High-Calorie Nutrition

At any age, your child may need some help gaining weight. This can be done by adding calories to your child’s diet. A nutrition plan is typically developed with a healthcare team based on your child’s specific needs. Below are some general tips on high-calorie, nutrient-dense nutrition.

How can you help your baby gain weight?

Helpful tips

• Feed your baby breast milk and/or formula as they show hunger cues (typically every 2–4 hours).
• Breast milk and/or formula are your baby’s main source of nutrition. Avoid water, juice, or Pedialyte unless instructed by your healthcare provider.
• If you were told to mix formula or fortify expressed breast milk to a calorie concentration higher than 20 calories per ounce, follow the recipe provided by your healthcare team.
• Avoid distractions like TV, toys, and tablets during mealtimes. Follow your baby’s cues and never force or sneak feeding. Persistent feeding techniques can make your baby averse to eating and drinking. If you are concerned about your baby’s intake and/or feeding skills, talk with your healthcare provider.

4–8 months

• Continue breast milk and/or infant formula. Goal volumes are individual for each child. Your healthcare provider and/or dietitian will inform you of appropriate goals for your child.
• At 4–6 months, check with your healthcare provider to see if your baby is ready to start eating solids. Example signs of readiness include sitting up on their own, good head control, and showing interest in your food. Once cleared to begin solid feedings, begin spoon feeding and introduce foods one at a time.
• It can take more than 15 times for a child to accept a new food. Be patient.
• Do NOT introduce honey until your baby’s first birthday and speak with your healthcare provider first.
• Fats such as butter and oil (including olive, coconut, canola, and avocado oil) are a great choice to add to solids because they are high in calories.  
• To each 2–4-ounce serving of purees, try to add one of the following options:
  • 1 teaspoon oil 
  • 1 tablespoon oatmeal cereal
  • 1 scoop of formula powder
• If you are following a baby-led weaning approach, include foods cooked in oils and age-appropriate dips and spreads.

8+ months

• Offer 3–4 meals per day. Start with 1 tablespoon of food from three food groups and let your baby ask for more.
• Offer purees or solids first, when your baby is most hungry; then offer breast milk or infant formula.
• It is okay to offer pasteurized whole-milk yogurt or sprinkle shredded cheese onto baby cereal, mashed potatoes, or other baby foods.
• Mash higher-calorie solids into preferred fruits, such as banana, avocado, sweet potato, or potato. 
• Let your baby decide when to bring a new food to their mouth. Encourage them to explore new foods through touch and smell, and model eating those foods.

How can you help your child gain weight?

Helpful tips

• Avoid grazing and use set meal and snack times, separating meals and snacks by 2–3 hours. Only offer water in between meal and snack times. If your child refuses, end the meal or snack and do not offer food until the next scheduled meal or snack time.
• Fats are a great choice to add to solids because they are high in calories. Some good examples of fats are:
  • Oil, butter, full-fat dairy, nut butters, avocado, heavy cream
• Offer caloric- and nutrient-dense foods such as:
  • Dips: Hummus, avocado, whole-milk yogurt, bean dips, pesto
  • Spreads: nut butters, ricotta cheese, seed butters
  • Snacks: nuts/seeds/trail mix, cheese sticks, granola bars 
• Avoid distractions like TV, toys, and tablets during mealtimes. Avoid prolonged mealtimes and negotiating at mealtimes.
• Include your child in meal preparation. Eat with your child to model the desired behavior.
• Use “food bridging” or combining preferred foods with new foods. You also can add sauces to food whenever it makes sense. Pair preferred and non-preferred foods on the same plate at mealtimes to encourage exposure to new foods. Keep portions of new and non-preferred foods small. Remember your child we are learning about foods. Encourage your child to discuss sensory properties of foods they don’t prefer, rather than simply telling you they like or don't like the food. This can include what the food looks like (color), feels like (texture), sounds like (when bitten or squeezed), and tastes like (sweet, sour, bitter, tangy, spicy).  
• Use division of responsibility in feeding—the goal is for parents and caregivers to be in charge of the "W's": 

• • When the meal occurs. This includes both the timing of when foods are offered for meals and snacks as well as how long the meal lasts.
  • Where meals occur, whether at a table, kitchen counter, living room, or where the child sits.
  • What foods are offered. Your child should always be in charge of what food they eat. 
• Toddler formulas are not routinely recommended without the guidance of a dietitian or healthcare professional. 
• Decreasing Community Toddler Formula Use (app.org)

Author: Michelle Yavelow, MS, RDN, LDN, CNSC, CSP
Editors: Anthony Porto, MD and Wendy Elverson, RD, CSP, LDN
September 2024