Queen Teen is tiny compared to other 13 year old girls. At 4'10" and 77 pounds she is just below the small end of "normal" on the growth charts. Her height and weight are proportional though, so she doesn't look too skinny. She's not starving for calories.In fact, she's healthy and eats enough food to fuel a linebacker. The problem is she burns so much energy just trying to maintain her balance and see where she's going, every calorie disappears and nothing remains to be converted into fat. Just breathing puts her food intake at a deficit.
Being so tiny is only a problem when she gets sick and stops eating, so to ward off the starvation that comes from catching the flue, I took her to see a Dietitian.
Every Nutritionist and Dietitian I've ever talked to has been grumpy. I guess I'd be too if people came to see me to discuss their diet and then promptly ignored everything I told them about what they should eat. Happily, the Dietitian Queen Teen and I talked to was cheerful and great with kids. She took out plenty of plastic models of food and let Queen Teen explore and chat about what she liked to eat. The woman had Queen Teen laughing and sharing ideas in less than ten minutes, which is a record these days. Most doctor's appointments begin with a surly mood the second we enter the building and it only gets worse from there. I guess props help, especially a piece of rubber Swiss cheese with holes you can look through like a spy glass.
The Dietitian and I discussed ways to help Queen Teen bulk up, including adding butter to EVERYTHING. Basically her diet is good, with plenty of fruits and vegetables, protein, and not too much junk. The Dietitian encouraged me to let Queen Teen eat anything she wanted, including junk food and ice cream, especially since Queen Teen doesn't have a big sweet-tooth. This is a kid who can use all those empty calories.
Here is a recipe for a milk shake which will add 600 extra calories to Queen Teen's diet:
Base: 1/2 cup whole milk.
2 T powdered milk (get the whole milk kind, not non-fat)
1/2 cup ice cream
The base has 400 calories and 12 grams of protein.
Then add any kind of flavoring you wish. The more you add, the more calories.
2 T chocolate syrup, butterscotch syrup or any fruit syrup = 90+ calories
1/2 C mashed banana + 1/2 tsp. vanilla = 64 calories
2 T jam or jelly = 120 calories
3 T malt powder = 115 calories
1/2 C fruit or 1/4 C fruit juice = 40 calories
A couple of favorite combos are:
2 T chocolate syrup + 2 T peanut butter = 265 calories
2 T peanut butter = 1 T honey + 1/4 tsp vanilla = 240 calories
If you need to add more protein, use 1/2 pkg of Instant Breakfast (65 calories and 4
grams of protein) or 1/4 C egg substitute (70 calories and 6 grams of protein).
If I make Queen Teen a shake using the base (400 calories and 12 grams of protein) and add in the Chocolate and Peanut Butter favorite combo (265 calories and 9 grams of protein) plus some egg substitute for a bit more protein (70 calories and 6 grams of protein) I've created a shake with 735 calories and 27 grams of protein!
That should help add on a few pounds.
Other helpful suggestions were:
-Add powdered milk to yogurt, gravies, mashed potatoes, hot cereal and baked
-Add grated cheese to rice, vegetables, pasta and eggs.
-Eat veggies with lots of butter. Butter is Queen Teen's weight gaining pal.
Put it on everything!
-Add a dip with her snack, like peanut butter for her apple slices, or
cream cheese with her graham crackers. All those extra sauces and dips help
add more calories.
-Having ice cream every day is a good thing for an underweight child.
I plan to make milkshakes with Queen Teen every day after school to see if that helps her gain five pounds before we see the dietitian again in January. Ten pounds would be better. I just have to be careful not to dip into her chocolate sauce too much or I'll be the one gaining the weight (and this time of year, I don't need any more temptation. mmmmmm.... chocolate milkshakes. yummmmmm!).