Poor Weight Gain in Children

Growth can slow when a child takes in too little energy (poor appetite, feeding difficulties, limited food, difficulty sucking or swallowing), absorbs too little (coeliac disease, cow's milk protein allergy, cystic fibrosis, liver and bile problems, chronic diarrhoea), or needs more energy than usual (chronic infections, heart or lung disease, inflammatory bowel disease). Hormonal, kidney, genetic and emotional or social factors also play a role. Often more than one factor is present.

Concerns about growth are a common reason for visits to child health services, especially in the first years of life. Most children are found to be getting too little food energy for their needs, often because of feeding difficulties, rather than having a serious disease.

Family and relatives often encourage extra feeding or offer traditional remedies and tonics. Please check with your doctor before giving herbal products or "weight gain" supplements to a child, and avoid pressuring a child to eat.

The doctor plots your child's weight, length or height and head size on growth charts, compares with earlier measurements and with the parents' sizes, and asks about pregnancy, birth, feeding, stools, development, family and home. A feeding history or a diary of what your child eats over a few days is very helpful. Tests are chosen according to the story and examination, and are not done for every child. They may include blood, urine and stool tests, and sometimes tests for coeliac disease, infections or other conditions. A dietitian is often involved.

Calm, regular mealtimes help most children eat better.

• Offer meals and snacks at regular times, about 3 meals and 2 to 3 snacks, with no grazing or constant milk or juice in between.

• Eat together at the table without screens, and let your child feed themselves when old enough.

• Keep mealtimes relaxed and under about 30 minutes. Do not force, bribe or punish; pressure often makes eating worse.

• Weigh your child only as often as your clinic advises; very frequent weighing can cause worry.

• Keep a simple food diary to share with the doctor and dietitian.

The aim is to increase healthy energy intake without harming the child's appetite. A dietitian can tailor a plan.

• Offer energy-dense foods such as full-fat dairy (if allowed), eggs, avocado, nut butters (where age-appropriate), olive oil and well-cooked meat and fish.

• Do not make a young child's diet low-fat or high-fibre unless advised, since this fills them up without giving enough energy.

• Limit large amounts of milk, juice and sweet drinks that fill the stomach before meals.

• Do not start special formulas, supplements, appetite stimulants, or restrictive diets without medical advice; if supplements are needed, the doctor or dietitian will choose them.

• For breastfed babies, a feeding assessment by a trained professional can identify latch or supply problems.

There is no medicine that simply "makes a child grow"; treatment targets the cause.

• If a medical cause is found, such as reflux, allergy, coeliac disease, infection or anaemia, it will be treated specifically.

• Vitamin or iron supplements are given only after assessment.

• Appetite stimulants and herbal "weight gain" products are not recommended for children without medical supervision and can be unsafe.

• The doctor decides every medicine and dose.

Most children never need a procedure.

• If tests suggest a gut cause, the specialist may recommend an endoscopy with biopsies, ultrasound or other imaging.

• A short hospital stay is sometimes used to observe feeding and growth and to test responses to a feeding plan.

• Children who cannot take enough by mouth may be offered tube feeding for a time, planned and supervised by a specialist team.

Many children catch up once the cause is found and treated, especially when the problem is identified early. Long-standing undernutrition in the first years of life can affect growth and development, so early assessment matters. Your doctor will monitor progress closely.

• Is my child's growth really a concern, or are they following their own pattern?

• What tests, if any, does my child need?

• How many calories or what kind of feeding plan is right for my child?

• How often should my child be weighed and measured?

• Which signs mean we should return sooner?

This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the Approved for publication by SGA; individual clinician review is ongoing. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.