Maternal obesity, gestational weight gain, Research increasingly shows that fat babies are at higher risk of being obese later in life.
Original title: Fat babies = fat adults
If you are a parent of a fairly small baby, chances are your older relatives would advise or even nag at you to get your baby’s weight up.
They will tell you that chubby babies are perceived to be well-fed and, thus, strong and healthy.
Besides, it is common thinking that the child’s baby fat will melt away when he grows up.
Yet, more and more research is saying otherwise. Fat babies are, in fact, at a higher risk of becoming overweight or obese children.
These obese children are, in turn, more likely to be obese as adults, putting them in greater danger of serious health problems such as heart disease, type 2 diabetes and cancer.
This link was underscored in a US study published last year, which tracked 10,186 children from birth to seven or eight years old.
Babies with a hefty birth weight of above 4.5kg at full term were 69 per cent more likely to be obese by the time they entered kindergarten.
This was compared with babies with an average birth weight, said researchers from the University of Virginia School of Medicine.
The average birth weight of Singaporean Chinese babies at 40 weeks is about 3.2kg.
Doctors in Singapore agree the danger is real.
Dr Yang Linqi, a paediatrician at Thomson Paediatric Centre, said higher birth weight is associated with greater body mass index in childhood and later in life. But the individual could be gaining more lean mass rather than fatty tissue, she pointed out.
The problem does not just affect babies born with high birth weights.
Even smaller infants, such as those who had poor growth during pregnancy, can be at risk, studies show.
This is because they tend to pile on weight more quickly in their early months – and this leads to increased central fat deposition in their bodies, said Dr Yang.
In Singapore, there is a group of researchers studying an entire generation of babies to find out how their mothers’ pregnancies impact them as they grow up – and the researchers are also keen to uncover more about the link between fat babies and fat adults.
Associate Professor Lee Yung Seng, head of paediatrics at National University Hospital who is involved in the study, said that it is “a simple and yet interesting question which we plan to analyse when the children are older”.
The study, termed Growing Up In Singapore Towards Healthy Outcomes (Gusto), started in 2009 and tracks the health of more than 1,000 children. The oldest child in the study is now eight years old.
A better understanding of the relationship between birth and future weight could help to address the uptrend of overweight children here.
The 11- and 12-year-olds in Singapore today are more likely to be overweight or severely overweight, compared with 20 years ago. This is based on the
Health Promotion Board's (HPB’s) height and weight screening data from 1990 to 2015.
In 2015, about four in five children who were overweight or severely overweight at seven years old remained overweight when they reached 11 or 12 years old.
In 1995, the figure was lower at about four in six children, according to the HPB figures.
A possible factor is the feeding of formula milk to infants. Dr Christelle Tan, a specialist in paediatric medicine at Raffles Specialists – Holland V, noted that overseas studies have found that formula-fed infants may be at greater risk of overfeeding and rapid weight gain and, hence, childhood obesity.
WHY DO FAT BABIES STAY FAT?
A theory is that accelerated growth in a child’s early years has a longterm impact on the body’s hormonal feedback systems.
These systems regulate one’s weight, food intake and metabolism and can thus affect the presence of fat deposits, said Dr Tan.
Weight gain in babies is fastest in the first three months and will gradually slow down throughout the first year of life, said Dr Han Wee Meng, head of nutrition and dietetics at
KK Women’s and Children’s Hospital.
On average, babies would double their birth weight at around three to four months and triple it by one year of age.
Fat babies become fat adults through the cumulation of excess fatness in each stage of the babies’ growing up years, said Associate Professor Fabian Yap, who heads the endocrinology service at KK Women’s and Children’s Hospital’s department of paediatrics.
The fatness of a newborn baby is a direct result of nutrition from the mother during pregnancy, and it also depends mainly on maternal factors , he said.
Subsequently, for the first six months of a baby’s life, his fatness primarily stems from milk feeding practices, added Dr Yap.
Most babies would be fully weaned to a solid-based diet by the time they turn one year old. A habitual eating pattern emerges thereafter that continues throughout his childhood and beyond.
“Maternal obesity, gestational weight gain, gestational diabetes, excessive milk feeding and delayed weaning are examples of early life factors that can lead to fat babies and infants, setting the stage for higher risk of adverse health outcomes later in life,” said Dr Yap.
Beyond infancy, a child’s dietary habits and physical activity will influence weight gain, he explained. “These behaviours often reflect the culture and mindsets of a child’s parents and caregivers,” he added.
IF YOUR BABY IS TOO CHUBBY ...
Parents in Singapore can keep track
of their child’s growth trajectories
by looking at growth charts, rather
than absolute weight gain.
These charts are in the health
booklet issued by the hospital at
birth, and allow the child’s growth
and development to be compared
against his peers.
If you find that your baby is very
large for his age – for example, he is
among the higher percentile of the
growth curve – here are some measures
you can take, said Dr Han Wee
Meng, who heads nutrition and
dietetics at KK Women’s and Children’s
Recognise your child’s cues for
hunger and fullness, and respond
Babies are born with an ability to
self-regulate their own feeding, so
parents should help to maintain
Often, parents and caregivers become
anxious when the child eats
less than expected or refuses food.
They force the child to eat, but this
results in the child losing the ability
to self-regulate his feeding.
Avoid doing so. Simply remove
the plate of unfinished food without
commenting on it.
2 HAVE REALISTIC
The stomach capacity of children
may be limited by their size and
They may also not have the attention
span to sit still and eat for long
Therefore, it can be challenging
for them to meet the target of three
substantially-sized meals a day.
Instead, offer small and nutrient-dense
snacks. Space their meals regularly
throughout the day.
Avoid making comparisons between
your child and other children,
as every child shows his own
hunger and fullness signals.
3 ENCOURAGE REGULAR
Skipping breakfast has been associated
with obesity and other health
issues. This is possibly due to people
making up for the missed meal by
eating more calorie-rich foods during
the rest of the day.
Parents should expose the child
to a wide variety of foods. Avoid categorising
foods as good or bad, referring
to certain items as “special
treats” or using food as reward.
It is also unwise to dangle the
promise of a food that the child likes
– for example, cupcakes – just to get
him to eat something he does not
like, such as vegetables.
Introduce healthy food choices in
a neutral way, without placing emphasis
that the child needs to eat. Be
encouraging when he makes a positive
change to his eating behaviour.
4 FOCUS ON MEALS,
NOT ON SCREENS
Mealtime interactions are important
to create a positive and enjoyable
Avoiding distractions during
meal times will help to turn the focus
on what and how much is eaten,
which helps the child to be more responsive
during meal times. Discourage
snacking when the child is
engaged in another activity, such as
when watching television.
5 INCREASE ACTIVITY TIME,
For young children, encourage free
play and limit their screen time to
less than two hours per day.
Toddlers and pre-schoolers
should be motivated to walk rather
than be transported in strollers.
In older children, routine exercises
and organised sports may be
initiated as their motor skills and coordination
would have improved;
and they should be able to engage
in physical activity lasting 30 minutes
a few times a week.