Boosting Calories for Babies, Toddlers, and Older Children

When and how to boost caloric intake for children with poor growth or weight gain
A high-calorie diet increases the calories and protein of food intake without significantly increasing the volume of food intake. Depending on underlying conditions and nutritional needs, the plan for power packing will vary by individual and be carried out at home. When calorie boosting occurs at home, the primary care clinician and dietician are often involved with recommendations. Establishing the underlying cause of poor weight gain and treating it is fundamental to helping children with faltering growth. In addition, increasing caloric density can help with gaining and maintaining weight. Below are general tips for boosting caloric intake for babies, children, and teens. The Resource section has information about detailed recipes and support for families.

Other Names

  • High-calorie diet
  • Increased caloric density
  • Power packing
  • Supplemental nutrition

Key Points

  • In general, the easiest way to pack food with calories is to add fats and carbohydrates and include more high-protein foods.
  • No honey in children < 1 year of age, raw or cooked into food (including bread, graham crackers, Honey Nut Cheerios) due to risk of botulism infection.
  • Be aware of the child's ability to safely swallow different consistencies, textures, and temperatures. Feeding & Swallowing Problems in Children has further information.
  • Encourage caregivers to compare food labels for calories.
  • Families can use a blender or food processor to adapt the texture of the high-calorie foods.
  • If unable to attain adequate nutrition or fluid intake, consider the placement of a feeding tube. See Feeding Tubes & Gastrostomies in Children for more information.

Power Packing Ideas

For infants, the primary recommended way to increase calories is to concentrate or fortify the breast milk and/or formula, typically to 22-24 calories per ounce. Fortifying Breast Milk (Minnesota Health) (PDF Document 67 KB) has instructions for fortifying breast milk. Duocal can also be used to add caloric content. Formulas and Fortifiers for Premature and Low Birth Weight Infants (PDF Document 94 KB).
If an infant is older than 4-6 months old and able to start solids, options include:
  • Add 1 teaspoon of vegetable oil (such as corn oil or olive oil) or liquid margarine to each baby food jar.
  • Mix any dry infant cereal with infant formula rather than water.
  • Use a blender to puree high-calorie table foods. See Thickened Liquids & Modified Foods.
  • Use whole milk, custard-style, unsweetened yogurt without fruit pieces (such as Noosa, Stoneyfield, and Chobani).
For toddlers and older children:
  • Add oil, margarine, butter, and/or cream cheese to bread, crackers, pasta, rice, and vegetables.
  • Add gravies, sauces, dips, and toppings to the child’s favorite foods.
  • Give the child whole milk to drink. Limit juice, water, and soda. Some children “fill up” on water, juice, or soda and then refuse to eat.
Here is “food for thought” on ways to power pack, organized by sources of fats, proteins, and carbohydrates. However, providing a combination of fats, proteins, and/or carbohydrates typically increases calories the most.

Fats

  • Butter
  • Sour cream
  • Margarine
  • Whole fat or custard style yogurt
  • Oils
  • Powdered milk
  • Mayonnaise
  • Evaporated milk
  • Cheese (including cream cheese and cottage cheese)
  • Nut butters and seed butters
  • Whole milk and cream
  • Olives
  • Ice cream
  • Coconut milk
  • Avocado
Examples:
  • Butter both sides of the toast. Add butter to sandwiches, hot dogs or hamburger buns, and bagels before cream cheese. Use butter for cooking eggs, sautéing vegetables.
  • Use dips or cream sauces for veggies (like ranch).
  • Add olive oil to bean dips and hummus.
  • Add cheese to sandwiches, vegetables, and eggs. Mix into sauces, casseroles, or noodles.
  • Add nut butter or avocado to sauces, crackers, or sandwiches, or use as a spread or dip.
  • Use evaporated milk or coconut milk in a sauce or cooking.
  • Substitute whole-milk or custard-style yogurt for lower-fat or non-fat.
  • Use whole milk, whipping cream, or half-and-half instead of water or lower-fat milk.
  • Mix dry infant cereal with high-calorie milk or infant formula rather than water or juice.

Proteins

  • Eggs (avoid raw egg)
  • Tofu
  • Dairy products (see above)
  • Textured vegetable protein
  • Nuts and seeds
  • Tempeh
  • Nut or seed butters
  • Beans or hummus
  • Meats (including jerky) and seafood
  • Protein powder
  • Beans and legumes
Examples:
  • Add cooked meat or bacon bits to vegetables, salads, casseroles, soups, omelets, scrambled eggs, sandwiches, stuffing, and baked potatoes.
  • Use extra eggs in salads or make French toast, pancakes, and waffles.
  • Blend soft tofu into smoothies or mousses.
  • Use bean dips for vegetables.

Carbohydrates

  • Sugar
  • Dried fruits
  • Agave syrup
  • Jams or jellies
  • Maple syrup
  • Instant breakfast
  • Ovaltine and other drink mixes (but avoid the ones with artificial sweeteners)
  • Honey (not for use in babies <12 months)
  • Cornstarch or tapioca starch (these often serve as thickeners but add calories as well)
  • Molasses Polycose (a powdered carbohydrate supplement available in pharmacies)
Examples:
  • Add syrup, jam, or sugar to jars of baby food or fruit purees.
  • Add "instant breakfast" mix into beverages.
  • Add to cereals, milkshakes, fruit, desserts, yogurt, toast, muffins, French toast, pancakes, and cookies.

Supplemental Nutrition

Many ready-to-use bottles, pouches, mixable beverage powders, and packets of supplemental nutrition are available in most large grocery or drug stores. Some high-calorie mix-ins include Duocal, Benecalorie, and Polycose. Supplemental formulas include PediaSure, Kindercal, Boost Kid, Ensure, Resource, Orgain, Instant Breakfast, Ovaltine, and NIDO. They are fortified with vitamins and minerals to varying degrees, a good source of calories, and convenient to use. Some come with added fiber. See Formulas for Toddlers & Older Children (PDF Document 296 KB) for more information on supplemental nutritional formulas and mixes. The drawbacks of these products are that they may replace normal food and cause a picky or selective eater to have worse eating habits. They should not be used as a meal replacement.

Tips to Help Families at Mealtime

  • Eat meals and snacks together so children feel a part of the family. Place the highchair at the table.
  • Be positive about food and eating to create a pleasant, stress-free setting. This will make eating more enjoyable.
  • Schedule meals and snacks 2-4 hours apart to encourage a good appetite. Offer eating 5-6 times per day (3 meals and 2-3 snacks).
  • Allow enough time for each meal or snack, at least 15-30 minutes.
  • Do not allow children to graze or snack between eating times.
  • Don’t get upset or force a child to eat; children can be picky eaters. Do not push a child’s favorite foods, as that can cause food aversion.
  • Minimize distractions that may take a child’s attention away from eating. No TV, phones, or other electronics during mealtime.
  • Involve the child in planning and preparing food. Children’s cookbooks, parenting magazines, and websites are great resources for fun food ideas.
  • When the child wants the same food day after day, this is called a food jag. It is common, and it’s okay to give the preferred food for a few days with small amounts of other foods.
  • Allow the child to feed themselves. Offer finger foods, and use a baby-sized spoon and cup with handles. Use plastic dishes so children can feed themselves safely. Expect messes.
  • Offer small portions, and then give more when they finish what was served. Large portions can be overwhelming. Many children like plates with compartments to improve visual presentation.
  • Try different forms of the same food, such as fried eggs, scrambled eggs, and/or boiled eggs.
  • Choose foods that are easy to chew and swallow, especially if the child has physical or neurological deficits.

Services & Referrals

Nutrition Assessment Services (see UT providers [7])
Consult with a dietitian to develop feeding plans and provide guidance on appropriate calories, nutrients, and fluid intake for individual children.

Resources

Information & Support

For Parents and Patients

Fortifying Breast Milk (Children's Minnesota) (PDF Document 67 KB)
Breast milk plus standard infant formula recipes by calories per ounce.

Patient Education

Power Packing Fact Sheet (Intermountain Healthcare) (PDF Document 223 KB)
Calorie-boosting ideas with a comparison of calorie counts for regular snacks and meals vs. power-packed ones.

Power Packing for Children (Intermountain Healthcare) (PDF Document 138 KB)
Behavioral tips and recipes for regular, power-packed, and super power-packed meals and snacks.

Tools

Formulas and Fortifiers for Premature and Low Birth Weight Infants (PDF Document 94 KB)
A chart that lists the major brands of formula and the key differences among their ingredients; created by the Medical Home Portal.

Formulas for Term Infants (PDF Document 265 KB)
A chart that lists the major brands of formula and the key differences among their ingredients; created by the Medical Home Portal.

Formulas for Toddlers & Older Children (PDF Document 296 KB)
A chart that lists the major brands of formula and the key differences among their ingredients; created by the Medical Home Portal.

Formulas for Metabolic Conditions (PDF Document 138 KB)
A chart that lists the major brands of formula and the key differences among their ingredients.

Services for Patients & Families in Utah (UT)

For services not listed above, browse our Services categories or search our database.

* number of provider listings may vary by how states categorize services, whether providers are listed by organization or individual, how services are organized in the state, and other factors; Nationwide (NW) providers are generally limited to web-based services, provider locator services, and organizations that serve children from across the nation.

Authors & Reviewers

Initial publication: September 2008; last update/revision: January 2023
Current Authors and Reviewers:
Author: Kathryn Murray, MD
Contributing Author: Jessica Clayton, RDN, CDN, IBCLC
Reviewer: Emily Vaterlaus Patten, PhD, RDN, CD
Authoring history
2016: first version: Meghan S Candee, MD, MScR
AAuthor; CAContributing Author; SASenior Author; RReviewer