My child is (too) thin - motivate soup pasper to eat

Dr. oec. troph. Eva-Maria Schröder

Many parents are worried about their child (supposedly?) not enough eats and seems too thin to them. This concern may well be justified, because according to the Nutrition Report 2000, 8% of all girls and boys aged 6 to 17 are underweight. That means they are more than 15% below their (age and size dependent) reference weight. However, parental care is also often unfounded, since “thin phases” are quite normal during childhood. Therefore, this article would like to give advice on right Provide an assessment of the situation and help to spice up actual “soup pasper”. Morbid underweight (Anorexia) and eating disorders (e.g. bulimia) are not addressed.

Children don’t always eat the same amount

Children of the same age do not always eat the same amount. In addition, the individual amount consumed often changes from day to day. Striking descriptions of eating behavior range from “eats like a barn thresher” to “soup chaser”. Such eating behavior can therefore be completely normal and (alone) does not have to be a cause for concern.

Nevertheless, many children have an “incorrect” body weight – too high or too low – based on their age and especially their height. Of course you have to keep that in mind. However, assessing whether a child is overweight or underweight, eats “good” or “bad” should not be a “snapshot” because children go through different phases as they develop. The proportions of the body change significantly from baby to adolescent. Sometimes the growth in length dominates, sometimes the growth in width, and then again the focus is on mental development. It is therefore important to always look at the "individual child" in connection with its development over a longer period of time and to document the weight and height curve.

For example, we have the first phase of growth from birth to the end of the second year of life, which is followed by the first extension approximately between the fourth and seventh year. Here the length growth is stronger than the weight gain; the children’s appearance appears thinner and slimmer (baby fat disappears). Around the age of 10 we can also see a growth spurt in which the weight gain is less than the growth in size. As a result,

previously normal weight children appear lean (er) and
obese children become slimmer beforehand (therapeutic use!).

Body weight and development

However, if a child stands out because it is significantly thicker or thinner than its peers for a long time, the pediatrician (and possibly the psychologist) must first clarify possible causes, such as a disease requiring treatment. Adjusted to this, one can then try to normalize the weight by changing the diet and exercise behavior, ie in the longer term “shifting” it to a size that is appropriate for age and development. But that means neither strict starvation nor fattening.

The "normal" weight

Before we speak of overweight or underweight in children, we must first clarify which weight is actually "normal". Because of the different growth phases, a normal weight cannot be given as easily in children as in adults. Various options are available to facilitate assessment.

First there is the (but rather superficial) appearance, preferably undressed or in swimwear: If the child is significantly leaner than comparable children and the bones are clearly visible, one should definitely observe the further development. If there is anorexia, listlessness, poor performance, excessive susceptibility to illness and constant fatigue, the pediatrician must be consulted (at the latest now).

It is much easier (the doctor) to determine the respective state of development with the help of formulas (Body Mass Index – BMI), tables and diagrams (somatograms). They give specific indications as to whether the child’s weight is in the normal range. Narrow, dainty children should lie in the lower area, strong, stable children can lie on the upper limit.

Somatograms – growth and weight curves

In addition to complicated formulas, so-called growth and weight curves (somatograms) provide information about the child’s state of development, which should be carried out by the pediatrician from birth if possible over the following years of development. With a certain tolerance range you can see which weight range is acceptable depending on body length and age. If the individual values of a child deviate significantly from this scheme for a longer period of time, there is an overweight or underweight that requires treatment.

To assess the actual situation, this longer-term observation is more useful (weight / height development) than a “snapshot” (inspection), which can be distorted by growth phases.

Example: Schematic representation of a somatogram

tables

Tables that are available to the pediatrician offer a further orientation. The “target” weight can be read from the corresponding body size. Age and gender have little influence until puberty. The tolerable fluctuation range up or down (+/-) can also be read. If the child clearly falls “out of this framework”, therapeutic measures are essential.