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

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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.

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