Q:
My son is 2-months-old and already weighs about 13 lbs. I'm worried that he is gaining too much weight too fast. He is breast-fed and his doctor says not to worry, but if he keeps growing this fast he will be 25-30 lbs. at 4 months. I work in a daycare and have 1-year-olds that don't weigh that much. Is he normal?
A:
Andrea, although your son is growing fast, he's probably growing normally. It's good that you take him to the doctor for his well-baby checks at 2, 4, 6, 9 and 12 months. At each visit, the doctor will examine your baby thoroughly, weigh and measure him, and plot his growth on a growth chart.
Ask your doctor to show you your son's chart so you can understand it better. (You can also view sample growth charts at www.cdc.gov/growthcharts/.) The doctor checks to see that your son's weight falls within the normal range for his age, that his weight gain follows the proper curve over time and that his weight and length stay in line with each other.
At 2 months, your son's weight falls at the 90th percentile. That means he's larger than 90 percent and smaller than 10 percent of babies his age, which is within the normal range. If your son weighed around 9 pounds at birth (the 90th percentile at birth), then he would have grown nicely along his growth curve over the past 2 months.
Doctors become concerned about a child becoming overweight only when there's a pattern over time of gaining weight a lot faster than his normal growth curve, or when a child is over the 95th percentile on the weight-for-length growth chart. After 2 years of age, doctors follow your child's BMI, which is also a measure of weight for height. If your baby continues to grow properly along his growth curve, he'll weigh 17 to 18 pounds at 4 months, not 25 to 30 lbs. Trust your doctor's advice that you don't need to worry about your baby being overweight yet.
It's great that you're breastfeeding, as that's the best nutrition for your baby. Studies have also found that breastfed babies are less likely to become overweight. The American Academy of Pediatrics recommends breastfeeding for a year or more, and to hold off giving your baby solid foods like cereal, fruits or vegetables until 4 to 6 months of age.
Are you concerned that your baby may be nursing too much? Notice how often he feeds. Every two to four hours is typical. If he fusses between feedings when you think he may not actually be hungry, he may want something other than milk. Try a pacifier to let him suck, talk with him, pick him up, walk around and check his diaper. Be sure to continue with the well-baby visits and talk with the doctor about your son's nutrition and growth over time.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician