September 2010 Dr. Mama Question
Dear Dr. Mama,
Our little Angel just had his first birthday, and he’s been with us since he was 6 months. I’ve recently been concerned about his rapid weight gain. He’s always been on the big-for-his-age side and has an appetite that just won’t quit. At his 1-year check up last week he weighed 28.5 lbs, which puts him above the 95th percentile. He’s tall too … about the 80th percentile, but with all we’re learning about childhood obesity and the health problems that come from it I’m worried we’re on the wrong track.
This baby will eat pretty much anything we put in front of him. I try to offer healthy foods without a lot of sugar and fat, but it seems like he’s always hungry. At most meals he polishes off way more food than our 4-year-old, and then goes on to drink a full bottle. We’re giving him whole milk because the doctor said that after switching from formula he needs the extra fat until he’s 2. It sure doesn’t seem like it.
It also doesn’t help that when he goes for visits with his bio mom, she seems to stuff him with his favorites non-stop. Last time we picked him up she told us he now loves jelly donuts!
What can we do to slow down his weight gain and get things moving in a healthier direction?
Alarmed in Alpine
Dear Alarmed,
It’s so great that you’re conscious of the nutritional issues that are so important to the health of our kiddos. We now know that the seeds of lifelong weight problems are often sown in the first months and years, so it’s critical to get even the youngest ones off to a healthy start. Let’s take a look at some ways to make a difference for your guy.
Appetite and hunger start out as physical drives. Most tiny newborns know when their bodies need fuel, and when the tank is full. That’s why breast fed babies can be trusted to suck until they’re satisfied, even though we can’t accurately measure how many ounces they’re getting (much to the concern of new moms).
But it doesn’t take long before our cultural and emotional beliefs about food begin to take hold. By the time babies are happily eating finger foods at about 6-9 months, it can start to take on a whole new meaning. Food can be comforting, it can be a means of control, it can soothe anxiety, and so much more. You should never put a baby or toddler on a diet, but you can take steps now to instill good habits for a lifetime of healthy weight. Here are some ideas that may help.
- Help your guy heed hunger signals. At mealtime, place small servings of protein, grains and vegetables on his plate or tray. If he finishes what you’ve given him, wait a few minutes to allow his brain time to catch up with his belly and register that he’s had enough. Distraction with a toy, song, or game can help here. Don’t offer seconds unless he absolutely can’t be distracted by another activity and is giving signals that he’s truly hungry.
- Curb emotional eating. Don’t encourage food as a source of comfort, substitute for attention, or cure for boredom. That means not giving sweet treats to keep him quiet, get cooperation, or make a boo-boo feel better.
- Offer milk in a sippy cup and limit the bottle to plain water. He can still have the bottle for comfort, but he’ll avoid the extra nutrition he doesn’t need. Your doctor is right about whole milk for babies under 2. They need it for proper brain growth. But if you haven’t discussed your weight concerns with her yet, do so at the next visit. She may be able to make adjustments.
- Don’t offer juice drinks. Most fruit juices contain sugar (in the form of fructose), water, and a bunch of calories. They don’t add much nutrition and aren’t necessary. Offer plain water instead.
- Encourage exercise. Provide him with plenty of opportunity for physical activity. When you can, let him walk instead of riding in the stroller. Chase a ball instead of putting him in the play area with a passive toy.
- Use praise and cuddles as a reward. Sometimes kids see food as evidence that they’re loved. Give him plenty of opportunity to feel your affection.
It may take a bit of time to get him used to some new habits, but if you stick with the plan you can reset the signals that tell him he’s had enough.
The issue of what he eats when he’s not with you is a different one. You can’t control what he’s given, but you can try to explain the problem and get buy-in to the solution. If you stress that everyone’s working towards the same goal – a healthy and happy child – you may be surprised at the response. It’s that old (and true) line about catching more flies with honey …
You are doing a terrific job with your little Angel. Thank you for your commitment.
~ Dr. Mama
