackers Added with margarine/ peanut butter/ cheese
Milk Added with chocolate powder / ice-cream
Eggs Added with milk/ oil/ margarine/ cheese
Potato ? mashed/ baked Added with milk/ oil/ margarine

How much should my child eat?

  • Encourage frequent eating and snacking. Six small meals may be easier to eat than three larger meals. Your child should eat as much as he or she can without feeling uncomfortable. Do not pressure your child to eat.
  • Offer plentiful meals and snacks to your child throughout the day.
  • When your child goes to school, give him or her plastic sandwich bags filled with snack foods, such as crackers, dried fruit (like raisins), carrots and nuts. .
  • At first, your child may not be accustomed to eating so much. Offer positive support for any positive changes. Realise that changes may not take place overnight. Be patient.

How can I create a positive body image in my underweight child?

  • Remember that each child is unique. Each child’s body shape is unique. Children come in different sizes, shapes, and weights. They also grow at different rates. Everybody is a good body.
  • Do not weigh your child frequently. Home should be a comfortable and accepting place for children, not stressful. Your doctor may request regular visits to monitor your child’s progress. You can use this opportunity to obtain information about your child’s weight. Also, be sensitive about discussions focusing on weight.
  • A healthy weight is weight that can be maintained healthfully, ensuring that children are well nourished, active and have a positive attitude about their body and size.

Examples of menu

Tomato Rice Treasure (Serves 4 persons)


90g rice, uncooked
1 tablespoon of margarine
30 ml tomato puree
125 ml tomato juice
125 ml water
5g vegetable oil
10 g garlic, pounded
10 g ginger, crushed
60 g onion, sliced
100 g tomatoes, chopped
125 g tender cut of beef (eg: striploin), thinly sliced
Salt, sugar and pepper to taste


  • In an electric rice cooker, cook rice with tomato puree, 1/4 of tomato juice and water. Add 1 tablespoon of margarine.
  • Meanwhile, saute, ginger and onions in a separate pan. Add in chopped tomatoes and remaining tomato juice. Add beef slices. Cook until the meat is tender. Add extra water, if required. (for very young children, use minced beef or chicken)
  • Remove from flame and set aside.
  • Scoop cooked rice into small round jelly moulds. Make a hollow at the centre of the rice and scoop in the stir-fried beef.
  • Turn out the tomato rice with beef onto a plate and serve.

Nutritional Content Per Serving

Calorie (kcal) = 173
Protein (g) = 10.0
Iron(mg) = 3.5
Fat (g) = 2.0
Calcium (mg) = 25


An example of a menu with High Calorie Food for Children Aged 1-3 Years Old
1 glass of milk (full cream milk)
1 slice french toast
2 teaspoon margarine
Morning Tea
1/2 slice papaya
2 pieces biscuits
1 glass milk based drink
1 cup of rice (added with 1 1/2 tablespoon cooking oil/ margarine)
1 Ikan Kembong
1 cup spinach
1 glass plain water
1 banana
1 cup fried mee (added with 1 1/2 tablespoon cooking oil/ margarine) with 2 pieces chicken (match box size and chopped)
1/2 cup vegetables
1 glass plain water
1/2 slice papaya
1 glass milk (full cream milk)


An examples of menu with High Calorie Foods for Children Aged 4 – 6 Years Old
1 glass of milk (full cream milk)
1/2 glass fried rice (added with 1 1/2tablespoon cooking oil/ margarine)
1/2 cup vegetables
1 fried egg
Morning Tea
2 pieces cream cracker biscuits
1 tablespoon margarine
1 glass milk based drink
1 cup of rice (added with 1 1/2 tablespoon cooking oil/ margarine)
1/2 fish standard size
1 cup vegetables
1 glass plain water
1 banana
Afternoon Tea
1 piece of currypuff
1 slice of bread
1 glass of milk based drink
1 cup rice (added with 1 1/2 tablespoon cooking oil/ margarine)
2 pieces chicken (match box size)
1 cup vegetables
1 glass plain water
1 apple


Last reviewed : 11 November 2008
Writer : Rashadiba bt. Ibrahim