Monitoring infant's healthy growth
Dear Dr. Donya,
We would appreciate your thoughts on the following problem.
Our baby boy is 10 months old, 72 centimeters tall and weighs 7.8 kilograms. According to charts, his weight and height are at the very bottom of the normal range.
He is a fussy eater (especially for solid food), but his daily intake of formula milk is around 750 to 800 ml. I believe this amount of milk is not a lot, but still sufficient.
Over the last few months his weight gain has been poor. And, in the last 20 days or so he has not gained any weight at all. He has had no major illnesses apart from the regular illnesses that are common in a child of his age. He is otherwise a happy and playful child (he crawls now and attempts to stand with support).
I have been trying to introduce solids to my baby since he was 4 months old. However, he seems to dislike anything but one particular type of cereal (and that only sometimes).
However, his rate of growth is a constant worry for us, especially since he was a very healthy baby at birth (weighing 3.75 kg). As you can see, since birth he has not gained much (only 4 kg in 10 months). He looks much smaller than other babies of his age.
Pediatricians have only prescribed multivitamins to increase his weight, but its not showing any results. Also, some doctors say the reason for his low weight gain could be that he is very active. We are confused. Shouldn't babies be active? How do we wean him off milk so that he becomes accustomed to solids? Thanks a lot for your kind attention.
Best regards,
RK
Dear BRK,
Here are some important points regarding your baby:
1. What is the difference between a thin child, a weak child and an underweight child?
Thin refers to a child of normal height and low weight (but still within the normal range); weak would mean that the child was not active or easily tired compared to others. Underweight is below the normal range.
2. What constitutes a baby being healthy, weight or activeness?
Activeness is more important.
3. Why does a baby who had a healthy birth weight fail to gain weight steadily in the early months? Is this normal? it this a major concern?
It is a little concerning in your son's case. Normally a baby's weight will have doubled at four months, after which there will be slow weight gain. However, we should look at the growth curve, if the curve drops significantly this could be cause for concern.
You may want to take your baby to another pediatrician. If he cannot find anything wrong, maybe it is your baby's dislike for solid foods that is causing slow weight gain.
4. Is he not gaining because he is not eating enough solids and only drinking milk?
Possibly, after six months, milk alone is not enough. It would be better to cut down his milk consumption and stop feeding him milk before meals.
5. How do multivitamins work?
Vitamins are beneficial if a child suffers from poor nutrition, however, too many vitamins are not good either.
6. Should we force a baby to eat his meal? How long should we wait for him to eat? When should the baby eat proper food instead of milk?
Wait for 45 minutes, if he does not eat that means he will not get any food or milk till the next meal break. Giving milk before or straight afterward, when he has not eaten any solid food, will simply encourage him to drink to feel full.
7. How should we, as parents, approach a baby if he refuses to eat solid foods?
A meal is a meal, let him learn by giving him a schedule, but not too strict. If he is hungry, you will know, then you can give something to him.
At his current age, seating him at the family dining table may help. You are not the only parents who have this problem, it is quite common. Try to be patient, be sure that he is active, sleeps soundly, passes regular bowel movements, and enjoys playing -- soon he will eat well too.
Best regards,
Dr. Donya