When do babies triple their birth weight

Slow Weight Gain in Infants and Children

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Slow weight gain is sometimes called “failure to thrive." It is not a disease itself, but a manifestation of many medical, social and environmental factors that prevent a child from getting the calories they need for healthy growth.

Typically, a baby’s weight doubles within their first 4 to 6 months of life and triples in their first year. For instance, a baby born weighing six pounds would typically weigh about 12 pounds by the time they were 6 months old and about 18 pounds by the time they turned 1.

Slow weight gain is not always a concern. Some infants and children are simply smaller than most other children their age. However, between 1 and 10 percent of children in the United States show delays that require some form of intervention. It is important to tell your child’s physician about any delays in your child’s growth.

When is slow weight gain a problem?

Slow weight gain is a problem when it interferes with a child’s healthy development, particularly during your baby’s first year when their brain is developing.

Slow weight gain could be a problem if:

• your newborn doesn’t regain their birth weight within 10 to 14 days after their birth
• your baby up to 3 months old gains less than an ounce a day
• your infant between 3 and 6 months gains less than 0.67 ounces a day
• your child of any age has been growing steadily and suddenly stops growing

Although you should always discuss slow weight gain with your child’s doctor, it is less of a concern when:

• your newborn wakes up on their own and wants to feed 8 to 12 times a day
• your baby is growing at a steady rate
• your baby has about the same number of wet and dirty diapers as other babies

How we care for slow weight gain

The Growth and Nutrition Program at Boston Children's Hospital is a multidisciplinary program of doctors, nurses, dietitians, social workers, behavioral specialists and speech therapists who will work together to determine the causes and treatment for slow weight gain for your child. We work in partnership with parents, primary care providers, and staff from other disciplines across the hospital to develop an individual long-term treatment plan for each child and address the factors affecting their growth.

If your child’s gain in height is the primary concern, not their weight gain, we may refer your child to the specialists in Department of Endocrinology.

Slow Weight Gain in Infants and Children | Symptoms & Causes

What are the symptoms of slow weight gain?

One of the most obvious symptoms of slow weight gain is size: your child is much smaller than other children their age. This may include weight, height and size of their head.

If your baby is not getting enough calories, you may notice the following symptoms:

• lost interest in the world around them
• extreme sleepiness
• frequent crying and fussiness
• missed physical milestones: not rolling over, sitting up or walking at the same time as other kids their age

What causes slow weight gain?

Several possible factors can cause slow weight gain, from a medical condition to social or financial hardship. Anything that interferes with a child’s access to food or ability to digest food can impair their growth. Often it is caused by a combination of factors.

Medical causes:

• Premature birth can make it hard for your child to feed until the muscles they use to suck and swallow fully develop.
• Down syndrome can also interfere with a child’s ability to suck and swallow.
• Metabolic disorders like hypoglycemia, galactosemia or phenylketonuria can interfere with the body’s ability to convert food into energy.
• Cystic fibrosis can prevent a child from absorbing calories.
• A food allergy or food intolerance may limit what foods your child can eat without feeling ill.
• Gastroesophageal reflux can cause your child to vomit frequently.
• Anything that causes chronic diarrhea can prevent your child from receiving enough nutrition.

Social and financial causes:

• Parents may not prepare formula correctly or understand how often their infant or child needs to eat.
• Household stress from divorce, death or another disruption can cause a child to stop eating.
• Poverty may make it hard for parents to provide enough food for their children.

Slow Weight Gain in Infants and Children | Diagnosis & Treatments

How is slow weight gain diagnosed?

Since slow weight gain is not a specific condition but the result of other factors, your child’s doctor will focus on discovering the underlying cause. Diagnosis typically starts with a full medical history and physical exam. The doctor will also review your child’s pattern of weight gain in relation to the standard growth curves.

Screening tests may include a blood count, screening studies for celiac disease, thyroid hormones, serum electrolytes and urinalysis.

How is slow weight gain treated?

Treatment depends on what is preventing a child from gaining weight. If the cause is an underlying medical condition, your child’s doctor may focus on treating that condition.

If poor nutrition is contributing to your child’s slow weight gain, a nutritionist may work with you to develop a plan for providing your child a well-balanced diet.

If your child has trouble chewing or swallowing, a speech pathologist will provide strategies to develop the necessary muscles.

If your child seems healthy but refuses to eat, a behavioral psychologist may be able to help your child and you work through issues that lead to this behavior.

Depending on your child’s age and underlying medical condition, more aggressive forms of nutritional support, such as a feeding tube may be necessary. This intervention may be temporary until your child develops healthy eating habits that support their growth and development.

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Newborn weight gain: what's normal & when to worry

Babies typically lose weight after birth, before they start to gain. A generally accepted rule of thumb is that a baby can be expected to lose about 3–7 percent of their birth weight during the first 5 days after birth. Parents should expect their baby to return to his or her birth weight by about day 10. 

Many babies double their birth weight by age 4 to 6 months and triple their birth weight by their first birthday. But babies who gain more slowly or more quickly may be perfectly healthy too. Your baby's doctor will monitor your baby's growth over time (weight, length, and head circumference) to ensure that they're getting all of the calories and nutrients they need. This is one reason why it's recommended babies have at least 6 doctor's visits during the first year.

Babies’ weight gain and loss doesn’t follow a pattern

It’s not clear how much weight exclusively breastfed babies lose and then gain in their first 14 days. A recent study of weight change in nearly 150,000 healthy babies found that it’s not uncommon for newborns to be below their birth weight even 21 days after delivery.

What are signs my baby is eating enough? 

Parents’ concern over weight is easy to understand given that it’s the only reliable indicator of growth. But if you know the signs that your baby is getting enough to eat, you don’t need an expensive in-home baby scale. A well-fed baby will… 

• be active and alert 
  
• be satisfied after breastfeeding 
  
• breastfeed at least 8–12 times during each 24-hour period 
  
• by day 3, have three or more poops a day
  
• by day 5, have yellow poop
  
• by day 5, have clear or pale yellow pee and six or more wet diapers a day
  

After 4 weeks of age, some babies continue to poop after every feeding, while others poop only once every other day, or once every 3–5 days. (Click here for more scoop on poop.) 

As long as you see these indicators of good health, there’s generally no reason to worry about having your baby’s weight measured between well-child visits.

What if my baby suddenly stops gaining weight? 

As long as your baby is reaching her developmental targets and isn’t losing weight, there’s no need to worry about a pause in weight gain. Children who fail to gain enough weight in the first 9 months will usually catch up over time. So parents seldom need to increase their child’s calories (by supplementing with donor milk or artificial infant formula). Consuming too many calories in infancy can actually lead to weight problems later in life. 

But if your baby loses more than 7 percent of their birth weight or gains weight slowly in the early days and weeks following their birth, your baby’s health care provider may ask you to bring them in for weight checks. A review of your breastfeeding routine and periodic weight checks will ensure that they're getting enough to eat and that there are no underlying health issues.

Does weight really matter? 

Weight is a measure of nutrition. When babies get too little food, too much food, or the wrong type of food, they can become malnourished. Today, experts agree that a brief period of underfeeding (days versus weeks or months) is unlikely to cause permanent damage.  It can, however, have serious short-term consequences. Timing seems to be the key factor, since even a brief period of underfeeding in the first days after birth can lead to hyperbilirubinemia (jaundice) and hypoglycemia (low blood sugar). And if you’re concerned about your baby’s growth or feeding, contact their pediatrician.

Last updated February 12, 2021

Child weight control. Obesity and risk factors.

Height, body weight, head and chest circumferences are the main anthropometric measurements by which the pediatrician evaluates the physical development of the child. Weight gain and height standards are set by the WHO. However, they differ for breastfed and formula-fed babies: formula-fed babies gain weight faster than breastfed peers. Breast milk has an optimal composition, is better absorbed and contains substances that protect the baby from infections. nine0003

In this article we will touch on only one parameter - weight, as the most important indicator of a child's development.

The average weight of a full-term newborn is 2600-4500 g. In recent decades, there has been an acceleration of biological development, and therefore babies "get heavier": now it is not uncommon to give birth to 5-kilogram children.
Babies grow and gain weight very quickly. True, this does not happen immediately. In the first week, body weight may even decrease slightly (by 5-10%): the baby loses fluid. Then, during the first month, the child gains an average of 20 grams per day. Every day of the second month, this increase will be 30 grams. By the fourth month, the baby's weight doubles. nine0003

At the age of seven months, the baby gains 110-120 grams per week. Its weight, depending on individual characteristics, is from 8 to 8.5 kg, and sometimes more. At the end of the eighth month, your baby weighs about 9 kilograms. Until about the ninth month of life, the daily increase is 16-18 grams (for two weeks - approximately 250 grams). Over time, this figure will decrease. By one year, a child's weight triples relative to birth weight. From the age of 2 to puberty, the weight of the child increases by an average of 2 kg per year. nine0003

Overweight and obese children are increasingly common in today's society. This is especially important when you consider that overweight leads to such serious diseases as type 2 diabetes, diseases of the cardiovascular system, dysfunction of the gallbladder, pancreas.

Risk factors for the development of this condition are:

• overeating
• inactive lifestyle (physical inactivity).
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How to avoid overeating?

• Don't force your child to eat - food cravings develop very early in babies. In the second year of life, the child begins to show independence in relation to food. He already wants to eat what he wants, and as much as he wants. Never force a child to eat more than he wants. Babies need far fewer calories than you think!
• Do not offer food as a consolation to your child when he is sad or bored - this is how an increased attention to food and food addiction develop, the habit of "jamming" stresses. nine0017
• It's also not worth making rewards or punishments out of food (“well done, here's some candy for you!”, “if you don't remove the toys, you won't get ice cream!”). Mindless chewing is a direct path to obesity.

In most cases, your child is a reflection of your own habits, although perhaps exaggerated. In his lifestyle, healthy or not, the baby obeys the example, both good and bad, of his parents.

How to deal with physical inactivity?

• Discuss with your child the benefits of being active – your child needs to exercise at least 1 hour a day. The task of parents is to help the child choose the type of physical activity that he likes the most. It is better to diversify these exercises. It’s good if a child dances for one day, swimming for the second, and you can just play on the third. nine0017
• Limit screen time! During the time that the child spends in front of the TV or computer screen, he will spend the minimum number of calories. Considering that the child sits both at school and at home, doing homework, it often turns out that the child sits all day. Help your child find the right balance between "sitting" and being active.
• Set an example for your child! There is nothing more natural for a child than to follow the lifestyle of parents. If you prefer “forays” into nature, skating or cycling on the weekend, lying on the couch in front of the TV, the child will grow up in an “active” environment, where they have not heard of hypodynamia! nine0017

We hope that these tips will help you and your baby will be healthy and cheerful!

Author of the material: pediatrician of the clinic on Rodionovskaya Kolinichenko TV

Increase in height and weight for children of the first year of life. Tables

Dear parents, your baby is growing and you are worried about whether he is gaining enough weight and height. For control, there are centile tables for assessing the physical development of children, weight and height indicators. At the same time, you must remember that each baby is individual, he cannot grow according to the textbook. These weight and height recommendations are based on an average number of children and 10% deviation is normal. In addition, the centile corridor from 25% to 75% is an average physical indicator. That is why they say: Physical development is mesosomatic, macrosomatic, microsomatic. nine0003

It is important that the weight and height indicators are in the same centile corridor, but no more than two adjacent ones. Then we can talk about harmonious development. If the gap is more than two centile corridors, the development is disharmonious. Then we can think either about an unbalanced diet or about a pathology associated with obesity (paratrophy), or protein-energy deficiency (hypotrophy). In addition, one should not forget about the constitutional characteristics of the child, about genetic predisposition. Therefore, in no case should you compare your child with a neighbor's. To talk about the health of a child, we evaluate his condition according to many criteria. This is neuropsychic development, laboratory examination data, anamnesis, heredity. How many times in my practice have I met children who gained 400-450 g in weight every month, by the year they barely gained 7.8-8 kg. But at the same time, children already at 10 months began to walk, pronounce syllables, and follow complex instructions. nine0003

We'll talk about weight and height gain for term babies. In preterm infants, rates of weight gain and height differ according to the degree of prematurity. In addition, children can be born with intrauterine malnutrition.

The tables for girls and boys are different in terms of numerical indicators, but at 1 year of age, these differences are quite minimal.

Centile tables for assessing the physical development of girls from 0 to 12 months. nine0003

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Body length (height), cm. Centiles in %							Age in months	Body weight, kg. Centiles in %
3	nine0002 10	25	fifty	75	90	97		3 nine0003	10	25	fifty	75	90	97
nine0002 45.8	47.5	49.8	50.7	52.0	53.1	53.9 nine0072	0	2.6	2.8	3.0	3.3	3.7	3. 9	4.1
48.5	50.3	52.1	53.5	55.0	57.3	one	3.3	3.6	3.8	4.2 nine0003	4.5	4.7	5.1
51.2	53.3	55.2	58.0	59.3	60.6	2	3.8	4.2 nine0003	4.5	4.8	5.2	5.5	5.9
54.0	nine0002 56. 2	57.6	59.3	67.7	61.8	63.6	3 nine0072	4.4	4.8	5.2	5.5	5.9	6.3	6.7 nine0003
56.7	58.4	60.0	61.2	62.8	64.0	4	5.0	5.4	5.8	6.2	6.6 nine0003	7.0	7.5
59.1	60.8	62.0	63.8	66.0	68.0	five	5.5	5.9	6.3 nine0003	6.7	7.2	7.7	8.1
60.8	62.5	65.5	67.1	68.8	70.0	6	5.9 nine0003	6.3	6.8	7.3	7.8	8.3	8.7
nine0002 62.7	64.1	65.9	67.5	69.2	70.4	71.9 nine0072	7	6. 4	6.8	7.3	7.7	8.4	8.9	9.3
64.5	66.0	67.5	69.0	70.5	73.7	eight	6.7	7.2	7.6	8.2 nine0003	8.8	9.3	9.7
66.0	67.5	69.1	72.0	74.1	75.5	nine	7.1	7.5 nine0003	8.0	8. 6	9.2	9.7	10.1
67.5	70.3	71.9	73.2	75.3	76.8	10 nine0003	7.4	7.9	8.4	9.0	9.6	10.1	nine0002 10.5
68.9	70.1	71.5	73.0	74.7	76.5 nine0003	78.1	eleven	7.7	8.3	8.7	9.3	nine0002 9.9	10.5	10. 9
70.1	71.4	72.8	74.1 nine0003	75.8	78.0	79.6	12	8.0	8.5	nine0002 9.0	9.6	10.2	10.8	11.3

At the same time, until the age of three months, the child adds 20-30 grams per day daily, respectively, from 140 to 200 per week. If we talk about the average weight gain by months, then it is only 600 g per month, since the child after birth has physiological weight loss (with urine, feces, transition from intrauterine feeding to breastfeeding during the adaptation period), approximately 10% of the weight, which is 200-300 grams. nine0003

More often, by 3-4 days, the child restores its original weight, and then there is an increase. But I had a case in practice when the child began to gain weight from the 20th day of life, while the girl was active, reflexes were alive, her appetite was good, she could withstand the night interval, stool 4-5 times a day, urination was sufficient, developed according to age. Therefore, do not worry. Our indicator is the well-being of the child. If the baby is active, eats with appetite, sleep is calm, the skin is clean, physiological functions are not disturbed, be calm, your baby is healthy and not hungry. You see from the table the range of weight per year is from 8 to 13 kg. This is the norm. There is no reason to run to the endocrinologist, genetics, to examine the child. nine0003

Or the opposite situation: in the first months of life, a child gains 1-1.5 kg while breastfeeding. If the baby does not have colic, he does not spit up, there are no gastrointestinal manifestations, he is active, the skin is clean, physiological functions are not disturbed - this is also the norm. Remember, as often happens, premature babies quickly gain weight and catch up with their peers by the year. And large babies gain weight more slowly. In my entire thirty-year practice, only two children weighed 14-15 kg by the year, although their parents were large and tall. By the age of three, they weighed almost the same, added only in height, the rest of their peers caught up with them. nine0003

It is believed that by 4-4.5 months the child should double the weight, and triple by the end of the year.

It happens that the increase in height and weight goes in leaps, seasonality, unevenness, and sometimes asymmetry of growth are noted. Pediatricians are concerned about the circumference of the head and chest, by 2-3 months they should be equal. Further, the breast grows faster. This is important so as not to miss the pathology. nine0003

The younger the child, the faster his growth. In the first 3 months of life, body length increases by 3 cm monthly, in the second quarter by 2.5-2 cm monthly. In the third - 1.5-2 cm, in the fourth - 1 cm monthly. The total increase in height in the first year of life is about 25 cm.

Centile tables for assessing the physical development of boys from 0 to 12 months.

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