During infancy and childhood, children gain weight and grow more rapidly than at any other time in life. However, some children do not gain weight at a normal rate which may occur for a variety of reasons. It is important to recognise and treat children who are not gaining weight normally because it may be a sign of undernutrition or an underlying medical problem that requires treatment. Some babies do not gain enough weight starting at birth. Other babies gain enough weight for a while, but then slow down or stop gaining weight. If the baby isn’t gaining enough weight, the clinician will want to figure out why. He or she will treat the cause and work with the parents to help the baby gain more weight. Babies need to gain enough weight so that they can grow and develop normally. Babies who do not gain enough weight can have problems later in life, such as learning problems or problems with the body’s infection-fighting system. Reasons that a baby might not gain enough weight can include; being born too early, not getting enough food (for example, some babies have trouble sucking at the breast or bottle, or parents might not feed their baby often enough), having a medical problem that affects the stomach, mouth, throat, or their heart. Changes or stress in the home or family, and having things around that take attention away from eating, can affect the baby’s way of feeding and gaining weight. The doctor or nurse will tell you if one’s baby is not gaining enough weight. At each visit, he or she will weigh the baby. Then he or she will compare the baby’s weight to the weight of other babies who are the same age and sex. Babies who weigh less than other babies of the same age and sex are not gaining enough weight. He will do an exam and might also ask the mother questions about the child’s eating habits. He or she might ask you to keep track of all the food that your child eats. It is important that the mother informs the doctor if the child has vomiting or diarrhoea, does not eat certain foods or drinks much more than he or she eats. In case the doctor detects that your child isn’t gaining enough weight, he or she will work with you to make a plan to help your child gain weight. He or she might recommend that you also work with other experts, such as a dietitian. A dietitian is an expert on food and eating. Most children can be treated at home. But some children who are found to have more severe forms of failure to gain weight, or who have complications related to it, need to stay in the hospital for a short time, where doctors can treat children and watch them closely. You can do different things to help your child gain enough weight. You can help your child gain weight by feeding him or her foods with a lot of calories. Talk with your doctor, nurse, or dietitian about the right way to do this. He or she might recommend that you add extra calories to your baby’s feedings. Or you might need to add cheese, butter, or sour cream to foods that your older child eats. Your doctor or nurse might also recommend that your child take a vitamin every day. Babies might need more feedings each day to gain weight. Older children might need to eat every two to three hours, and have three meals and three snacks a day. Making changes to the area where your child eats might help your child eat more. For example, some children eat more when the whole family eats together or when meals are fun. Dr. Ian Shyaka , Resident in Surgery, Rwanda Military Hospital, iangashugi@gmail.com
