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What Causes Poor Weight Gain In A Child?
Question: Hi Doctor,
As updated to you in my last question, Vihaan(6 Months 10 days) is being fed as below.
Right now his feed cycle is
Nestum - 3 scoops in the morning at 9 AM
Pureed Apple - 11.30
Shishu Aahar -3-4 Scoops 3 pm
Pureed Pear - 5.30 pm
Occasionally Banana is being fed.
He poops close to 4-6 times a day from last week.
My Concern is that he doesnt seem to gain any weight at all from the last two months. His birth weight was 3.5 kgs He was 6.9 kgs when he was 5 months.. He was 7 when he was 5 1/2 months and now at 6 months 10 days he is back to 6.9 kgs which makes me worried.
He plays, crawls and all that. Can you please let me know it is a case for concern.
Your analysis would be much appreciated. please let me know if you need additional information on this.
Thanks
XXXX
As updated to you in my last question, Vihaan(6 Months 10 days) is being fed as below.
Right now his feed cycle is
Nestum - 3 scoops in the morning at 9 AM
Pureed Apple - 11.30
Shishu Aahar -3-4 Scoops 3 pm
Pureed Pear - 5.30 pm
Occasionally Banana is being fed.
He poops close to 4-6 times a day from last week.
My Concern is that he doesnt seem to gain any weight at all from the last two months. His birth weight was 3.5 kgs He was 6.9 kgs when he was 5 months.. He was 7 when he was 5 1/2 months and now at 6 months 10 days he is back to 6.9 kgs which makes me worried.
He plays, crawls and all that. Can you please let me know it is a case for concern.
Your analysis would be much appreciated. please let me know if you need additional information on this.
Thanks
XXXX
Brief Answer:
SUGGESTIONS AND ANALYSIS ON BABY'S WEIGHT
Detailed Answer:
Hi...I understand your concern.
I will tell you something about centile or percentile calculation so that you will be in a better position to understand what I am going to explain and analyse.
in calculating percentile of kid's weight any value in between 5th to 95th percentile is normal. But at the same time when the baby is crossing down two centile limits, it is called failure to thrive or if baby is less than 5th centile then also it is considered failure to thrive.
Now coming to Vihaan's issue...his centiles are as follows -
At birth 25-50th centile
5 months 15-25th centile
5 1/2 months 15-25th centile
6months 10 days 5-10th centile.
Technically speaking he has crossed down 2 centile segments.... so it is failure to thrive (FTT) theoretically.
But as he's becoming more and more active physically, this reflects in spending of some of the energy derived from feeding into exercise (unlike the whole energy being spent in weight gain alone when he was a young infant).
If I were your pediatrician I would do this (as he has crossed 6 months now), try giving more aliquots if feed, by adding more ghee and making the food energy dense. In this way even if less quantity goes in (at any given time) the energy gained will be more and we can positively see weight gain. With this plan I would wait for a month.
If by the end of 7months and 10 days he has gained weigh so thst ge has crossed at least one centile segment upwards, then I will be happy. But if he is still not showing appropriate weight gain and not crossed centile up, then I will consider investigations and will suggest you accordingly.
Hope you are in agreement with this plan.
Regards - Dr. Sumanth
SUGGESTIONS AND ANALYSIS ON BABY'S WEIGHT
Detailed Answer:
Hi...I understand your concern.
I will tell you something about centile or percentile calculation so that you will be in a better position to understand what I am going to explain and analyse.
in calculating percentile of kid's weight any value in between 5th to 95th percentile is normal. But at the same time when the baby is crossing down two centile limits, it is called failure to thrive or if baby is less than 5th centile then also it is considered failure to thrive.
Now coming to Vihaan's issue...his centiles are as follows -
At birth 25-50th centile
5 months 15-25th centile
5 1/2 months 15-25th centile
6months 10 days 5-10th centile.
Technically speaking he has crossed down 2 centile segments.... so it is failure to thrive (FTT) theoretically.
But as he's becoming more and more active physically, this reflects in spending of some of the energy derived from feeding into exercise (unlike the whole energy being spent in weight gain alone when he was a young infant).
If I were your pediatrician I would do this (as he has crossed 6 months now), try giving more aliquots if feed, by adding more ghee and making the food energy dense. In this way even if less quantity goes in (at any given time) the energy gained will be more and we can positively see weight gain. With this plan I would wait for a month.
If by the end of 7months and 10 days he has gained weigh so thst ge has crossed at least one centile segment upwards, then I will be happy. But if he is still not showing appropriate weight gain and not crossed centile up, then I will consider investigations and will suggest you accordingly.
Hope you are in agreement with this plan.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Your reply is very encouraging. I'd want to try this right from tomorrow. Can you please let me know how do I go about the below that you mentioned.
As updated to you previously, we are giving nestum and shishu aahar(this has ghee already), do you want us to include ghee in nestum as well.
Kindly suggest some of the foods that you would suggest us to start or add to the menu that I shared with you.
We would follow your guidelines strictly and then we can take a call after 1 month if he is not gaining any more weight by then.
Please elaborate below.
"If I were your pediatrician I would do this (as he has crossed 6 months now), try giving more aliquots if feed, by adding more ghee and making the food energy dense. In this way even if less quantity goes in (at any given time) the energy gained will be mo`re and we can positively see weight gain. With this plan I would wait for a month."
Thanks
Your reply is very encouraging. I'd want to try this right from tomorrow. Can you please let me know how do I go about the below that you mentioned.
As updated to you previously, we are giving nestum and shishu aahar(this has ghee already), do you want us to include ghee in nestum as well.
Kindly suggest some of the foods that you would suggest us to start or add to the menu that I shared with you.
We would follow your guidelines strictly and then we can take a call after 1 month if he is not gaining any more weight by then.
Please elaborate below.
"If I were your pediatrician I would do this (as he has crossed 6 months now), try giving more aliquots if feed, by adding more ghee and making the food energy dense. In this way even if less quantity goes in (at any given time) the energy gained will be mo`re and we can positively see weight gain. With this plan I would wait for a month."
Thanks
Brief Answer:
Complimentary feeding
Detailed Answer:
Hi....what I meant was that as he's crossed 6 months you can feed him complimentary feeding.
At this age you can start giving Cerelac stage one rice or Nestum rice stage 1 etc. All are same in calories and energy.
Only thing is palatability which is subjective for each kid.
Other home-made food options will be -
1. Daal and rice well cooked and made into a porridge along with ghee
2. Boiled apple or banana and mashed into a paste.
3. Any made cereal porridge preparation with additional ghee added.
Remember certain principles like -
1. Add one food material / cereal or fruit per week. This will be useful because if he develops vomiting or diarrhoea, we will know what to avoid.
2. Add vegetables and fruits made into a paste surely to avoid constipation.
3. Do not add too much sugar as it may cause diarrhoea.
My battery is running out and I am.in XXXXXXX stuck in cyclone...no power...will take your questions tomorrow pl, if there are any.
Regards - Dr. Sumanth
Complimentary feeding
Detailed Answer:
Hi....what I meant was that as he's crossed 6 months you can feed him complimentary feeding.
At this age you can start giving Cerelac stage one rice or Nestum rice stage 1 etc. All are same in calories and energy.
Only thing is palatability which is subjective for each kid.
Other home-made food options will be -
1. Daal and rice well cooked and made into a porridge along with ghee
2. Boiled apple or banana and mashed into a paste.
3. Any made cereal porridge preparation with additional ghee added.
Remember certain principles like -
1. Add one food material / cereal or fruit per week. This will be useful because if he develops vomiting or diarrhoea, we will know what to avoid.
2. Add vegetables and fruits made into a paste surely to avoid constipation.
3. Do not add too much sugar as it may cause diarrhoea.
My battery is running out and I am.in XXXXXXX stuck in cyclone...no power...will take your questions tomorrow pl, if there are any.
Regards - Dr. Sumanth
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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