Adding Calories to Your Child’s Diet

Many children face a challenge that we adults can’t relate to: the challenge to consume more and to gain weight. In a society filled with weight-loss products and get-skinny-quick advertisements, we may joke that we “wish we had that problem”, but it can actually be a serious issue that is quite concerning for physicians and parents.

Roughly 5-10 percent of US children are diagnosed with failure to thrive (FTT), which means that a child’s current weight or rate of weight gain is significantly below that of other children of similar age and sex. FTT can be caused by inadequate caloric intake, insufficient caloric absorption, or excessive caloric expenditure. But, regardless of the cause, the long-term goal for individuals with FTT is to boost calorie intake and normalize growth. So, in today’s post, we’ll discuss some ways to add calories to your child’s diet.


For infants, the solution is usually fairly straight forward. Your physician or nutritionist may recommend concentrating your child’s infant formula to make it more calorically-dense. The standard concentration for all infant formulas is 20 calories per fluid ounce. To add more calories without increasing volume, the concentration of the formula can be increased, for example to 24 or 27 calories per fluid ounce. This means that your baby is taking in more calories while still drinking the same amount of formula.

There are several ways to concentrate your infant’s formula and you should only do so under the direction of your child’s health care professional. Some infant formulas come in high-calorie versions which are already more concentrated. With powdered infant formulas, like Neocate, the formula can be concentrated by adjusting the way you mix it [i]. In some cases, instead of concentrating the formula, the healthcare provider will recommend adding lipids (fats), carbohydrates, combinations of both lipids and carbohydrates (such as Duocal [ii]), or occasionally protein, to the regularly-prepared formula.


For children eating solid foods, it may take a little more creativity to add calories into the diet, especially when your little one has food allergies limiting the types of calories they can consume. For some tips and allergy-friendly, high calorie food ideas, visit my previous blog article on FTT.

For more information on FTT, check out these resources:

NASPGHAN handout on FTT

KidsHealth: FTT

Failure to Thrive: What This Means for Your Child

How have you added calories to your infant or child’s diet? What has worked for you? What advice would you offer other parents?



Photo: Flickr user Poppy Thomas-Hill: Maggioni A, Lifshitz F. Nutritional management of failure to thrive. Pediatr Clin North Am. Aug 1995;42(4):791-810. Cole SZ, Lanham JS. Failure to thrive: an update. Am Fam Physician. 2011 Apr 1;83(7):829-34. Rabinowitz SS. Nutritional Considerations in Failure to Thrive. Medscape Reference.July 2, 2012. .

[i]If your physician or nutritionist has recommended that you concentrate Neocate to a higher dilution, we can help you with mixing instructions for how to prepare it this way. Call our Nutrition Specialists for more information at 1-800-365-7354.

[ii]Duocal is a modular medical food and not intended to be used as an infant formula or as a sole source of nutrition. Always consult with your child’s health care provider before making any nutritional changes to the diet.

– Mallory West

Published: 09/18/2012
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