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Are 'Fat Babies' Healthy? When Is Baby Weight A Concern?

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Babies with chubby cheeks, round tummy, and prominent skin folds look adorable. Besides, they are generally considered healthier than their lean peers. But many parents might be curious if that baby fat indicates overweight or obesity. Are the so-called “fat babies” really healthy?

It is normal for most babies to be a bit on the heavy side, but in some cases, it could indicate excess weight gain. Read to know when heavier babies are healthy and when they are not, and how to prevent excessive weight gain in babies.

Are “Fat Babies” Healthy?

According to Richard I. Shader, MD, “most adequately nourished newborns have fat rolls on their legs and arms and noticeably short to absent necks (1).” At birth, about 15 percent of the baby’s weight is fat, which is higher than many mammals.

Therefore, babies naturally tend to have a roundish appearance. Most babies who appear plump are completely healthy, and their bulkiness may not necessarily indicate an underlying problem, overweight, or obesity.

During the entire first year, most babies gain weight and become heavier; however, some may appear fat and some may not, depending on their height.

Functions of baby fat

About 95% of baby fat is subcutaneous white fat or subcutaneous white adipose tissue, while the remaining 5% is brown fat or brown adipose tissue. Body fat, especially brown fat, is necessary for babies to support several body functions, such as the regulation of body temperature through insulation. Baby fat also works as an energy reserve facilitating the baby’s rapid brain growth and development (2).

Why Are Some Babies Heavier Than Others?

The birth weight and subsequent weight gain in babies can depend on several factors (3).

  1. Genetics: Research shows that parental height and weight can influence the baby’s birth weight and weight gain pattern during infancy(4). Also, women of certain genetic backgrounds may usually give birth to heavier babies.
  1. Gender: Full-term boys tend to be heavier at birth and gain weight faster than full-term girls. Androgen (a male hormone) activity might be responsible for the occurrence (5).
  1. Birth order: Evidence suggests that second-born babies are usually heavier than their first-born siblings, although there can be exceptions. Several factors, including changes in gestational age, may cause this weight disparity (6).
  1. Maternal weight: An overweight or obese pregnant woman could have a higher risk of delivering a heavy baby (7). The baby may also have excess weight gain later.
  1. Maternal health status: Certain maternal health conditions during gestation could lead to a heavier baby at birth. For instance, gestational diabetes may lead to high birth weight and other complications in newborns (8).
  1. Maternal diet: A woman’s diet during gestation could influence an infant’s birth weight and weight gain pattern. According to a Harvard School of Public Health study, women who consume excessive trans-fat foods, such as fried foods and baked goods, during pregnancy usually give birth to larger babies (9).
  1. Post-term delivery: Babies born after 42 weeks (post-term) of gestation are likely to be larger than those born full-term (10). Very few babies are born after 42 weeks, and the reasons for the pregnancy to prolong are unclear(11).
  1. Excessive formula feeding: Overfeeding formula or feeding formula in large bottles could lead to weight gain in formula-fed babies (12).
  1. Inappropriate solid foods: A baby older than six months consumes various solids and drinks. Feeding the baby high-sugar, processed foods, and drinks, such as fruit juices, could cause excess weight.

Some of the other factors that can influence a baby’s birth weight and weight gain are fetal chromosomal abnormalities and multiple births. The intertwining of multiple factors could result in a specific growth trend, causing some babies to become heavier than others.

What Are The Health Risks Of Excess Weight In Babies?

Several studies note that excess and rapid weight gain during the first two years of life is strongly co-related with overweight and obesity in later life (13)(14). Babies constantly gain weight through infancy and toddler hood. However, weight gain at a rate faster than normal is what usually indicates that the baby is becoming overweight or obese.

Babies with excess weight may find it difficult to balance their neck and maintain posture. They are also likely to experience developmental delays due to a likely delay in attaining developmental milestones, such as crawling and walking (15).

Most risks of excess weight gain can be mitigated through regular monitoring of the baby’s weight. If you feel your baby is gaining too much weight, do not hesitate to talk to a pediatrician.

How To Know If Baby’s Weight Is A Cause For Concern?

The average birth weight of a full-term, healthy baby can be between 5.5lb (2.5kg) and 10lb (4.5kg) (16). The birth weight of most babies doubles by the fourth or sixth month and triples by the 12th month (17). Throughout this time span, a pediatrician will periodically plot your baby’s weight, height, and head size on a standard growth chart to monitor their growth.

A standard growth chart is an assessment tool that compares a baby’s head size, weight-for-length, length-for-age, and weight-for-age against the standard ranges for babies of the same gender and age (18). If a baby’s weight-for-length is greater than the 98th percentile, they are considered large or heavy (19) (20).

Many babies lose weight by the time they become toddlers. However, if baby fat persists or increases, your doctor will monitor the baby more closely and suggest strategies to regulate weight gain.

Note: Use the World Health Organization’s (WHO) growth charts for monitoring the growth rate of babies under two years of age (18).

How To Keep A Baby At A Healthy Weight?

In most cases, baby fat isn’t a concern, yet keeping your infant’s weight within a healthy range is good for optimal long-term health. Below are some tips that may help keep your baby’s weight on track (21) (22).

  1. Breastfeed your infant more and for a longer time, which may be beyond 12 months. Breastfeeding reduces your infant’s risk of gaining too much weight.
  1. Give expressed breastmilk to your baby as much as possible if breastfeeding isn’t possible.
  1. Use smaller bottles to feed your baby as large bottles often lead to overfeeding.
  1. Do not give a bottle to your baby to self-soothe or fall asleep. Instead, teach babies ways to self-soothe as early as three months of age.
  1. Avoid adding cereal to thicken the formula unless directed by your pediatrician.
  1. Follow responsive feeding. Identify your baby’s hunger cues and feed accordingly rather than following a time table.
  1. Avoid serving processed foods, such as sugary cereals, and beverages, such as packaged juices, to babies. Instead, offer various foods made with fresh fruits, vegetables, grains, pulses, fish, and lean meat.
  1. Encourage healthy snacking between meals in limited portions. Choose fresh, homemade snacks instead of packaged options, such as biscuits.
  1. Encourage physical activity in older babies and toddlers by engaging them in active games, such as outdoor games.
  1. Avoid pacifying babies and toddlers with food. A baby crying doesn’t always mean they are hungry. A baby/toddler cries due to several reasons, such as boredom.
  1. Avoid food reinforcement in older babies and toddlers. Do not use food as a reward since it may set unhealthy eating habits and lead to overweight and obesity (23).

Observe a health feeding pattern, but remember not to put a baby or a toddler on a weight loss diet.  Most babies are chubby and plump, but that does not mean they are necessarily overweight or obese. Baby fat is mostly normal and has critical physiological roles to play. Visiting the pediatrician periodically and monitoring weight at home can help you determine excess weight gain in a timely way.

References:

1. Baby Fat or a Fat Baby?; Clinical Therapeutics
2. Fatness At Birth; Center For Academic Research And Training In Anthropology
3. Your Newborn’s Growth; Kids Health From Nemours
4. Lucy J Griffiths, Carol Dezateux, and Tim J Cole;Differential parental weight and height contributions to offspring birthweight and weight gain in infancy; NCBI
5. F de Zegher, et al.;Fetal growth: boys before girls; NCBI
6. Silvia Bacci, et al.;Differences in Birthweight Outcomes: A Longitudinal Study Based on Siblings; NCBI
7. Obesity and Pregnancy; American College of Obstetricians and Gynecologists
8. Yi Yang, et al.;The association of gestational diabetes mellitus with fetal birth weight; NCBI
9. Mother’s trans fat consumption linked to baby’s size; Harvard T.H. Chan School of Public Health
10. Tracking Your Baby’s Weight and Measurements; Healthy Children
11. When you pass your due date; U.S. National Library of Medicine
12. Bottle Size and Weight Gain in Formula-Fed Infants; AAP
13. Jessica Appleton, et al.;Infant formula feeding practices associated with rapid weight gain: A systematic review; Online Wiley Library
14. TorillAliseRotevatn, et al.;Infancy weight gain, parental socioeconomic position, and childhood overweight and obesity: a Danish register-based cohort study; Biomed Central
15. M Jaffe and C Kosakov;The motor development of fat babies; NCBI
16. Physical Growth in Newborns; University of Michigan
17. Slow Weight Gain in Infants and Children; Boston Children’s Hospital
18. WHO Growth Standards Are Recommended for Use in the U.S. for Infants and Children 0 to 2 Years of Age; CDC
19. Assessing Growth Using the WHO Growth Charts; CDC
20. Infant BMI or Weight-for-Length and Obesity Risk in Early Childhood; AAP
21. 6 ways to help keep your baby at a healthy weight; Harvard Health Publishing
22. Weight of the Nation: Healthy Mom, Healthy Baby – The Risks of Excess Weight; Oregon Health Authority
23. Why Parents Shouldn’t Use Food as Reward or Punishment; University of Medical Rochester