New Outlook on Baby Weight

An interview with Dr. Alison Reed, pediatric endocrinologist, and Lonnie Wong, R.D., CNSC, registered dietician, at Sutter Pacific Medical Foundation’s Pediatric Specialty Care Center at CPMC

Trim the Baby Fat

People often believe that a fat baby is a healthy one, but a recent study by the National Academy of Sciences says that that may not always be true.

Research shows that 10 percent of U.S. babies and toddlers below age two are already overweight, and overweight infants are at risk for later obesity. With obesity on the rise in the U.S., the academy is now urging parents, caregivers, and doctors to monitor children’s weight more closely.

Personal Growth

In light of the study, Alison Reed, M.D. and Lonnie Wong, R.D., CNSC warn against making blanket statements about weight when it comes to babies. “We should look at each patient individually,” says Reed.

Generally an infant is considered overweight at the 85th percentile and obese at the 95th percentile. Yet things are not always that cut and dry. Some children may lie within the 95th weight percentile for most of their infancy and be perfectly fine.

The rate of gain is often more telling. “If infants stay on their curve consistently, they could be considered healthy, but if a baby’s curve goes straight up and crosses upwards on percentile, it’s a concern,” says Wong. If you think your baby has gained a lot of weight in a short period of time, it’s a good idea to talk to your pediatrician.

Reed and Wong also emphasize that it’s more accurate to look at a baby’s “weight for length” curve, rather than just weight. Even then “some breastfed babies may initially have a weight for length ratio above the 85th percentile,” Reed explains, “but then it decreases into the normal range over time.”

Four Steps to Healthy Weight

To keep children, including babies, at a proper weight, the National Academy of Sciences recommends:

• Make sure children get enough exercise. Because infants can’t walk, exercise may seem counterintuitive, but movement is still important. “When less than three months of age, tummy time is vital for development,” Reed urges. “In general, it’s important that infants move about and explore.”


• Limit television time. The American Academy of Pediatrics (AAP) says children under two should not watch TV at all.


• Be mindful of sleep. Most parents know how difficult it can be to get babies to go down, but make sure they have opportunities to sleep and an environment conducive to rest.


• Give children the right diet. Infants should be exclusively breast- or formula-fed for four to six months before starting solids. Since breastfed babies are at lower risk for obesity, AAP encourages breastfeeding for at least a year. Children on solids should consume a diet rich in nutrient-dense fruits, vegetables, milk and dairy products, and whole grains, and avoid energy-dense, nutrient-poor foods, like candy, fast food, and other processed foods.

The Best Baby Food

If a child does become overweight, your pediatrician or specialist may suggest a nutritional plan.

“When we see babies who are consistently skyrocketing on weight, parents are usually overfeeding,” says Wong. “They might be mixing formula incorrectly. Or they may be automatically feeding their infant whenever he or she cries. The baby then gets used to the bottle and doesn’t listen to his or her own internal cues that he or she’s hungry.” Infants over six months should feed every four hours, as opposed to every two or three.

If a baby does have a weight problem, Reed and Wong recommend structuring meals around breakfast, lunch, and dinner, with one or two snacks per day. At mealtime, parents should offer solids first and then liquids.