When our child looks thin or skinny, we, as parents tend to worry. The funny thing is, at a time when we worry about overweight and obesity, there are quite a number of children who struggle to put on weight.

Being underweight (too thin for their height), especially during a child’s early years, can lead to serious developmental consequences later in life. Some of these consequences include frequent sickliness, anemia, learning and attention issues, and failure to start walking, talking or grow taller. In fact, based on the National Health and Morbidity Survey 2022, one in five children in Malaysia is stunted (too short for their age) while one in ten is affected by wasting (severe weight loss due to malnutrition).

An earlier report says that the proportion of underweight and stunted (too short for their age) Malaysian children under five years of age increased from 11.6% and 16.6% respectively in 2011 to 14.1% and 21.8%, respectively in 2019.

While something can be done to help children gain weight if they are underweight, stunting is irreversible.

Many Reasons Why a Child May be Underweight

Not all cases of childhood thinness lead to such dire outcomes of course. It may be a passing phase such as a growth spurt, changes to their circumstances or environment like moving to a new school or new home or new area, illness, an undiagnosed food allergy or intolerance, teeth and oral problems, gastrointestinal conditions, worms, or even behavioral, developmental or neurological issues.

Certain medications can also interfere with appetite leading to weight loss or weight plateaus in kids. Some drugs used for treating attention-deficit hyperactivity disorder (ADHD), for example, are known to affect appetite. You could talk to your pediatrician to voice your concerns.

Genetics could also play a role in the child’s slender frame. The parents’ body shape often determines that of their child, although all children must gain weight in order to grow, regardless of hereditary factors. If the child is not growing out of their clothes after a long while, and his rib cage is sticking out too much, then it may be time to check with the paediatrician.

If the Problem is Caused by Diet

Assuming your child has no underlying medical issues, and he is otherwise active and alert, but needs to put on a few pounds, then, as parents, there is certainly something you can do about it.

Since this is about his diet, you can control or alter it so that he or she takes in the right, or enough calories, nutrients and minerals to support healthy growth and development.

Check for the Correct Weight

Before you begin, do check to see if your child is really underweight for his or her height and age, or if he is just looking a little bit skinny to you.

A good way to check is by calculating his Body Mass Index (BMI).

Use this BMI Calculator.

The child’s results will be given as a percentile and will show if they are at a healthy weight for their gender, height and weight. For this reason, you will need to provide their age, height and weight accurately.

Tips for Weight Gain for Underweight Kids

If your child is underweight, start by ensuring that most meals and snacks are nutrient-rich. They will also need to take in more calories. According to Malaysian Dietary Guidelines for Underweight Children, the nutrients most needed for these children to gain weight and grow are: Protein, carbohydrates and fats.

1. Protein: Protein is a very important nutrient that provides essential amino acids that help children grow and develop properly. Protein is a part of every cell in the body and helps to build and repair muscles, tissues, skin, nails and hair. Protein also helps build hormones, enzymes and a healthy immune system. A research paper on the role of protein in children says that high quality proteins such as those in milk have been found to be effective for good growth because individual amino acids such as lysine and arginine have been found to be linked to growth hormone release in young children. Protein intake in early life is positively associated with height and weight by 10 years of age.
2. Carbohydrates: When eaten, carbohydrates are broken down by the body into simple sugars. These sugars circulate in the bloodstream to provide the body’s cells with energy. The brain uses one of these simple sugars (glucose) as its primary source of energy. The growing child needs carbohydrates to stay alert and active. Very active children need more carbohydrates (energy) to burn and so do underweight children to help them gain weight.
3. Fats: Babies, toddlers and young growing children need more fats in their diet than adults. This is because fast growing bodies need fats for growth and development. Fats fuel the body and help absorb fat soluble vitamins such as Vitamins A, D, E and K, without which the body cannot absorb them. Fats are also needed for brain development. The brain is 60% fat. Fats store energy, insulate the body, protect the vital organs and help proteins do their job.

Pay attention to certain nutrients such as Calcium, Vitamin D and Vitamin A as the Nutrition Survey of Malaysian Children (SEANUTS Malaysia) says that 50% or one in two children did not fulfil the Recommended Nutrient Intake (RNI) for Calcium and Vitamin D while Anaemia, Iron Deficiency and Iron Deficiency Anaemia (caused by a lack of Vitamin A is at 39.8% among school children below the age of 10.

In a 2023 study published in the New Straits Times, one in three children have been found to be at risk of Iron Deficiency Anaemia. Its key findings found that young children were at a higher risk of being anaemic than older children while underweight children are likely to be anaemic. Furthermore, both urban and rural children are equally at risk of anaemia.

What Not To Do

• Do not give empty calories such as foods that are high in unhealthy saturated fats (deep fried empty flour snacks), salt and added sugars. These foods might add a few kilos but they will not provide the nutrients the child will need to build strong bones and a healthy body.
• Do not give caffeine or caffeinated drinks such as fizzy sodas.
• Do not give them drinks and snacks before their main meals. They might be too full to eat their proper meals and miss out on essential nutrients.
• Do not get frustrated if they do not finish everything on their plate. Do not force them to eat food they do not want to. It might turn mealtimes into a negative experience and make them associate eating with punishment and that will make the situation worse.
• Do not force them to eat or try foods they are do not want to eat. Instead, use creativity to change it up to entice them. Sometimes, it’s the presentation that makes the difference. Make food and mealtimes fun.
• Do not skip meals especially breakfast. If there’s no time to eat owing to the very early hours the child must go to school, have him drink a glass of milk. Fortified, formula milk with all the necessary nutrients in such as Morinaga Chil-kid would be a good idea.
• Do not stop them exercising or being active. Physical activity helps them develop stronger bones and muscles. However, if your child has been playing actively, do have him or her stop and rest for at least 15 minutes before eating.

What To Do

• Include more starchy carbohydrates such as tubers (potatoes, sweet potatoes, yam, tapioca) bread (both white and wholemeal), rice, beehoon, kway teow, mee, laksa, and putu mayam.
• Increase calorie intake with healthy fats by adding dairy or dairy products such as grated or cream cheese to meals or milk to porridge. Or make creamy soups instead of clear consommé. Add an egg or cream into the soup to thicken it.
• Add butter or margarine to pasta, rice, mashed potatoes and steamed sweet potatoes.
• You can bump up calories to fruit snacks too by adding toppings such as yoghurt to apple slices, or a spoonful of peanut butter to bananas, or avocado topping or milk when scrambling eggs to make it creamier or richer.
• Give them high calorie drinks in between meals such as milkshakes or smoothies.
• Make mealtimes happy times. Eat together. Meals should be enjoyed together without the distraction of devices being brought to the dinner table.
• Eat smaller but more meals. Children who are underweight should not be limited to eating only three meals a day but up to five or even six times a day whenever they feel hungry. Some of these “mealtimes” can consist of rich beverages or soup.
• Have snacks available whenever they are hungry. Try yoghurt or biscuits dipped in milk.
• Provide a variety of age-appropriate foods and introduce them gradually and in small portions over a few days. If they are toddlers and are fussy eaters, this will help them get used to the texture and taste of these new foods.
• Give them fatter cuts of meat. Chicken should be served with skin on. Eat fatty fish like Salmon. It has 515 milligrams of Omega 3 per 100gm fillet.

Omega 3 fatty acids (ALA, EPA and DHA) are the Number One brain food for the child. Apart from boosting brain function, development and learning, Omega 3 also provides other benefits such as vision, heart, skin and immune health and helps with lessening anxiety, stabilizing mood and behaviour while promoting better sleep. With the child feeling better, it may even help promote a better appetite.

If salmon is too expensive or is unavailable, there are many other local fish that are also impressive sources of Omega 3.

A few examples of Omega 3-rich local fish are:

5. Siakap – Fat Content: 2.7gm per 100gm fillet | Omega 3 Content: 139milligrams per 100gm fillet.
5. Ikan Kembung − Fat Content: 1.8gm per 100gm fillet | Omega 3 Content: 370 milligrams per 100gm fillet.
5. Bawal Putih − Fat Content: 2.1gm per 100gm fillet | Omega 3 Content: 406 milligrams per 100gm fillet.
5. Bawal Hitam − Fat Content: 2.3gm per 100gm fillet | Omega 3 Content: 772 milligrams per 100gm fillet.
5. Ikan Keli − Fat Content: 13gm per 100gm fillet | Omega 3 Content: 1,240 milligrams per 100gm fillet.
5. Ikan Patin − Fat Content: 6gm per 100gm fillet | Omega 3 Content: 1.75milligrams per 100gm fillet.
5. Sardines − Omega 3 Content: 2,955milligrams per 100gm fillet. The entire fish in the tin can be consumed.
5. Ikan Tenggiri − Omega 3 Content: 850 milligrams per 100gm fillet.
5. Ikan Bilis − Fat Content: 3.1gm per 100gm fillet | Omega 3 Content: 6.6milligrams per 100gm fillet.
5. Tilapia − Omega 3 Content: 16milligrams per 100gm fillet.
5. Ikan Haruan – Fat Content: 2.1gm per 100gm fillet |Omega 3 Content: 40milligrams per 100gm fillet.

How Morinaga Chil-kid can help Children Fulfil Kids’ Daily Nutrient Requirements

Formulated for Asian children aged one to seven, Morinaga Chil-kid is a Japanese formulation that has all the nutrients a growing child needs. You wouldn’t have to worry about your child not taking in enough Vitamin A, D, Calcium or all the essential fats, carbohydrates and protein because the formula is packed with over 45 essential nutrients to that meets the needs of fast-growing children.

Coupled with proper nutrition from their daily meals, just two servings of Morinaga Chil-kid a day can help your child achieve his or her daily Recommended Nutrition Intake (RNI).

The milk provides 100% protein as well as polyunsaturated and monounsaturated fatty acids like DHA, ARA, Omega 3&6 LCPs, the prebiotics GOS, 5 Nucleotides plus 27 Vitamins and Minerals including Vitamins A, D, the B group vitamins, plus Calcium, Iron and many more.

Morinaga Chil-kid’s formulation is backed by Morinaga’s R&D Institute in Japan with a history of over 100 years of innovation. All of the milk comes from cows in the Netherlands and is produced and packed in a state-of-the-art plant in the Netherlands which go through a double inspection process before being exported to Malaysia.