Patient education: Poor weight gain in babies and children (The Basics)

How do I know if my baby is not gaining enough weight? — Your baby's doctor or nurse will tell you if they are not gaining enough weight. At each visit, your baby will be weighed. Then the doctor or nurse will compare your baby's weight to their weight at the last visit. They will also compare your baby's weight to the weight of other babies of the same age and sex. They use this information to tell whether or not your baby is gaining enough weight.

Some babies do not gain enough weight starting at birth. Other babies gain enough weight for a while, but then slow down or stop gaining weight.

If your baby isn't gaining enough weight, their doctor or nurse will want to figure out why. They will treat the cause and work with you to help your baby gain more weight. Babies need to gain enough weight so that they can grow and develop normally. Babies who do not gain enough weight can have problems later in life, such as learning problems or problems with the body's infection-fighting system.

What are reasons that a baby might not gain enough weight? — Reasons a baby might not gain enough weight can include:

●Being born too early

●Not getting enough food – For example, some babies have trouble sucking at the breast or bottle. Or caregivers might not feed their baby often enough.

●Having a medical problem that affects the stomach, mouth, throat, or heart

●Changes or stress in the home or family

●Having things around that take attention away from eating

Why isn't my child gaining weight? — To figure this out, the doctor or nurse will do an exam and ask you questions about your child's eating habits. They might ask you to keep track of all the food your child eats (form 1). Let the doctor or nurse know if your child:

●Has vomiting or diarrhea

●Does not eat certain foods

●Drinks much more than they eat

Your doctor might also order some tests.

Who do I work with to help my child gain weight? — Your child's doctor or nurse will work with you to make a plan to help your child gain weight. They might recommend that you also work with other experts, such as a dietitian. A dietitian is an expert on food and eating.

Most children can be treated at home. But some children need to stay in the hospital for a short time. In the hospital, doctors can treat children and watch them closely.

What can I do to help my child gain enough weight? — There are things you can do to help your child gain enough weight (table 1). You can change:

●What your child eats – You can help your child gain weight by feeding them foods with a lot of calories. Talk with a doctor, nurse, or dietitian about the right way to do this. They might recommend that you add extra calories to your baby's feedings. Or if your child is older, you might need to add cheese, butter, or sour cream to their foods. The doctor or nurse might also recommend that your child take a vitamin every day.

●How often your child eats – Babies might need more feedings each day to gain weight. Older children might need to eat every 2 to 3 hours, and have 3 meals and 3 snacks a day.

●Where and how your child eats – Making changes to the area where your child eats might help your child eat more. For example, some children eat more when the whole family eats together or when meals are fun.

What other treatments might help my child gain enough weight? — Sometimes, other types of treatments can help. These can include:

●Medical treatments – Some children need to be treated for medical problems that can keep them from gaining enough weight.

●Physical or occupational therapy – Some children have problems with their body or behavior that can make it hard for them to eat enough food. People called "physical therapists" or "occupational therapists" can work with children to improve these types of problems.

●Family help – Some children do not eat enough because of problems at home. A family might not have enough food, or a caregiver might be too sick to take care of a child. Your child's doctor or nurse can work with you to find programs or people who can help with these types of problems.

When should I follow up with the doctor or nurse? — Your child's doctor or nurse will follow up with you on a regular basis. On each visit, they will weigh your baby or child and talk with you. Be sure to let them know if you have questions or are having any problems with treatment.

More on this topic

Patient education: Breastfeeding (The Basics)
Patient education: Food allergy (The Basics)
Patient education: Diarrhea in children (The Basics)

Patient education: Poor weight gain in infants and children (Beyond the Basics)