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Friday, March 7, 2014
Overweight 9-Month Old
My son had his 9-month check-up on Friday and he is officially overweight, and quite significantly so. He weighs 12.3kg (27 lb) and is 73cm (29 “) long. The doc said that it’s not a problem now because he will likely slim down over the coming months as he becomes more mobile, but she said that we should be aware of it and act to prevent it becoming a problem. She recommended that we take him off formula and switch to half-fat cow’s milk and that we work on upping his food intake, particularly veg and fruit. I think he has definitely been drinking too much formula (he’s still waking for multiple feeds during the night) and he has been very slow to take to solids, but I was kind of surprised that she would suggest switching to cow’s milk since normally that’s strongly advised against before age 1 and similarly half-fat milk is normally not recommended before age 2.
I feel like I have to trust that our paed knows best, but it`s hard not to question her recommendations when they seem to go against the normal advice. I hope his weight will just rectify itself as people keep saying, but I can’t help but be a bit worried about it after reading online about research that seems to suggest that overweight babies and babies that gain weight too quickly during the first few months are more likely to become overweight adults.
I can certainly understand your confusion, it sounds like you are very concerned about your son. There may be a couple things to try before starting your son on cow's milk.
At his age, he should be getting about 24oz of formula each day. A typical feeding schedule for a 9 month old who is not breastfed would consist of about 6oz formula about 4 times over a 24 hour period, plus some baby cereal/fruits and vegetables a couple times throughout the day. Of course, this varies widely with each child, but that pattern should give him an appropriate amount of calories. If your son is eating more than that at this time, I would recommend trying to cut back a bit on the volume of formula before switching to cow's milk. Make sure to count any formula that you use to mix his cereal towards his total formula volume during the day. If you are breastfeeding at all, you should cut back even further on the formula.
When working with moms in your situation, I always have them double check that they are following the mixing instructions listed on the formula to be sure it isn't being prepared at too high of a concentration. Lastly, if you are mixing any solid foods in his bottle (cereals, baby foods, etc) that can lead to rapid weight gain, so any solids should be offered with a spoon only. Also, if you exclusively breastfed for the first several months of your son's life, it is fairly normal for him to be overweight at his age and generally it balances out over time. Finally, you should begin the process of thinking about introducing your child to soft table foods as his 12 month birthday rolls around.
I would recommend having another talk with your doctor, maybe find out if you have any other options before moving to cow's milk. The proteins in cow's milk can be difficult for some infants to digest and the fats found in higher fat milks are important in a young child's brain development. Good luck.
Ihuoma U Eneli, MD
Associate Clinical Professor of Pediatrics
Medical Director of the Center for Healthy Weight and Nutrition
College of Medicine
The Ohio State University