"Wah! Why your baby so skinny one? Better give formula and make fat fat..." We hear this all the time from well-meaning strangers. But is it really so bad if you have an underweight baby?
A parent with an underweight baby
When you have a skinny baby, you're going to get a lot of unwanted attention. People who have absolutely no role or significance in your life will walk up to you and give you advice about how to fatten up your child. Like it's your fault the little one is not huge.
It does not matter to them that the baby has always been small, is on top of his milestones, and is healthy and clever. No. A skinny baby just evokes strong emotions in strangers.
Even close relatives are not kind to mums when it comes to lean babies. Random pieces of advice are doled out and the mum starts to feel pressured into fattening the baby up!
Dads seem to be more immune to this, but even they eventually give in. I have a skinny baby. He is also tiny. And I am a work-from-home dad. So I have been responsible for his weaning and nutrition while his mother is away at work. So I know, mums. It stings!
Here, I am going to give you some information about skinny babies, primarily to learn about the causes, and secondarily, to shove this article in the face of someone who comments "'ffff" the next time.
Determining an underweight baby at birth
When your paediatrician says your kid is "on the chart," they're probably referring to the World Health Organization's (WHO) growth charts. This is also recommended by the Center for Disease Control and Prevention (CDC) for children from birth to age 2 according to their own growth chart.
These charts are based on years of high-quality research and use breastfed infants as their baseline. There are separate charts for girls and boys. Your doctor may utilise the World Health Organization's weight-for-age or weight-for-length charts, or both.
The WHO charts display your baby's length or weight data points on one axis and their age on the other. Your baby's percentile for their age is determined by where the two intersect on the graph.
Understanding Percentiles of Growth
How do you know when your newborn baby is underweight?
Consider the following example to better grasp what the numbers mean: A kid in the 25th percentile for weight is heavier than 25% of children his or her age.
Remember that on a growth chart where the 50th percentile is deemed average, 49 babies out of 100 will be "lower than average," which is a lot of newborns!
In general, a newborn is deemed underweight if their weight-for-age measurement is in the 5th percentile or less. This is not always applicable if your baby was delivered prematurely or with specific medical issues.
If you don't want to wait until your next doctor's appointment to find out where your child is on the curve, you may figure it out by charting their length and weight on the WHO’s online charts.
It's also worth mentioning that, while adults frequently use the body mass index (BMI) to determine the weight, the CDC does not advocate this for infants.
Why are some children skinny
Firstly, not all babies who appear skinny are underweight. Appearances can be deceiving. You all know what dark colours and vertical stripes can do to the way you look! So, it is important to judge objectively if the baby/child is truly underweight. For that, we use
- Weight and height for age charts
- Body Mass Index charts
If a child really appears to be skinny, it can be due to the following reasons:
They are just born tiny and have a genetic makeup to be skinny.
In our goal to produce a kid at a specific position on the development chart, we may overlook how much our genes may play a role in children's size.
So, ask yourself, "How big am I?" What is the size of the baby's other parent? If you and/or your baby's other parent are smaller, it stands to reason that your child will be as well.
However, it is also true that size genetics may not manifest until after birth. A baby's weight may be more related to their birth weight in the first year or two.
Your child's birth weight is too low
If your baby was born at a low birth weight due to early or premature delivery, or because they are a multiple, they may remain small for several months, if not longer.
Remember that kids born at low, normal, or high weight might progress at different rates. A slight slip on the growth curve can be a typical component of the "two steps forward, one step back" dance of baby growth — but if you find this happening, consult your doctor. Regression on the growth curve might be an indicator of a problem in some cases.
Breastfeeding vs. bottle-feeding
It may sound like a cliche, but weight gain discrepancies between breastfed and bottle-fed newborns are common in the first year of life. According to a 2012 study, the more infants who were nursed gained less weight at 3, 5, 7, and 12 months. In contrast, the more bottle feedings the newborns received, the heavier they were.
This does not imply that a breastfed baby must be bottle-fed for healthy growth – or that most formula-fed newborns are overweight! Observing other crucial signs of your baby's well-being might provide you with peace of mind concerning the number on the scale.
I am going to give you a table to differentiate between the two as well, later on.
Lean baby vs Underfed baby
Genetics or not growing properly in the womb can cause babies to be lean. At birth, they may be on the lower side of normal when it comes to weight and height. However, they usually maintain the percentile point as they grow up.
These babies are generally healthy. The hallmark of a healthy baby is one that takes an interest in his surroundings and interacts well with others. He eats well, sleeps well, and is playful. He achieves his milestones on time. He eats his fill, is interested in food, and does not have to be force-fed.
These babies may be born normal or lean. However, they do not feed properly, are quite clingy, and are active. Yet they do not choose to interact with their surroundings. If the state of underfeeding continues, doctors label them as "failure to thrive."
Special measures should be taken in such cases. It might be due to improper feeding techniques, lack of nutrients in their diet or due to underlying health conditions. In either case, their paediatrician can recommend special care.
Should You Fatten Up a Skinny Baby?
As a mother, you might be looking for tips to fatten up a skinny baby. However, that should not be your objective.
The main reason for nutrition is growth and development, not to make your baby fall within the accepted societal standards! If you are worried that your baby is skinny, the first thing you need to do is to look at this chart and see what describes your baby accurately.
If your baby is lean, don't worry. Let him be. Overfeeding can cause aversions and frequent throwing up. This will worry you even more. If your baby is underfed, on the other hand, you should see a doctor about it.
What About Skinny Toddlers and Young Children?
As soon as the baby learns to walk, his baby fat is going to disappear. So suddenly, your baby would no longer look like a baby.
Children are quite active, and the more active they are, the skinnier they appear. Just ensure that your child:
- is eating enough
- meets milestones
- does not appear lethargic
- is not terribly small for his age
BMI is a good indicator for judging if you need to fatten up a skinny baby! If the BMI is within the normal range, do not worry. Check out this BMI calculator here, or speak to a paediatrician if you are concerned.
Overfeeding may cause obesity and health complications later on, and you wouldn't want that for your child. So, just focus on his development and ignore all the comments about his weight. After all, you are the best person to judge how well your baby is growing, aren't you?
My Baby Looks So Thin, Should I Be Worried?
Is My Chubby Baby Healthy? What You Need to Know About Overweight Babies
Baby Check-Up: A Quick Guide on What to Ask the Paedia, What to Expect, and What to Watch Out For
Signs that your baby isn't eating enough
If, on the other hand, your child's developmental milestones appear to be delayed — or if they aren't being met at all — it's time to consult with your paediatrician.
Similarly, seek medical treatment if your baby's sluggish growth is accompanied by any of the following symptoms:
- inability to feed adequately from a bottle or breast
- not generating wet or dirty diapers
Other reasons for a growth failure
When a newborn does not gain adequate weight, this is referred to as failure to thrive. This diagnosis is typically provided when your child's weight falls below the 5th percentile on standard growth charts, according to the American Academy of Family Physicians.
Failure to thrive may sound frightening, but it is not always a perpetual sentence of doom and gloom. In many cases, it is a transient condition caused by inadequate breast or bottle feeding. This is often resolved when feeding interventions return the baby's weight to normal.
Failure to thrive can be caused by a hereditary or physiological problem in some situations. Babies with Down syndrome, heart issues, cystic fibrosis, cerebral palsy, and other underlying illnesses can all experience growth difficulties. Digestive issues such as acid reflux or celiac disease might potentially prevent your child from eating properly, resulting in low growth.
Individual development charts have been created for children with a wide range of special needs, including Down syndrome, Prader-Willi syndrome, and Marfan syndrome. If your kid has a medical issue, your paediatrician may choose to utilise one of these customised charts to better properly monitor their growth.
What your doctor may suggest if your kid isn't gaining weight
When it comes to assisting your child in gaining weight, every circumstance is unique. If you've determined that your child's underweight is a true issue, consult with your doctor about how to effectively handle it.
If you're breastfeeding, your doctor may encourage you to nurse your infant more frequently or take other steps to increase your supply. They may also advise you to start (or increase) your intake of solid foods or to supplement with formula. Formula-fed babies' parents may also be urged to increase feedings or finger foods.
Offering greater variety, choosing higher-calorie, more nutrient-dense foods, and attempting to make mealtimes an enticing, pleasurable experience are all weight-promoting alternatives for babies who have started solid foods but are still not eating enough.
Image source: iStock
Babies come in many forms and sizes, whether they are long, short, thin, or plump. While society may offer the notion that your little nugget must have rolls of baby fat to be healthy, this is not the case.
You probably don't need to be concerned as long as they're reaching developmental milestones, are attentive and active, and are feeding properly. The key to a baby's well-being is consistent growth, not exponential growth.
Also, keep in mind that your paediatrician, not your neighbour or relative, is the greatest expert to assess whether your baby needs to gain weight. Even if your child does need to fatten up, there are numerous tools and resources available to help them get back on track.
Here at theAsianparent Singapore, it's important for us to give information that is correct, significant, and timely. But this doesn't serve as an alternative for medical advice or medical treatment. theAsianparent Singapore is not responsible for those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend consulting your doctor for clearer information.