August 9, 2007

Question: My mom is worried about my baby because she says he's too skinny. I say he's just fine, but she has this idea that a baby isn't healthy unless he's chubby. How can I know for sure, and what can I tell my mom?

Answer: It used to be that people thought "healthy baby" and "chubby baby" were synonymous; but now we know that's not the case. In fact, with childhood obesity at epidemic levels in the United States (and Type II diabetes increasingly common at young ages), growing "chubby" kids is not a desirable goal. That said, babies vary greatly in size and body type, and there's a wide range of normal. Up to the age of 2 years, a baby's weight is not very predictive of size or weight later in childhood or adulthood.

There are two situations in which a baby's low weight may be cause for concern. First of all, a baby weighing less than 5.5 pounds at birth is considered a "low birth-weight baby" and may have a higher risk of developmental problems than a normal-sized baby. Low birth weight is sometimes a result of maternal smoking or poor nutrition during pregnancy. A second scenario is a baby whose growth proceeds at a slower rate than normal. This may indicate a physical problem or, in rare and serious circumstances, a condition called "failure to thrive," which may result from extreme emotional neglect or hard-to-diagnose medical problems in the child.

Chances are your baby is just fine. Your pediatrician can show you exactly where your baby falls on the normal growth curve for both height and weight and can track his growth over time, reassuring you and your mother that he's on track in spite of his slender body type. Beyond looking at his growth patterns as compared to others his age, it's also important to pay attention to other indicators of your baby's health and well-being -- for example, skin tone, muscle tone, energy level and his achievement of major developmental milestones such as rolling, sitting, pulling up and grasping.

As for what to say to your mother, it's important to let her know that you appreciate her concern about your baby's health. Then let her know what your doctor says about your baby's growth, perhaps showing her where he falls on the growth chart or even inviting her to go along for a well-child visit. No doubt, your mother has much to teach you, and you will have things to teach her as well. Knowledge about child development, nutrition, and parenting is changing all the time, so welcome your mother to be your partner in learning all you can about what's most important for your child.

Dr. Erickson and her daughter can be heard every Sunday, from 2 - 4 pm, on "Good Enough Moms," on FM107.1 radio in the Twin Cities or via Webcast at www.FM1071.com