Addressing Weight Concerns in Infants: Tips for Parents

Baby weight issues?

Hello, doctor.
My baby boy was born at 36 weeks and weighs 1500g.
His corrected age is one year, with a height of 68 cm and a weight of 7 kg.
He drinks milk every 3 hours, and previously he drank a maximum of 120 cc.
After he caught a cold at 10 months old and took medication for nasal congestion (which increased his appetite), his milk intake increased to 165 cc.
For complementary foods, he previously had watery stools when trying new foods, so he currently only eats rice cereal, chicken puree, soft white rice, and apple puree.
He had an allergy to egg yolk when he was 10 months old.
Recently, he has shown little interest in drinking milk.
He doesn't eat much of the complementary foods because he won't sit still to eat; if I force him to sit, he refuses to eat.
Even after 1 to 2 hours, he still seems unsatisfied.
He only wants milk when he is about to fall asleep.
His activity level is good; he crawls quickly and can walk more than 10 steps independently.
At 4 months, his head circumference, height, and weight were all above the percentile lines.
However, at the 9-month health check, his weight fell below the growth curve.
By the 11-month health check, both his height and weight had dropped below the percentile curve.
In October, he had a cold, experienced food allergies, and had skin allergies.
The doctor from the previous health check prescribed vitamin drops and suggested adding Abbott Similac Neosure.
However, he refuses to drink the Similac, so I had to buy the Honey Bear formula from the pharmacy, which he accepts.
He initially refused the Similac but I will try again.
Doctor, should I supplement him with anything else, like calcium or other nutrients? How can I help him gain weight? It seems like he eats less than a typical child.
He was breastfed until one month old and then switched to Abbott Similac Neosure (as recommended by a doctor) until he turned one, and now I am transitioning to a lower weight formula.
Will drinking these two types of formula put a heavier load on his kidneys? Is this transition okay? After he started teething, I give him water after his milk, and he drinks a lot.
Yesterday, he drank 50 sips of water after adjusting his formula.
I find the milk quite sweet.
Could it be that he doesn't like it that sweet? Doctor, should I give him Similac or find a milk he enjoys? I am worried because his weight is not increasing.
I would like to consult you.
Thank you!

Xiao Tu Ma Mi, 30~39 year old female. Ask Date: 2008/11/03

Dr. Xie Degui reply Pediatrics

1.
According to the description, the baby's development is not delayed, but growth is insufficient and height is below normal, indicating a lack of nutrition for some time.

2.
Besides being premature and having a low birth weight (SGA), the baby may also have intestinal sensitivity issues, leading to frequent watery stools.
Generally, a hypoallergenic formula is recommended.
The premature infant formula (0.8 kcal/cc) or Similac Neosure (1 kcal/cc) is considered high-energy; if there are no skin sensitivities or gastrointestinal issues such as gas or diarrhea, these can be used.
However, since the baby has reached a corrected age of one year, formula should no longer be the primary source of nutrition, and there should be an emphasis on semi-solid and solid foods.

3.
Drinking water can occupy stomach capacity, indicating that the baby can still drink more.

4.
Consideration should be given to the possibility of anemia and deficiencies in trace elements, which should be supplemented.

5.
Clinically, the use of probiotics may be considered.

6.
Follow-up in the outpatient clinic is recommended, as both height and weight are significantly below normal.

Reply Date: 2008/11/03

More Info

Addressing weight concerns in infants, especially those who are premature or have experienced health issues, can be a challenging task for parents. Your situation with your one-year-old son, who was born at 36 weeks and currently weighs 7 kg with a height of 68 cm, raises several important considerations regarding his nutrition and overall health.

First and foremost, it is crucial to understand that growth patterns in infants can vary significantly, especially for those who were born prematurely. The fact that your son has experienced fluctuations in weight and has fallen below the growth percentile lines is a concern that should be monitored closely. It is essential to maintain regular check-ups with a pediatrician to track his growth and development accurately.

Nutritional Recommendations
1. Balanced Diet: At one year of age, your son should be transitioning to a more varied diet that includes a range of foods. While you mentioned he is currently consuming rice cereal, chicken puree, soft white rice, and apple puree, it is important to introduce other food groups gradually. Consider adding mashed vegetables, fruits, and other protein sources like beans or lentils. This variety will help ensure he receives the necessary vitamins and minerals for healthy growth.

2. Caloric Intake: Since your son is not consuming enough calories, it may be beneficial to include higher-calorie foods in his diet. Foods like avocado, nut butters (if there are no allergy concerns), and full-fat dairy products can help increase caloric intake without requiring large volumes of food.
3. Milk Intake: You mentioned that your son is currently drinking a low-weight formula and is transitioning to a different formula. It is crucial to ensure that the formula he is consuming is appropriate for his age and nutritional needs. If he is not drinking enough milk, consider offering it in different forms, such as smoothies with fruits or mixed with cereals, to make it more appealing.
4. Hydration: It is good that you are giving him water after milk, but be cautious about how much water he consumes. Excessive water intake can sometimes interfere with nutrient absorption. Ensure that he is getting enough milk or formula before offering water.

5. Addressing Food Preferences: If your son is rejecting certain foods or formulas, it may be helpful to experiment with different brands or flavors. Sometimes, the sweetness of certain formulas can be off-putting to infants. If he prefers a less sweet option, try to find a formula that meets his taste preferences while still providing the necessary nutrients.

Behavioral Considerations
1. Eating Environment: Since you mentioned that he does not sit still to eat, creating a calm and engaging eating environment can help. Try to minimize distractions during meal times, and consider using fun plates or utensils to make eating more enjoyable for him.

2. Routine: Establishing a consistent feeding routine can help him understand when to expect meals and snacks. This predictability can encourage better eating habits.

3. Patience and Persistence: It is common for toddlers to be picky eaters or to refuse food at times. Continue to offer a variety of foods without pressure. It may take several exposures to a new food before he accepts it.

Medical Considerations
Given your concerns about his kidney load due to the formulas, it is advisable to consult with a pediatric nutritionist or your child's healthcare provider. They can provide tailored advice based on his specific health needs and growth patterns. Regular monitoring of his growth and nutritional intake is essential, especially since he has experienced allergies and other health issues.

In summary, focus on providing a balanced diet with a variety of foods, ensure adequate caloric intake, and create a positive eating environment. Regular consultations with healthcare professionals will also help address any underlying concerns and guide you in making the best nutritional choices for your son. Your proactive approach to his health is commendable, and with the right support, you can help him thrive.

Similar Q&A

Understanding Weight Issues in Infants: Common Concerns and Clarifications

Dear Doctor, Thank you for the detailed information in the attached file. After reading it, I have a more concrete understanding of the causes of underweight in young children. However, I have a few questions that I hope you can clarify. Thank you. 1. Generally, the growth asse...

Dr. Pei Rensheng reply Pediatrics
Hello, You are a very dedicated mother. 1. The growth curve data provided by the Department of Health in June 1999 is now over seven years old and may not accurately reflect your baby's current situation. Theoretically, with advancements over time, babies tend to be tall...

Guidance for Parents: Addressing Pediatric Weight Concerns

Hello, Dr. Chang. My baby boy was born at 37 weeks with a weight of only 1885 grams. When I asked the doctor why he was so underweight, the doctor said it was due to a tight and tangled umbilical cord, which resulted in him not receiving adequate nutrients in the womb. After birt...

Dr. Zhang Yingwen reply Pediatrics
The baby is one year and six months old and weighs only eight kilograms, which is indeed underweight and indicates poor growth. It is necessary to consult specialists in four areas for evaluation: pediatric neurology, pediatric endocrinology, pediatric gastroenterology, and pedia...

Understanding Sleep Challenges in Infants: Insights for Concerned Parents

Dear Dr. Wang, Hello. My baby has just turned seven months old. Normally, infants are expected to have long sleep durations, but since birth, my baby has always struggled to sleep for extended periods. During the day, he often wakes up crying after just half an hour of sleep, an...

Dr. Wang Jiayi reply Pediatrics
I apologize for the delay in responding to your question due to personal matters. To assess a child's physical and mental growth and health, it is essential to first check if their height, weight, and head circumference are within normal ranges. A basic physical examination,...

Concerns About Low Appetite and Stagnant Weight in Toddlers

Hello, doctor. My daughter is currently 1 year and 6 months old. Her weight has been around 9.2 to 9.4 kg since she turned 1 year old. Her eating habits have not been very good; whether she is given baby-specific solid foods or eats with adults, even when dining out at regular re...

Dr. Xiao Kaiwen reply Pediatrics
A 1.5-year-old girl weighing 9.4 kilograms falls within the 25% to 30% percentile range, which does not indicate malnutrition at this stage. Additionally, if her height is growing normally, this situation can be considered acceptable. It is also important to take genetic factors ...