My baby does not gain weight: what to do?

Baby growth is a matter of attention among practically all mothers. During visits to the pediatrician, many even ask: “Has my son gained all that he needed to gain?”; “My baby doesn’t get fat. Is my milk weak?”.

As a result of this concern, some people sometimes end up making wrong decisions out of sheer anxiety. Many mothers may think, for example, that their baby is not gaining weight because their milk is not being good enough for him. However, this is a myth, there is no such thing as weak breast milk. It is worth remembering that each mother produces the milk her baby needs and in the right amount. The fact is that the woman’s body only needs to regulate the amount of milk in the first days after delivery.

Other families still believe that powdered milk can be the solution when the baby does not gain weight. However, in fact, there is a lot to be taken into account and only a pediatrician will be able to give the correct guidelines according to each case.

“There are no specific and broad statistics about babies who do not gain weight, but this complaint is not uncommon in the pediatrician’s daily life”, comments Camila Richieri Gomes, pediatric endocrinologist at Clínica Dr. Family.

On the other hand, Tatiana Miranda, pediatrician at Hospital Leforte, highlights that the socioeconomic transition, added to the development of the health system and the improvement of sanitation conditions that Brazil is currently experiencing, has been favoring the reduction of the weight gain deficit (difficulty gain weight). “In addition to this new epidemiological characteristic, the country is also experiencing the so-called nutritional transition, which is characterized by the presence, in the same territory of malnutrition, of micronutrient deficiencies and overweight. Since today we are very concerned about the other pole of this problem, which is obesity, even in babies”, she says.

“In children, these two transitions, epidemiological and nutritional, can be noticed when there is a growing increase in the prevalence of overweight and obesity throughout the country, to the detriment of cases of malnutrition (low weight). The prevalence of obese children in Brazil is currently 6.6%”, adds Tatiana.

How to find out if your baby is under the recommended weight

It is not enough to simply look at the baby and think that he is “too skinny”, much less compare his development with that of other children.

Tatiana explains that the pediatrician will assess the child’s weight and height. “There are so-called normal weight percentile curves for each age, suitable for the Brazilian population, and divided by sex as well”, she says.

That is, there are reference tables and graphs for weight, height and body mass index of children, according to age and sex. And they are the ones who will “tell” if your baby, in fact, is not gaining weight.

The charts currently most used and recommended by the Brazilian Society of Pediatrics are the charts from the World Health Organization, according to pediatrician Camila. Check the links below:

• For girls from 0 to 5 years old
• For boys from 0 to 5 years old

Why is the baby not gaining weight?

Tatiana explains that the main causes of malnutrition stem from four elementary conditions:

1. Insufficient caloric intake. The child is eating fewer calories than his body needs.

2. Inadequate absorption. “The child eats what he needs, however, for various causes, diseases that we call malabsorption syndrome, his body does not properly absorb everything that is ingested”, explains the pediatrician.

3. Increased metabolic demand. “The child is in some condition where their body needs more calories than normal – chronic diseases, recurrent infections, are conditions where this can occur”, says Tatiana.

4. Misuse of nutrients. Unbalanced diet, poor quality or poorly prepared food.

Camila points out that, in general terms, children do not gain weight properly because they do not eat enough, or are not absorbing enough. “Of all these causes, the most common is inadequate intake,” she says.

What should parents do when they notice that their baby is not gaining weight?

1. Don’t make comparisons. It is important to point out that parents should not compare their child with other children in the family, for example, saying that their baby is too thin “because a friend’s child is the same age and is much chubby”. There are reference charts for weight, height and body mass index of children, according to age and sex, in this way, they are the ones who will “tell” if your baby is, in fact, not at the recommended weight.

2. Don’t blame yourself. The mother should never feel that it is her “fault” that the baby is not gaining weight. The idea “my milk is not good enough for my baby” is wrong.

3. Do not take any action on your own. It’s no use forcing the child to breastfeed/eat when he doesn’t want to, or trying to insert foods that you think will help him gain weight (if he’s already on complementary feeding). Only the doctor can pass the appropriate recommendations.

4. Always take it to the pediatrician. “Regular and periodic follow-up should be carried out with the pediatrician, who is capable of early detection of any problem that is happening to the baby. That’s what childcare consultations are for, that is, consultations in which the baby and the child go to the pediatrician without any specific complaint, to monitor their development”, highlights Camila.

Tatiana reinforces that the pediatrician is the professional who will assess whether there is really a deficit in weight gain, “and what will look for and elucidate the cause or multiple causes of why the baby does not gain weight”, she concludes.