Ask Dr. Marla: How can I tell if my five-year-old is thin or under-nourished?

By Dr. Marla Shapiro on July 23, 2013
My five-year-old son is so skinny. How can I tell if he’s under-nourished?


There is a difference between thin and under-nourished. A child who is under-nourished will not have the suffi cient or proper food to maintain health and normal growth. The fi rst place to start is with your health care provider who can chart your child’s growth and development with respect to weight and height. This will allow you to know what percentile of growth your child is in and whether or not he has fallen off his growth chart. In other words, is he continuing to grow along the growth curves he has established? It is a concern when a child crosses two percentiles below where they normally are.

Children will often eat smaller amounts but eat more frequently. It is important to offer a variety of foods from all the food groups. We encourage children to choose vegetables and fruit over juices. Your child also needs calcium and vitamin D. For that reason we encourage that you offer milk servings every day. Yogurt, a piece of cheese, a dish of ice cream or even a slice of pizza are all good sources of calcium.

Canada’s Food Guide is a great place to learn about proper nutrition for children. This incorporates both the right amount of food and the types of food to make sure your fi ve-year-old is getting the nutrients that are needed to thrive.

Typically we recommend that parents offer their five-year-olds daily:
  • five vegetables and fruit servings
  • four grain products such as oatmeal, whole wheat bread or rice
  • two milk servings
  • one protein serving
  • 40 ml of oils and fats such as fish

Some kids who are growing rapidly look very thin but as long as they are eating well it balances out in the end. A multivitamin during rapid growth times can be helpful.

Further resources

Go to to get good info on healthy eating or call Eat Right Ontario’s toll-free number, 1-877-510-5102, to speak to a dietician for free.

Got a health question? Submit it to Dr. Marla.

Originally published in ParentsCanada magazine, August/September 2013.

By Dr. Marla Shapiro| July 23, 2013

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