High Protein and High Energy diet for children

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Introduction

Some children grow more slowly than expected. This may be because they have a
poor appetite and cannot eat enough food or because they have increased energy
requirements.

This information sheet will give you ideas on simple ways to make the food your child
eats more nutritious and more calorie dense.

As a Guide

 If your child has a poor appetite it is important to offer three meals each day,
offering two courses at each meal. In addition offer 2-3 small snacks through the
day.

 Bedtime is a good time to offer snacks as it doesn’t spoil your child’s appetite for
other meals.

 If your child can only eat small portions, foods need to be as high in protein and
calories as possible.

 Sugary and fatty foods are good sources of calories and should be used generously
in your child’s diet at meal times to add extra calories.

 Do not let sweets replace more nourishing foods – give them after a meal or snack.

 Make meals colourful and interesting and offer smaller portions.

 Never force a child to eat; try to encourage a calm and quiet atmosphere at
mealtimes.

 Involve your child in food preparation.

Milk and dairy foods

Milk
 Use 1 pint of full cream milk daily. You can also add ice-cream, skimmed milk
powder or cream to milk to add further calories.
 Use in drinks, milk shakes, on cereals, and in puddings, e.g. rice pudding, angel
delight or instant whip.
 Do not use low fat milks (skimmed or semi- skimmed) as these are low in energy.

Yoghurt and fromage frais
 Choose full fat yoghurts and fromage frais.
 Try adding yoghurt to cereal for a change.
 Full fat fruit yoghurts or fromage frais can be used to put on top of fruit, or added to
milk puddings.
 Natural yoghurt can be added to casseroles to boost the protein content.

Cheese
 Full fat cheeses like Cheddar, Lancashire and Cheshire, soft cheese, or cream
cheese should be encouraged as they are nutritious.
 Avoid low fat cheeses like cottage cheese, curd or low fat hard cheese as they are
lower in calories.
 Offer cheese sandwiches, cheese on toast or cheese and biscuits as snacks, or
with grapes and pineapple. Add extra cheese to pizza.
 Sprinkle grated cheese over vegetables, potatoes, beef burgers, baked beans, and
pasta dishes or add to soups.
 Use cheese in sauces e.g. cauliflower cheese, cod mornay.

Meat, fish, eggs, dhal, and pulses

These foods provide protein to help your child grow.

Pulses and nuts

 Add lentils or red kidney beans to soups and casseroles.
 Reduced salt baked beans on toast or peanut butter sandwiches make good
snacks.
 Add chick peas to minced meat, stews, curries and chilli.

NB. Do not give peanuts or whole nuts to children under the age of 5 as they are at
risk of choking.

Eggs

 Use extra eggs in recipes for cakes and biscuits.
 Include chopped boiled egg in salads.
 Offer boiled, scrambled (with extra cream added), fried or poached egg for
breakfast.
 Try omelettes with extra cheese or eggy bread.

Meat and fish

 All types of meat and fish are suitable. Foods can be cooked in any way, but if
possible cook with added fat by frying or roasting, to add extra calories.
 Cut down on processed meats as they are higher in salt.
 Avoid leaner cuts of meat and do not trim off fat.
 Some children prefer meat to be moist and easy to chew e.g. shepherds pie,
meatballs, spaghetti bolognaise, lasagne. Add extra cheese to increase calories
further.
 Tuna, salmon, pate and sausage all make good sandwich fillers. Add extra
mayonnaise, salad cream or sauce to increase calories.
 Choose tinned fish in oil not brine.
 Add extra calories by adding cheese e.g. tuna melt, beef-burger with cheese.

Sugar and sweets

As you are giving your child extra sugar and sugary foods it is important to clean your
child’s teeth well with fluoride toothpaste twice a day. Visit the dentist regularly.

 Use sugar in hot and cold drinks, on cereals and in puddings, to increase calorie
content.

Offer sugary foods for example jam, honey, cakes, biscuits and sweets.

 Do not use low calorie squashes, fizzy pops or artificial sweeteners.

Fatty Foods

 All fatty foods are high in energy.

 Use butter or margarine liberally on bread. Add to vegetables, potatoes and pasta.
Do not use low fat spread.

 Try to cook food in added fat if possible by frying or roasting. Choose olive oil and
rapeseed oil which provide omega-3 fats.

 Encourage pastries, e.g. sausage rolls, steak pies, fruit pies, and quiches.

 Add cream to desserts, breakfast cereals, porridge, rice pudding, and to yoghurts.

FRUIT & VEGETABLES
Fruit and vegetables provide
Vitamins A, C, dietary fibre, and
some are good sources of iron.
Fruit and vegetables can be quite
filling so try to fortify with foods
high in fat and sugar.
Serve tinned, stewed, or fresh fruit
with cream, ice-cream, custard,
dipped in chocolate, or add fruit to
pies, cake or crumbles.
Avoid overcooking or soaking in
water as nutrients can be lost.
Offer fruit juice to help absorb iron.

MEAT, FISH, EGGS, BEANS and
other non-dairy sources of
protein
These foods provide protein to
help your child grow.
They also provide iron, zinc, B
Vitamins and Vitamin A. Some
also provide good sources of
omega 3 fats.
Offer at least 2 portions each day.
Double up on protein portions to
make meals more nutritious e.g.
ham, egg, and chips or cheese and
ham sandwich.

FOOD & DRINKS HIGH IN FAT
AND OR SUGAR
These foods will provide the best source of
calories although they have fewer nutrients.
Foods includes cream, butter, margarine,
salad oils, mayonnaise, chocolate, crisps,
sweets, biscuits, cake, ice-cream, pies,
pastries, fizzy drinks, jam syrup and sugar.
Fortify dishes by adding foods from this
section.

MILK AND DAIRY FOODS
These foods add extra calories;
provide protein, calcium, B
Vitamins and iodine.
Offer at least 3 servings every
day.
Use full fat milk, yoghurts and
yoghurt drinks.
Grate cheese onto scrambled
eggs, mashed potato or soups.
Use white, cheese or parsley
sauces to add extra calories to
meat, fish vegetables and pasta
dishes.

BREAD, RICE, POTATOES,
PASTA and other starchy foods
These foods provide plenty of
energy. They also provide B
vitamins, fibre and some iron and
zinc.
Serve with all meals and as
snacks.
Foods from this group include
breakfast cereals, bread, chapatti,
pasta, rice, couscous, potatoes and
chips.
Spread margarine thickly on bread
and also try marmalade, jam,
chocolate spread or lemon cheese.

Fruit and vegetables

Although these are not high in energy or protein, they are important in the diet to
provide vitamins and minerals.

 Melt margarine over vegetables, roast foods in oil, and try raw vegetables with
hummus, dips, salad dressings, mayonnaise, and salad cream.
 Make creamy soups from vegetables.
 Add extra vegetables to pizza.

Drinks

 Take care that your child doesn’t fill up on drinks and reduce their appetite for meals
and snacks. Try offering drinks after meals and snacks.
 Try to make drinks as nutritious as possible.

Vitamins

All children up to 5 years of age should take Vitamin drops containing vitamins A C and
D. Older children may need them if there is a risk of vitamin deficiency.

Snacks

Offer small high calorie snacks between meals.

 Toasted bread or biscuits spread with jam, peanut butter, cream-cheese, or
chocolate spread.
 Cheese triangles or cubes of cheese with crackers, chapatti or strips of pitta bread.
 Buns, cakes, muffins, scones with butter, cream or jam.
 Breadsticks with hummus, peanut butter, or cream cheese.
 Small sandwiches.
 Full fat yoghurt, fromage frais, or yoghurt drink.
 Dried fruit and nuts, or crisps.

Dessert ideas

 Fruit crumble with custard or cream.
 Banana/ stewed fruit and ice-cream or cream.
 Full fat yoghurt.
 Fruit dipped in chocolate.
 Fruit pie with evaporated milk or ice-cream.
 Rice pudding with jam.
 Chocolate brownie with chocolate sauce.
 Angel delight or instant whip.
 Jam sponge and custard.
 Pancakes and chocolate sauce.
 Milk jelly or jelly with ice-cream or cream.
 Individual readymade trifle/ mousse/ desserts.

Sample Menu

Breakfast
 Fortified breakfast cereal with full fat milk and sugar.
 Scrambled egg/baked beans/cheese and buttered toast.
 Bagel with full fat cream cheese.
 Pancakes with jam.
 Milk or orange juice.

Mid-morning – choose from snack list followed by milky drink.

Main meal ideas
 Spaghetti bolognaise with extra cheese, and salad.
 Fish pie with carrots.
 Sausages with mashed potato, peas and gravy.
 Lasagne with garlic bread and vegetables.
 Roast beef with roast potatoes, Yorkshire pudding and vegetables.
 Shepherds pie and vegetables.
 Mild curry or chilli served with rice or chips.

Mid-afternoon – snack from list followed by glass of fruit juice

Snack meal ideas
 Toast served with baked beans and cheese/scrambled or fried egg/ tinned pasta
shapes.
 Jacket potato with tuna mayonnaise and sweetcorn or beans and cheese or curry.
 Sandwich made with fish-fingers/sausages/tuna and mayonnaise/salmon and
cucumber/chicken or egg mayonnaise.
 Ham and cheese omelette served with salad.
 Quiche and baked beans.

Supper – warm milk with a high calorie snack or pudding.

Additional Information:

Worcestershire Acute Hospitals NHS Trust

Covering the Alexandra Hospital, Redditch,
Worcestershire Royal Hospital and Kidderminster Treatment Centre.

Tel: 01905 733953

Email: wah-tr.paeds.diet@nhs.net

If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best
placed to answer any questions or resolve concerns quickly. If the relevant member of
staff is unable to help resolve your concern, you can contact the PALS Team. We offer
informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can
investigate your concerns. You can make a complaint orally, electronically or in writing
and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:
The PALS telephone lines are open Monday to Thursday from 8.30am to 4.30pm and
Friday: 8.30am to 4.00pm. Please be aware that a voicemail service is in use at busy
times, but messages will be returned as quickly as possible.

If you are unable to understand this leaflet, please communicate with a member of
staff.