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Definition
- Your child looks thin or slender. Their weight is more than 20% below the ideal weight for their height. However, your child is well-nourished, with a normal fat tissue layer (8–12 mm). This is measured by a skinfold calipers.
- Normal slender children are not actually underweight. They do not need to gain any weight.
- True underweight children have a low fat tissue measurement. They do need to gain weight.
- Both normal slender children and underweight children can have a low BMI. (BMI is body mass index.) So, BMI is not helpful in understanding these children.
Health Information
Cause
Your child may have a thin body type or build because:
- Your family is naturally thin. One or both parents are thin, but healthy.
- Your child has a slender bone structure or frame.
- The cause is not eating too little. Your child has a normal diet and gets the right amount of calories.
Care Advice
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What You Should Know about Thin Kids:
- Make sure that your child knows that a thin body type is normal and healthy.
- Seeing some ribs is healthy. It’s called normal slenderness.
- Thin kids don’t need to see their doctor for this or have any special tests.
- Your child doesn’t need to gain more weight.
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Avoid Pressure to Eat More:
- Your child doesn’t need more calories.
- Eating more calories would add fat, not more muscles or bigger bones.
- A healthy child does not need to over-eat.
- Trust your child’s appetite center in the brain. It will make sure he eats enough calories for normal energy and growth.
- Avoid any comments or pressure about eating more.
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Keep Mealtime Pleasant:
- Serve well balanced meals and make mealtime pleasant.
- Talk about fun subjects unrelated to food.
- Avoid any comments or criticism about how much your child is eating.
- If your child complains about certain foods, or refuses to eat some foods, see the topic about picky eaters.
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Special Foods are Not Needed:
- Special high calorie drinks or foods are not helpful. Neither are any pills that promise to build muscle or put on weight.
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Exercise is Good:
- Encourage physical activity for everyone.
- This will improve your child’s strength, endurance, muscle mass and confidence.
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Bully-proof Against Teasing:
- Even though children know that they are healthy and look good, some teasing might be expected.
- Help your child rehearse a reply, such as "Yep, I’m all muscle and bone, lean and mean".
Call Your Doctor If
- Your child loses weight
- Your child does not gain weight for over 6 months
- You and your child argue about food or mealtime becomes a battleground
- You think your child needs to be seen
- You have other questions or concerns
Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC