Steady weight gain, sign that your baby is healthy and feeding well —Expert

During infancy and childhood, children gain weight and grow more rapidly than at any other time in life. Mothers tend to think that at a particular age, a baby must weigh an amount. However, some children do not gain weight at a normal rate, either because of expected variations related to genes, being born prematurely, or because of weight faltering or faltering growth, which may occur for a variety of reasons.

Poor weight gain is defined as gaining weight at a slower rate than other children who are the same age and sex. “Normal” ranges for weight are based upon the weight of thousands of children. “Weight is one of the indexes we use to measure growth and growth by definition means an increase in size, not necessarily acquisition of skills or maturity, which is development,” said Professor Adebola Orimadegun, a consultant paediatrician, University College Hospital (UCH), Ibadan.

According to him, “A baby that is born at term, that is 9 months of pregnancy, on the average should have a weight of 2.5 Kg as average, but it could be a little less. Anything less than 2.5kg, we say that the birth weight is low. So, a minimum of 2.5kg, but maximum, it shouldn’t be more than 3.9kg.  Once a baby crosses the boundary of 4.0kg, we consider such a baby as large for the gestational age. That comes with a lot of problems.”

It’s normal for babies to lose some weight in the first 7 to 10 days of life. Professor Orimadegun said about 5 per cent of the weight is what they lose, then the baby is expected to have a steady weight gain.

According to him, “They seem to have a larger proportion of water compared with older children at birth and that water must be shed. They also lose some of the fat they gained from their mother while still in their mother’s womb.

“So, more important to us as paediatrician is the steadiness of the weight gain, afterwards and not necessarily the absolute amount of weight that the baby has. That is why when we monitor weight, we look at the pattern of the weight gain in the baby’s “growth to health chart”.

“For instance, if a baby was born with a weight of 3kg, by the time the baby is 3 months, we expect the baby to have gained weight sufficiently so that about half of the weight at birth is already added. And by the end of one year, it should have tripled the weight. But what is important is the steadiness of the weight gain.

“If a baby gains weight and drops again, we talk about faltering. There is a way the weight drops that becomes worrisome and will require some intervention. We don’t pay attention to the absolute weight.”

Now, all babies are different and the way mothers perceive the weight of their babies sometimes could be wrong.  “Research has shown that the accuracy of mother’s prediction of their baby’s weight is not so high, so the objective way of checking baby’s weight is by weighing and that is why when mothers go for immunization clinic or infant welfare clinic, we expect the health worker to weight the baby and measure it against the standard,” he added.

There are established ranges of expected weight that are written or plotted on the baby’s growth to health chart. Professor Orimadegun stated “When the weight is plotted and it falls within the upper and lower, the child is considered to have a normal weight at that point in time.

“But if the next time, the child comes, it dips below the band, then we suspect that there might be a problem. The dip below the lower band is called growth faltering but weight measurements must be done at least 2 to 3 times at intervals of at least one month apart before you can make sure of a deduction.

“So the weight of the baby as a reflection of the baby’s health is only objectively inferred based on what happens over time, rather than one point measurement. The weight of a child that is less than 80 per cent of the expected weight is not good. So the best is between 95 per cent and 100 per cent of the expected weight.”

Certainly, there is nothing cuter than a chubby baby or toddler. However, excess weight gain can still be a concern for babies. “Having a chubby baby or heavy baby does not mean that the baby is healthy because even the chubbiness itself comes with its own attendant problem,” he added.

Research has shown that certain individuals who are too heavy or too large at birth may continue to maintain that largeness and they may become obese in their early adolescents and even later in life.

No doubt, a baby’s growth chart will not look exactly the same as another baby’s, even if they are brothers or sisters. Also, a baby will gain weight most rapidly in the first 6 to 9 months and the rate of growth will gradually slow down as they become a toddler and are more active.