Q&A: Her weight has dipped on her growth chart
My daughter is turning 1 soon and her weight is worrying me. When she was born she weighed 3.93kg, she was the biggest baby in the ward. She was in hospital for 14 days as she was on antibiotics as she came into contact with her faeces while she was still in the womb. By the age of 9 months she only weighed 6.5kg, and 2 months later had only gained 1.65kg. As she wasn’t gaining weight we started taking her to the clinic every month for observation. My daughter stays with my mother during the day and she doesn’t eat well at all. She spits out any food you give her and it seems like she just doesn’t like eating. She has gained some weight since our visit to the clinic but since she is teething she’s started to lose weight again as she doesn’t want to eat even the things she usually prefers. 

Simon answers:

I agree that you should be concerned with the weight gain and loss that your daughter has undergone. Her birth weight is impressive but unfortunately the birth weight does not determine how big your child will be.

It is true that big people generally have the big babies at birth but many times small moms can have big babies. I see this as the mother being a fantastic incubator but the baby may not be genetically wired to be a big person so their weight gain may be lower than expected. They will gain weight well along the lower percentile when they reach the weight that they are designed to be.

Your baby grew really well until 14 weeks of age with her weight tracking along the 75th percentile for age. This means that her weight was above the dark central line of the growth chart and in the top 75% for her age. It is important to note that she grew well even though she had a problem at birth and needed to stay in hospital longer than expected. This is usually the case with children who are sick at birth: once they have been treated they grow as well as you would normally expect.

Her weight gain slowed down dramatically and at 6 months of age it was now on the 25th percentile and then she lost weight over the next 3 months so that at 9 months she was under the 3rd percentile and has now gained back up to the 10th percentile.

This bit of weight gain is encouraging but we need to sort out why she dropped off so dramatically. For weight to have dropped from high on the graph to under the 3rd percentile which is in the bottom 3% for her age, something must have been wrong.

Children who are breastfed and who battle to wean and refuse to eat food can have a period around 6 months of age when they do slow down their weight gain and, in extreme situations, do lose weight. But you need to sit with someone with medical expertise and go through the full history of your child’s feeding including breast, formula and solids.

I would be very concerned by the severe drop in weight of your baby and suggest that you need to see a paediatrician to have the baby checked out for a medical problem. The other option is to see a dietician who can help you with feeding your baby. It does sound like she is a difficult feeder and she may require a supplement feed to help her gain weight.

This question illustrates the importance of regular weights and documenting the growth of a child. It is so very important that we use the clinic card to record the growth of our children. We must keep a longitudinal record as the mother who sent in this question has. She has been superb at attending the clinic and recording the weights and it helps immensely in trying to sort out the problem.

So all moms, please take your child’s clinic card with you every time you go to the clinic or see a doctor and make sure that the measurements are recorded.

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