Nutrition for your Underweight Child

child eating

Welcome to the Missouri WIC Participant Nutrition Education website. If you are a WIC participant, please enter your name and State ID number.  Type the Household ID if more than one family member is a participant.

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By the end of this session 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 your child
  • Recognize the food groups and number of servings for your child

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.

activity 1

 1. Why do you think your child is underweight?

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 under nutrition in children?

  • Too much Juice: Too much juice in the diet often replaces milk and other important food groups that the child should be eating. Juices often contain more sugar and fewer 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 children 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 vegetarian diets 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.



2. List 2 weight gain strategies.



* 3. Select if the following are Nutrient Dense foods? (Choose Yes or No)
Yes    No   
Yes    No   
Yes    No   
Yes    No   
Yes    No   
Yes    No   

My Pyramid (Kids) recommendations:

  • Grains provide carbohydrates, which is the primary source of energy and is the largest food section of the pyramid.
  • Vegetables Any vegetable or 100% vegetable juice counts as a member of the vegetable group. Vegetables may be raw or cooked; fresh, frozen, canned, or dried/dehydrated; and may be whole, cut-up, or mashed. Vegetables are organized into 5 subgroups (dark green, starchy, orange, dry and other) based on their nutrient content.
  • Fruit group Any fruit or 100% fruit juice counts as part of the fruit group. Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-up, or pureed.
  • Milk group provides calcium for bone growth and maintenance. All fluid milk products and many foods made from milk are considered part of this food group. Foods made from milk that retain their calcium content are part of the group, while foods made from milk that have little to no calcium, such as cream cheese, cream, and butter, are not. Most milk group choices should be fat-free or low-fat.
  • Meat group provides protein for building muscle and other important functions in the body. Eggs, nuts, and seeds are considered part of this group. Dry beans and peas are part of this group as well as the vegetable group. Click here for more information on dry beans and peas. Most meat and poultry choices should be lean or low-fat. Fish, nuts, and seeds contain healthy oils, so choose these foods frequently instead of meat or poultry. Click here to see more information on Why is it important to include fish, nuts, and seeds?
  • 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.

Most Americans consume enough oil in the foods they eat, such as:

  • nuts
  • fish
  • cooking oil
  • salad dressings

A person’s allowance for oils depends on age, sex, and level of physical activity. Daily allowances for fat are shown in the chart below.

Daily allowance of Fat/Oils per day*


2-3 years old
4-8 years old

3 teaspoons
4 teaspoons


9-13 years old
14-18 years old

5 teaspoons
5 teaspoons


9-13 years old
14-18 years old

5 teaspoons
6 teaspoons


19-30 years old
31-50 years old
51+ years old

6 teaspoons
5 teaspoons
5 teaspoons


19-30 years old
31-50 years old
51+ years old

7 teaspoons
5 teaspoons
5 teaspoons

* These amounts are appropriate for individuals who get less than 30 minutes per day of moderate physical activity, beyond normal daily activities. Those who are more physically active may be able to consume more while staying within calorie needs.

Click here to print My Pyramid for kids handout.

Child-Size Servings

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:

    Girl picking strawberries
  • Offering a variety of nutritious foods
  • Offering foods that are safe for the child
  • Offer quantities 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 decide 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!

Click here for information on "Picky Eaters"

Let's Review!

activity 3

* 1. At what percentile are children growing appropriately?

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

3. Should children eat the same amount of food as an adult? Why?

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

Thank you for completing the Nutrition for the Underweight Child Education Component.

* Which LWP WIC Office do you go to?  

 * Where are you taking today's lesson?

You have completed the Child Class on “Nutrition for the Underweight Child”. If you have any questions or comments, please contact your LWP nutritionist who will be glad to answer any of your questions. 

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