Too Thin

In our fast-food, overweight society, it is easy to lose our understanding of what a healthy body looks like.

Thin is in.

Every week, there is a new report about what foods or lifestyle habits cause obesity.

Parents are cautioned by pediatricians about how to best feed a child to prevent obesity. The nutrition guidelines have changed many times over in just the nearly-9 years I have been feeding kids...

Start vegetables first, so they don't develop a preference for sweets....Switch to 2% milk when they are 2 years old....Limit juice....etc.

Growth charts are treated as a status symbol, instead of a tool to monitor growth trends.

I am all for healthy children. It is very important to serve them nutritional meals, and make sure they are getting plenty of playtime (exercise).

But, I am also concerned that parents are being misled as to what a healthy child really looks like. I ran into this trouble with Jersey #2.

When Jersey #2 started falling to lower curves on the growth chart, I mentioned my concern. Initially, I was told, she was entitled to a little leverage, and maybe she was in a growth spurt.

Next, I was told that our society is used to looking at overweight people, so we think healthy people look too thin.

When I argued that thin is one thing, but her rib bones were sticking out...
I was told that the "experts" were now looking at BMI instead of the height/weight growth charts of yesterday.

When I mentioned that in addition to her bones sticking out, she had been wearing the same clothing size for nearly 2 years already....
I was told that each child is different.

Seriously? I am a mother of 5 children. My children are blessed with the genes of being tall and slender. I can plainly see when one of my children are missing the mark of those healthy genes. Jersey #2 could have been a model for one of those "feed the starving children" commercials. She had bones sticking out all over the place.

What is the point of the growth chart curves, if my child can drop from the 50th percentile to the 12th percentile in 2 years, and still be assumed to be healthy?

How many thin children are falling through the cracks of the system like this, as we focus only on obesity?

There are "unhealthy" reasons for being thin...

...not receiving enough calories/nutrition, for example

...or....not being healthy enough to utilize the nutrition properly.


For Jersey #2, it was an underlying health issue that was causing her to be so thin. After all of those suggestions that she was probably normal, the doctor decided to chart her growth and her BMI to prove it to me.

Instead, she had to announce that Jersey #2 needed open-heart surgery. Her heart was working too hard, and her health was fading. She couldn't hold onto calories if she wanted to.

She was described as being at "the lowest point of acceptable."

The surgical team who evaluated her, made a point to comment that she was extremely thin, but well nourished.

Extremely thin? Lowest point of acceptable? Yet, I was initially deemed clueless about what healthy looks like?

I can't help but wonder if parents of thin children go through similar dismissals of their concerns.

Thankfully, I had my Mom to point out the details...

Healthy children have a little fat over their ribs and hip bones, even if they are naturally thin or petite. The skin is not suppose to sink deeply between the ribs. There is suppose to be the slightest cushion.

The skin is not suppose to sink around the eye sockets either. There are parts of the body that require a cushion of protection.

The tummy is suppose to round out slightly. (Toddlers have a rounder tummy due to immature abdominal muscles). The abdomen should not sink inward.

A hydrated child will have skin that bounces back. Gently press a thumb into the skin over the sternum (breastbone), and let go. If an indention remains, the child is dehydrated.


Children can be small, petite, and naturally thin. They can also be underweight to various degrees that are still considered healthy. But, if they are naturally so, they will still maintain certain cushions of fat layers over specific bones. A child should not look like a skeleton with skin stretched across it. Bones should not bulge through the skin.

And, it is not normal to drop down half the growth chart. Infants are given leverage to pick a curve over time. 5 and 6-year olds are not.

Just as it is dangerous to be extremely overweight, it is also dangerous to be extremely underweight. The brain and heart get all the calories first, so the rest of the organs do without, if there is a limited supply. This can lead to digestive issues and growth being reduced or halted.

The best advice I had ever heard about how to help Jersey #2 was to increase her milk intake. Milk helps settle the stomach, fill the stomach, and stretch it out a bit. This encourages eating. This method is used a lot in nursing homes, with elderly who tend to lose their appetites. It is a quick way to check if your child might just need more calories in order to grow.

When we encouraged Jersey #2 to drink as much milk as she wanted, we noticed immediately that she was perkier and less weak. She ate more readily. We later added Pediasure nutrient shakes to help her acquire more calories and vitamins.

In her case, the cure was a new heart valve that functioned properly. Her heart no longer had to work so hard, so her bones and muscles were able to receive some of the calories too.

Fixing the underlying health problem, put meat on her bones again.

I wonder how soon I will be told that she is jumping up the growth charts too fast! A Mom can dream...