Overweight Infants, Prevention of

What is an overweight baby?

An overweight baby is a baby who gains weight far out of proportion to his growth in height. An overweight baby looks fat. Fat babies are not necessarily healthy babies. The infants who continue to be overweight as children and adults usually have parents, siblings, or grandparents who are overweight.

Any infant in a family with a strong tendency toward obesity needs help. Some physicians wait to make changes in the diet until the child shows signs of being overweight. However, prevention is easier than treatment.

How can I help prevent my baby from gaining too much weight?

The goal for growing children who are overweight is to slow the rate of weight gain (not to lose weight). If your family has a problem with weight gain, consider the following dietary precautions to help your baby:

• From the beginning, try to teach your child to stop eating before she feels completely full. Overfeeding teaches a child to overeat.
• Try to breast-feed. Breast-fed babies tend to be lighter in weight.
• If you are breast-feeding and your milk has come in, avoid grazing. Grazing is nursing at frequent intervals, sometimes every hour. Infants who graze learn to eat when they are upset and to use food as a stress reliever.
• If you are feeding your child with a bottle, don't allow your child to keep a bottle as a companion during the day or night. Children who are allowed to carry a bottle around with them learn to eat frequently and to use food as a comforting device.
• If your baby is bottle-fed, feed your infant no more often than every 2 hours at birth, and no more often than every 3 hours from 2 to 6 months of age. Change to 3 meals a day and 2 snacks by 6 months of age.
• Feed your child slowly, rather than rapidly. Don't do anything to hurry your child's pace of eating. (For example, don't enlarge the hole in the nipple of a baby bottle. The formula will come out of the bottle too quickly.) It takes 15 to 20 minutes for your baby to feel full.
• Don't make your baby finish every bottle. Unless your baby is underweight, he knows how much formula he needs.
• Don't feed your baby every time he cries. Most crying babies want to be held and cuddled or may be thirsty and need just some water. Teach your infant to use human contact (rather than food) to relieve stress and discomfort.
• Don't assume a sucking baby is hungry. Your baby may want just a pacifier or help with finding her thumb. Also, don't use teething biscuits or other foods in place of a teething ring.
• Avoid giving solid food to your child until he is 4 months old (6 months old if your baby is breast-fed).
• Don't insist that your child clean his plate or finish a jar of baby food.
• Don't encourage your child to eat more after she signals she is full by turning her head or not opening her mouth.
• Discontinue breast and bottle feeding by 12 months of age. A recent study by Dr. W.S. Agras found that delayed weaning was associated with more obesity.
• Avoid giving sweets to your child until she is at least 12 months old.
• Don't give your child food as a way to distract him or keep him occupied. Instead, give him something to play with when you need some free time.
• Use praise and physical affection instead of food as a reward for good behavior. Use food for rewards only to solve special problems such as difficult toilet training.
• CAUTION: Don't feed your baby 2% milk or skim milk before 2 years of age. Your baby's brain is growing rapidly and needs the fat content of whole milk.
• CAUTION: Don't underfeed your infant. While overfeeding is more common during infancy, underfeeding is more harmful.

When should I call my child's health care provider?

Call during office hours if:

• You are uncertain if your infant is overweight.
• You are concerned about your infant's weight.