At what point is my big kid (6 years old) “too skinny” or not growing enough? Weight and height measurement was such a focus when they were young, but now all the information seems to be geared to curtailing childhood obesity. How much should a child be gaining at this age, and at what point do I worry about my skinny kid?
––Considering milkshakes for every meal
When writing Cribsheet, I spent a lot of time in the literature on picky eating. When parents have very picky children, one consequence is often that the child doesn’t seem to eat very much, and may also be thin. One of the papers I read on this said, more or less, that the most important thing to do when a parent comes in with this concern is explain to the parent that they are overreacting. Which in a way validates what you are saying above: there isn’t much focus on whether a child is “too skinny.”
Globally, malnutrition is a significant problem. It generally occurs, however, in environments with food insecurity. Outside of disordered eating, in most environments with sufficient food availability, kids (and adults) will consume the calories they need. In these environments, we worry more about overconsuming abundantly available calories rather than under-consuming.
This doesn’t mean that your doctor will not pay any attention to your child’s weight. When they weigh and measure at a checkup, your pediatrician is looking for children moving up their growth curve. A kid who is at the 20th percentile for weight at age 4 and at 5 and at 6 is doing well. Where we’d worry is if they were at the 20th percentile and then dropped to the 5th. This could suggest some kind of overall need for intervention.
If you are worried, call your doctor! They can probably reassure you directly, and it’s an easy visit to just weigh and measure your child to make sure they are on track. Do this before you start in with the milkshakes.
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