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Ask Dr. Mom: Baby Fat

Q. My 1-year-old had nothing but breast milk for the first six months, and I was so proud when she doubled her birth weight at only 3½ months of age. Although her rate of gain has slowed down since then, her weight is in the 75th percentile. I've just read about a new study showing that babies who gain weight rapidly in the early months of life are more likely to be overweight in childhood. Should I be worried?

A.
Rather than being concerned, you should be pleased that your daughter thrived on exclusive breastfeeding. It's normal for breastfed babies to gain weight rapidly in the early months of life; you needn't worry about overfeeding an infant when it comes to breast milk.

The study you read about, conducted by researchers at the Children's Hospital of Philadelphia, showed that rapid weight gain in healthy, full-term infants during the first 4 months of life was linked to an increased risk of being overweight at 7 years of age. Keep in mind that this one study is not the final word on weight gain, and the researchers aren't certain how to interpret the study results.

Because the first 4 to 6 months after birth represent the greatest proportional weight gain in a child's life, it's possible that early infancy is a critical period for the development of overweight tendencies. It's also possible, however, that weight gain in the first 4 to 6 months reflects the influence of a genetic predisposition to being overweight.

Although recently published, the study findings were actually based on babies born in U.S. cities in the 1960's, a time when most were fed formula and given solid foods at an early age. Thus, the study results need to be confirmed with babies born more recently who are fed differently. And even if the findings can be validated, the seven-year follow-up of this study is not long enough to draw firm conclusions on the long-term impact of early weight gain, since most overweight 7-year-olds won't become overweight adults.

In fact, unhealthy weight gain is a complex problem influenced by heredity, caloric intake, and activity level, as well as parental eating habits. There are a number of simple things you can do to help foster healthy attitudes concerning food and exercise in your 1-year-old:

  • Respect your baby's hunger and fullness cues so she will learn to listen to her appetite. Coaxing, bribing, cajoling, and other coercive methods not only provoke power struggles, but they can also interfere with a child's ability to regulate her food intake, thereby predisposing her to becoming overweight later in life.

  • Avoid giving food emotional connotations by frequently using sweets as a reward, withholding food as punishment, or encouraging a pattern of eating in response to stress or difficult feelings.

  • In today's society, where "super-sized" portions are the norm, offer appropriate serving sizes.

  • As your daughter gets older, don't let her snack on high-fat, processed foods. Instead, provide nutritious snack options.

  • Finally, give your child plenty of opportunities for active play. And remember that your own model of physical activity and healthy eating will strongly influence your child's developing habits.

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