Can babies be obese?

"Baby fat," "thunder thighs," "chubby cheeks" — are these euphemisms for "fat baby"? Is there such a thing as a fat baby? There was a time when pediatricians focused on failure to thrive, a condition where babies did not grow and gain weight. Parents and grandparents often thought fat babies were healthy babies. Today, not so much.

We now know that we have a worldwide obesity epidemic, and attention is focused on prevention. Even infant feeding has been examined. Some studies suggest that breast-feeding may help prevent obesity later in life. Recognizing and respecting hunger and satiety cues in infants is important.

What are hunger cues in infants? Newborns may indicate hunger early on by rooting or turning to the side while opening their mouth and sucking. If food is not offered the rooting will eventually turn into fussing and then crying. It is important to learn what your baby's cries mean. Sometimes a cry is for food, but it also can mean a wet diaper, gas, boredom, or colic. By learning your baby's signals, you can avoid overfeeding the baby every time he cries.

Satiety cues are signs that your baby has had enough. He may pull away from the breast or arch his back. An older infant may shake his head and refuse to open his mouth. It can be tempting to "finish off" a bottle or dish of food in hopes that your baby will sleep longer, but by forcing food when your baby is done, you are overriding the satiety signal. Babies can then become unaware of when they have had enough.

By nine or 10 months, most babies are getting three meals of solids a day plus breast milk and/or formula. Resist the temptation to offer food all day. Some babies do better with several small meals a day, but grazing all day on snacks can lead to poor eating habits later.

Toddlers are notoriously poor eaters. They often eat by the week rather than by the day. If they have some protein, vegetable, fruit, and carbohydrate in the course of the week, they are probably fine. In addition, they should have three servings of dairy a day. Many parents respond to the natural lack of interest in food during the second year by chasing their children around with snacks all day. Remember one of my favorite quotes: "No child ever voluntarily starved themselves."

There is good evidence that having family meals promotes good eating habits later. Small portions. Slow eating. No television during meals. Snacks should be healthy.

Exercise is important even for infants and toddlers. Sometimes parents keep infants in car seats and bouncy chairs for long periods. It is better that the children have "floor time," so that they can move around.

If you get your children off to a good start early on, it will be easier to reinforce healthy eating and regular exercise later on. What are your strategies to build good habits in your kids?

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

Eat, Play, and Be Healthy
Parents are often bombarded with new information on children's nutrition, and as a result, the most important dietary considerations often get lost in the mix. From Harvard Medical School, Eat, Play, and Be Healthy offers guidance on healthy eating through the various stages of children's lives, from infants to eight-year-olds. From breastfeeding to school lunches, get the tools to put your child on the path to a healthy adulthood.

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