The Gist on Skinny Babies

It is common to equate chubby cheeks and Michelin rolls to a well-fed, healthy baby. Just see how everyone squeals in delight when they see one! But before you start feeling guilty for not producing enough milk, underfeeding or not investing in the best formula for your precious little bundle, pause and take a deep breath. 

Instead of being quick to misplace blame, it is more important to establish IF your baby is truly underfed in the first place or just genetically lean. So while everyone feels inclined to inject their well-meaning comment on your child’s size, take it with a pinch of salt. Unless confirmed by a paediatrician after a thorough review, for all we know, your baby’s lack of weight gain could just be genetics because, just like adults, babies also come in all shapes and sizes too.

How to determine if your baby is underweight

The easiest way to determine this is to refer to the World Health Organization’s (WHO) growth charts printed in every baby record book. It doesn’t matter if it was issued by Klinik Kesihatan or by a private hospital; parents can easily find this chart in every booklet. 

Every time your paediatrician explains your baby’s growth, he or she is most likely referring to this chart, and there are separate charts for girls and boys. Your doctor can easily determine if your baby is on the right track simply by plotting where the data point meets either on the length or weight on one axis and their age on the other. In short, by using the graph, you can determine your baby’s percentile for their age.

On average, a full-term infant is only considered underweight if they fall under the 5th percentile or less. However, this does not apply if your baby has other underlying health conditions or was born prematurely.

If you find the charts overwhelming, your doctor can always explain and walk you through and give you pointers on warning signs to look out for. More importantly, your child’s doctor will be able to carry out a physical assessment in person, take consistent measurements and track your baby’s growth progresses over time.

So why is my full-term baby underweight?

There are several reasons why your baby is underweight, so let’s tackle the possible causes one by one:

Is it Heredity?

Sometimes parents just want their baby to be chubby like every other baby, so much so that they forget how much their genes play a role too. Take a look in the mirror and assess yourselves. What is your body type? What if you compared yourself to the other baby’s parent? If you and your spouse have smaller statures, it is only natural for your baby to be just like you. 

Even if the genetics of size is not a strong determiner in infants, you can still gauge from their birth weight.

Premature and Low birth weight

Premature and multiple babies tend to have a lower birth weight and may continue to be on the smaller side for the first few months of life. Again, this varies from baby to baby as their weight can still fluctuate during this time. Hence, it is normal to note a slight drop in growth, but it is good to keep your doctor in the loop if you notice this happening. Most of the time, their weight and growth may regress for no reason whatsoever, so there’s no need to worry yourself to death. Still, it is good to share this information with your doctor so he or she can eliminate other underlying issues. 

Breastmilk or Formula?

Although it sounds cliche, and we are sure everyone in the breastfeeding community must be rolling their eyes now, but there are some minor differences in weight gain between breastfed babies and bottle-fed babies in the first year of life. Experts found that some breastfed babies gained less weight at 3, 5, 7, and 12 months, whereas babies on formula continued to pile on the weight. So this isn’t to say that breastfeeding mothers should stop at each growth spurt. We still stand by the fact that breastmilk is the best food for a baby, but knowing these key indicators can give breastfeeding mothers peace of mind, reduce their insecurities and boost perseverance to breastfeed. There are plenty of perfectly healthy breastfed babies who continue to thrive on breastmilk alone. 

More importantly..

The key point here is to look for signs that your baby is active and healthy instead of focusing on achieving those Michelin tyres thighs. As long as they are growing and meeting all their developmental milestones, these are better indicators of your child’s well-being. 

Watch your baby cross off all the milestones: from their first smile to being able to hold up their head without assistance, to rolling over and pulling themselves up to take that first step with their legs. An active and happy temperament all point to a healthy, thriving baby who is progressing just fine.

As long as they continue to do number one and number twos and provide you with regular soiled diapers, you don’t have to worry too much. Just enjoy the moment.

When to call your doctor

If you notice a delay in meeting milestones (or if they’re not meeting them at all), it is best to check in with your paediatrician. You should also call your doctor if your baby’s slow growth is accompanied by:

• lethargy
• not feeding well at the bottle or breast
• not producing enough wet or soiled diapers

It is good to have your baby checked out to rule out other underlying health condition. There are other more specialised growth charts for babies with underlying health conditions so that your doctor can accurately assess your child’s growth and progress. 

If it is a feeding problem, a lactation consultant can help rectify the situation. You may be advised to nurse more frequently and be given tips on how to boost your supply. Every case is different, and the methods to help your little one put on weight vary depending on how old he or she is. For example, parents with nursing babies may be asked to supplement with formula, while older children may need higher caloric food that is nutrient-dense.

Take home

Just because your baby is lean, it doesn’t mean he or she will remain underweight forever. When all underlying weight issues have been dealt with, your baby should get right back on track. Remember also that babies come in all shapes and sizes, so even if society may be sending a message that being chubby cute is healthy, this isn’t true.

As long as they meet developmental milestones, are alert and active, and are feeding well, you likely don’t need to worry.