Your dietitian may advise you need to fortify your child’s meals to help promote weight gain and prevent weight loss. This is a short-term dietary change to help your child gain weight.

If your dietitian has recommended this, you can follow the guidance below.

What meals to have

Offer three meals a day, aim to offer breakfast, lunch and dinner.

Offer a carbohydrate food at each meal, such as pasta, rice, potato, bread or cereal.

Offer protein twice a day, for example meat. Lentils, pulses, egg or fish.

Aim for at least five portions of fruit and vegetables a day.

Fortify foods with high calorie ingredients wherever possible.

Snacks

Try to have two snacks a day. This could be mid-morning, mid-afternoon or before bed.

Little and often

Consider this if your child can’t manage three meals and two snacks a day.

Large meals can be off putting, so offer smaller meals and snacks more often.

Offering realistic portion sizes can help to encourage your child with eating.

What is a portion?

Use your child’s hand as a guide.

• Carbohydrate – your child’s fist size.
• Protein – your child’s palm size.
• Fruit and vegetables – however much they can fit into the palm of their hand.

Drinks

Try to include nutritional drinks during the day, such as a small glass of fruit juice with breakfast or homemade milkshakes and smoothies as a snack mid-afternoon. You can also try a hot chocolate or malted milk before bed.

Offer drinks after main meals so your child does not feel full before the meal.

You can also try freezing nutritional drinks in a lolly mould.

Fortified milk

Try to use this on cereal and when cooking with milk, such as homemade custards or milkshakes.

How to make one pint

One pint is 400 calories and 25.3g protein.

Add one pint (570ml) of full fat milk to a shaker or glass, then add four tablespoons of skimmed milk powder.

Carefully place the lid on the shaker or use a whisk and mix, making sure there are no lumps.

Keep the fortified milk in the fridge. This milk can be used for the rest of the day, aim to have a pint of milk per day.

If your child has instant hot drinks such as cup-a-soups, hot chocolate or malted milk, then use the fortified milk recipe instead of water or make up the instant hot drink as per the instructions and add two teaspoons of skimmed milk powder.

High calorie milky drink recipes

• Simple milkshake: Add 200ml of fortified milk, one scoop of ice cream, one pot of yoghurt, with fresh or tinned fruit or milkshake powder and blend (300kcal, 10g protein).
• Chocolate dream: Warm up 200ml fortified milk, add one tablespoon drinking chocolate and sweeten to taste (230kcal, 17g protein).
• Banoffee treat: Mash a banana with 150ml fortified milk, one pot of crème caramel and a teaspoon of golden syrup and blend (350kcal, 12g protein).
• Banana and peanut butter smoothie: 150ml whole milk, 30g ice cream, four tablespoons of milk powder, one banana, one tablespoon smooth peanut butter, one teaspoon of honey and blend together (416kcal, 15.4g protein).

How to fortify common foods

Here are some examples of ingredients which can be added into meals to add extra calories to your child’s diet.

Product	Portion Size	Nutrition Added
Skimmed milk powder	1 tablespoon (9g) 1 teaspoon (3g)	30 calories, 3.3g protein 10 calories, 1.1g protein
Margarine	1 teaspoon (5g)	35 calories, 0g protein
Cream	1 tablespoon (10g)	43 calories, 2.5g protein
Double cream	1 tablespoon (10g)	50 calories, 0.2g protein
Dates	2 large (40g)	108 calories, 1.3g protein
Olive oil	1 teaspoon	40 calories, 0g protein
Avocado	50g	95 calories,1g protein

 

• Try mixing cream into porridge.
• Boil pasta or rice in full fat milk.
• Drizzle olive oil over pasta or make a creamy sauce to go with it.
• Mix cheese into a meal or sprinkle over the top.
• Mash avocado and mix into sauces.
• Blend dates and add to pudding.

Snack ideas

• Oat cakes – try adding a 100 calorie booster to this.
• Crumpet – try adding a 100 calorie booster to this.
• Thick and creamy yogurt.
• Custard pot.
• Olives.
• Fish fingers.
• Scotch egg.
• Eggy bread.
• Malt loaf with butter.
• Dried fruit and nuts (whole nuts not recommended if your child is under five due to the risk of choking).
• Breadstick with hummus or mashed avocado.
• Pitta bread with smooth peanut butter.
• Rice pudding pot – add a scoop of smooth peanut butter.

100 calorie booster ideas

These boosters are approximately 100 calories each and can be added to any appropriate meal or eaten alone.

Savoury

• Medium spread peanut butter (16g)
• Medium spread of cashew butter (16g)
• One level tablespoon mayonnaise (15g)
• Salad cream (30g)
• Two tablespoons hummus (50g)
• One heaped tablespoon pesto (20g)
• Cheddar cheese (37g)

Fruit and nuts

Whole nuts should not be given to children under five, due to the chocking risk. Nuts can be ground down for under-fives. Remove any stones where applicable for all ages.

• Small handful of peanuts (15g).
• Five Brazil nuts (15g).
• Handful of cashew nuts (20g).
• One banana (100g).
• Five dried apricots (50g).
• Six prunes (60g).
• Two to three dates (40g).
• One heaped tablespoon sultanas.
• Chocolate spread (16g) heaped tablespoon.

Dairy

If your child is on a dairy free diet, ask your dietitian for a cow’s milk-free food fortification diet sheet.

• 150ml full fat milk.
• One scoop ice cream (60g).
• 75ml evaporated milk.
• 30ml condensed milk.
• One small pot full fat yogurt.
• 40g full fat soft cheese.
• 50ml coconut cream.

It is possible to get additional calories from sweet foods such as sweets, sugar and honey, however, we would recommend using alternative ingredients to fortify the diet. Try to aim for unsaturated sources of fats rather than saturated fats, your dietitian will discuss this with you further.

Putting it into practice

Here are some ideas on how to increase the calories in your child’s meals.

Food	Nutrition before fortification	How to fortify	Nutrition after Fortification
2 eggs scrambled with a small knob of butter	168 calories 14.4g protein	Add 1 teaspoon of butter, 2 teaspoons of dried milk powder and 45g cream cheese	378 calories 20.7g protein
Porridge 25g with 150ml whole milk	189 calories 7.8g protein	25g porridge oats 150ml fortified milk 30ml double cream	421 calories 12g protein
Tinned custard 200g (1/2 tin)	193 calories 4.8g protein	½ tin custard plus 30ml double cream	333 calories 6.3g protein
Boiled carrots (30g)	7 calories 0g protein	Drizzle with 1 teaspoon olive oil	47 calories 0.2g protein
Mashed potato (60g)	62 calories 1.1g protein	Add 1 teaspoon butter, 2 teaspoons milk powder, 1 teaspoon double cream	170 calories 3.5g protein
Boiled pasta (50g)	84 calories 2.7g protein	Boil the pasta in 350ml whole milk on low heat for 30 minutes	308 calories 15g protein
Jelly instant sachet	1 serving: 100calories 2g protein	1 sachet instant jelly, 400ml fortified milk 2 tablespoons double cream	1 serving: 190 calories 7.4g protein