Babies' weight gain can predict later obesity, study shows

Conventional wisdom holds that a fat baby is well-loved, but pediatricians are warning parents not to go overboard.

A study released today in the journal Pediatrics suggests that rapid weight gain during the first months of infancy can predict obesity and high blood pressure later in life.

The finding echoes a pattern noted in a study of local overweight children last year by researchers at Children's Hospital of The King's Daughters and Eastern Virginia Medical School. That investigation led to recent efforts at CHKD to start obesity prevention earlier in children's lives.

"There's no procedure we could develop, no surgery we could perform, no drug we could discover that would have as profound an effect on children's health as keeping them from becoming obese," said Dr. Donald Lewis, chairman of pediatrics at EVMS and senior vice president for academic affairs at CHKD. "These two studies in tandem provide compelling data that we need to face the issue sooner with families."

The larger study released today by Harvard Medical School and researchers at a children's hospital in Boston tracked 559 children and found that those babies who gained the most in the first six months had a 40 percent higher risk of obesity at age 3.

The authors said weight gain, rather than weight at birth, influenced risk of later obesity, suggesting that infancy is a critical period for obesity prevention.

The Centers for Disease Control and Prevention estimates that 16 percent of children 2 to 19 years old in the United States are obese, a dramatic increase from past generations.

Dr. John Harrington, a CHKD pediatrician, said doctors tend to pay closer attention to rapid weight loss in infants, but said they are wise to monitor quick gains as well.

"We can't say 'This child will be heavy,' but they have an increased risk," he said.

Harrington participated in the local study that reviewed charts of 111 overweight children. The survey showed they began packing on extra pounds starting at 3 months. Fifty percent of those children were overweight by the age of 2 and 90 percent by age 5.

The CHKD results are being presented in May at a Pediatric Academic Society meeting in Baltimore.

Harrington said pediatricians are often reluctant to bring up obesity prevention with families of babies and toddlers, but it's easier to address weight issues when children are young than when they're adolescents.

He said infant weight gain can be tricky for pediatricians because, in some cases, the child will quickly grow in length, putting the length-to-weight ratio back in the normal range. Also, there hasn't been evidence that big babies turn into overweight adults.

But a quick weight gain in babies should raise a red flag for the pediatrician to give parental advice. And it's usually information that parents of all babies need.

"Your child is the best person to know the amount of food to take in," Harrington said. "If your baby turns their head, don't keep putting the bottle in his mouth."

He said some parents and grandparents, though, have a clean-plate philosophy that makes them urge a baby to drink every drop.

One baby visited his Norfolk office who weighed 30 pounds at age 6 months, which is above normal. The family said the baby didn't eat that much, but staff later observed them feeding the baby potato chips.

CHKD and its affiliated pediatric offices recently launched an effort called "5-4-3-2-1 Countdown to Family Fitness," that teaches healthy habits such as eating the right foods and being active.

"It has to be a family intervention," Harrington said. "The family's diet has to improve with the baby's diet."

The posters and pamphlets are geared to all families with children. Previous weight-management efforts, such as CHKD classes called "Healthy You," were aimed at children 8 and older.

Dr. Nancy Welch, health director for the city of Chesapeake, said the Harvard study about babies goes against traditional thinking that children's weight is best addressed after children learn to walk, a point in time when they often burn off so-called baby fat.

She said the study raises the antennae on the subject, and that she hopes it spurs more study.

"I think it's wise to see what other studies show."

Elizabeth Simpson, (757) 446-2635, elizabeth.simpson@pilotonline.com