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Every week I receive a ton of letters from anxious parents: is my baby’s weight ideal, is my child growing properly, is my parenting faulty? This week I’ll attempt to answer the most common questions.
The birth weight of normal Indian children is on average 3-3.4kg. It depends on the health of the mother, with relatively bigger babies born to diabetic or pre-diabetic mothers, and smaller babies to mothers with hypertension. Preterm babies and twins also tend to weigh less at birth.
The birth weight should ideally double at the end of the fifth month and triple at the end of the first year. This means that a child who weighed 2.5kg at birth will be around 7.5kg at the end of the first year. He or she will appear diminutive next to a child who was 3.5kg at birth and is therefore 10.5kg on the first birthday. Trying to force feed a child to gain more than expected is counterproductive. They may just regurgitate the extra food or develop an aversion to eating. There is no point in feeling guilty that you are a “bad mother” if your child is not the same size as your friends’ child.
For the first 120 days, the child should preferably be exclusively breast fed. After that, weaning on to semisolid food should be started. Home cooked cereals are best. Although packaged ready-to-use cereals may appear attractive and time saving, they may contain preservatives, flavouring or excessive sodium. These are not advisable or healthy. One new home-cooked food, such as pureed vegetables or fruits, should be introduced every two weeks.
Biscuits are not healthy or advisable. Patience and persistence is the key to successful weaning. The child should be eating a normal adult diet at the end of the first year. About 400-500ml of undiluted milk is all that is required after that age in a day. Teach your child to drink it without additives like tea, coffee or other “healthy” drinks.
Unfortunately, demand for a “tonic” to make the child grow fatter or improve the appetite may result in steroid or cyproheptadine drops being administered. These chemicals do increase the appetite, but at a tremendous cost to the health of the child. Steroid drops increase the weight of the child owing to fluid retention. The face may become moon shaped and hairy. They suppress the immune system, so the child may get frequent infections, which may then escalate and become life threatening.
Children need five meals a day — breakfast, a snack at 10-11am, lunch, a snack on returning from school, and dinner. Do not send them to tuitions hungry or to school without breakfast. Do not withhold food as punishment. (A snack does not mean packaged chips and biscuits).
The ideal weight from the ages of 2-20 years can be measured with the BMI. This is the weight divided by the height in metre squared. The normal is between 18-23. Ideally, in children, the BMI can be read off charts available in most immunisation booklets. A healthy child should be between the fifth and 95th percentiles. Once the child becomes 5ft in height, the formula for ideal body weight (IBW) in males: 50kg + 2.3kg for each inch over 5ft. For females, IBW = 45.5kg + 2.3kg for each inch over 5 feet.
India has progressed from being a country with malnourished children to one where the majority is overweight or frankly obese.
If your child falls into that category restricting food or dieting is not an answer. Instead, healthy eating should be incorporated for the whole family, with 4-6 helpings of fruits and vegetables a day, no fried or ready to eat snacks, restricted sweets and deserts and NO aerated cola or flavoured drinks. This has to be combined with exercise.
Physical activity is required from birth itself. Even before a baby crawls it should passively grasp, push and pull. Once a child begins to walk it should be active for at least three hours a day. This should be spread out with skipping, jumping hide and seek, playing ball and running. Just seating them in front of the TV (even if they would like to) is not a solution, nor is it helpful.
School age children need to be physically active for an hour a day. This can include structured activity like coaching in a specific sport, cycling or running. This time spend makes them physically and mentally stronger. They are able to concentrate, work past fatigue and develop a sense of self worth.
Habits like healthy eating and exercise inculcated in childhood remain throughout life. This definitely reduces the incidence of chronic diseases as they grow older. Also, in the process of rearing healthy children, you may change your diet and exercise habits, and become fit too!
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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Nice blog very useful information I will visit again to read more your post.
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