“How do you care for an underweight child?”

It all depends on if your daughter is growing along the growth curve or not. I have seen children that were always underweight but growing along the growth curve without falling of the percentile. After comprehensive investigation, these children were as healthy as other children. However, if she has fallen off the growth curve, she will then need further work up. The reasons can be nutrition, underlying illnesses, even environmental or mental issues.

Start out by having her overall health assessed. Make sure her growth is normal. A nutritional assessment with a pediatric dietician can be helpful. Some simple tests can rule out serious problems.

Michael G. Martin, MD

You should try to determine the cause. Is she taking in too few calories? Is she vomiting or having diarrhea so she is not absorbing the nutrients? Does she have an underlying genetic problem, heart problem(s), etc., that makes her need more calories? I try to get an estimate of what a child eats each day to see if it is enough calories. If not enough, I would add Pediasure, 1 bottle 2 times a day, and a vitamin and see if they gain weight. I usually check electrolytes to make sure they are normal and thyroid tests and celiac panel.