Weighty Issues

With the spotlight now focused on obesity in childhood, it is little wonder that so many parents are concerned about their child’s weight. Whereas once it was thought that the bigger the baby the better, many parents are now asking, “Is my baby too fat?” or “Is my child underweight?” In most cases, it’s unlikely that there’s anything to worry about. It is VERY important to keep in mind that growth and development are still one of the most important indicators of a child’s health.

Still, there is no denying that with figures showing around 20-25% of Australian children are either overweight or obese, there is good reason for concern. The most common consequences of obesity in childhood (and adolescence) are poor body image and self-esteem. The health impacts of childhood obesity include high blood pressure and blood cholesterol, raised blood sugar levels, Type II diabetes, joint problems, sleep apnoea, asthma, and fatty liver.

When is a child overweight?

The amount of body fat a baby has generally increases over the first 12 months – little wonder when you consider that breastmilk is over 50% fat. However, this then falls during the toddler and especially the preschool years, before rising again when children reach adolescence. There are special charts for children aged 2-20 years designed to assess a child’s risk of being overweight (see BMI below). Classing a child as overweight is a big call and something that even the professionals don’t do lightly.

This may be a good point to remind you that young children who are plump don’t necessarily become overweight adults, but if they continue this trend into school age then there may be an increased likelihood.

How is weight tested for children?

Body mass index, more commonly known as BMI, is the standard measure used for assessing body weight in both children and adults (although there are different charts for each). BMI is simply your weight-height ratio. For children (2 to 20 years) there are a set of BMI charts related to age.

The NSW Health Department website (http://www.health.nsw.gov.au/obesity/youth/bmi.html) has an excellent Children and Youth BMI calculator. See also the useful links at the end of this page.

Can a baby be overweight?

This is a tough call for even the best in paediatrics. It is not uncommon to find a very plump infant who is off the charts (percentiles); however, if bub is breastfed the chances of baby having a body-fat problem are far less likely. Breastfed babies generally have better control of their feeding regulation, which has been shown to have a positive outcome on body weight. Nonetheless, some research suggests that infants who experience rapid early weight gain (we are talking not the usual where bub’s weight veers off the percentile charts) may be at risk and should be seen by a health professional for monitoring. Mounting evidence suggests that weight patterns in very early life may be an important indicator of later health issues, so if you are at all in doubt, always seek the advice of your early childhood nurse or GP.

What are some of the reasons a child becomes overweight?

There are many reasons; some factors are genetic, while others are environmental. Even illnesses and sometimes medications can be the cause. Often it is not a single reason but rather, a combination. Every child is different and no two situations are the same.

Importance of early habits

Try to allow your child to self-regulate their own intake of food. Offer them a wide variety of healthy foods for them to choose from (but remember low-fat foods are not suitable options for young children). Of course, this doesn’t mean allowing a child to eat all day long but at regular intervals – say 5-6 times a day. You will need to pay attention to hunger and satiety (fullness) signals to avoid underfeeding or overfeeding so that our little ones maintain the healthy eating patterns that they were born with.

Getting active

Most of us are fully aware of the importance of physical activity and its positive effect on our health (heart, bone etc.) and development (physical, emotional and social). Children who are active can develop self-confidence, social skills and have an additional outlet for emotional expression, which in turn can lead to strong self-esteem and a healthy body image. In fact, being physically active is so important that it is included on most healthy eating pyramids and in most dietary guidelines. Interestingly, physical inactivity seems more strongly related to overweight and obesity in children than energy intake.