Understanding and Supporting Poor Weight Gain in Children
When my youngest child was diagnosed with failure to thrive, I remember the sleepless nights, the stress, and the helpless feeling of not knowing how to make things better. Poor weight gain isn’t something we can treat overnight, which is HARD. I’ve walked that path of worry, and it’s why I’m passionate about offering families the kind of support and guidance I needed and utilized during my time of need.
As parents, we often closely monitor our children’s growth, but what happens when weight gain slows down or halts altogether? Growth is a key marker of overall health in children, and deviations can be concerning.
Let’s dive into what the American Academy of Pediatrics (AAP) and World Health Organization (WHO) outlines about appropriate weight gain, when to worry about poor growth, and ways naturopathic medicine can help support children facing these challenges.
What is Appropriate Weight Gain?
The AAP, American Academy of Pediatrics, and WHO, World Health Organization provide growth charts as a reference tool, helping healthcare providers track a child’s progress. Typically, weight gain varies with age and developmental stages:
Newborns may lose 5-10% of their birth weight in the first week but should regain it by 2 weeks.
Infants (0-6 months) gain about 5-7 ounces weekly.
6-12 months: weight gain slows to about 3-5 ounces per week.
Toddlers and preschoolers: weight increases by about 4-6 pounds annually.
However, these are averages. Some children naturally grow slower or faster, but significant deviations from their growth curve warrant attention.
Red Flags for Poor Weight Gain
When there are red flags and specific criteria, doctors may diagnose a child as “failure to thrive, but this term is increasingly being replaced by terms such as "growth faltering," "weight faltering," or "poor weight gain" to describe children who are not meeting expected growth milestones. Be on the lookout for:
Stagnant or decreasing weight over several months on the growth chart.
A significant drop in percentile rank, especially crossing two major lines.
Symptoms accompanying poor growth include fatigue, developmental delays, persistent diarrhea, or frequent infections.
More severe cases may even show weight loss. If a child demonstrates these red flags, further evaluation is critical to identify the root cause.
Potential Causes of Poor Weight Gain
Inadequate caloric intake: Issues like feeding difficulties, oral-motor dysfunction, picky eating, reflux, GERD, or neglect can reduce calorie consumption. Food insecurity is also a reality for many families as well.
Increased caloric need: Conditions such as chronic illnesses or hyperthyroidism can raise energy demands.
Malabsorption: Celiac disease, food allergies, or gut parasitic or other infections may impair the body’s ability to absorb nutrients.
Psychosocial factors: Stress, anxiety, or trauma can affect appetite and digestion.
Environmental exposures: Chronic mold exposure, second-hand smoke, toxins, or infections may impact growth.
Chronic medical conditions: Heart defects, kidney disease, chronic or recurrent illnesses, or cystic fibrosis can increase caloric needs or impair growth.
Genetic syndromes: Conditions like Down syndrome, Turner syndrome, or other chromosomal abnormalities can impact metabolism and development.
Side effects of medications: Certain drugs, like stimulants for ADHD or chemotherapy, can suppress appetite or affect metabolism.
How Naturopathic Doctors Can Help
Naturopathic care takes a holistic approach to addressing poor weight gain by looking beyond calories and scales. Here’s how we support children:
1. Comprehensive Testing and Imaging
We begin with detailed history-taking and physical exams, complemented by tests such as:
Blood work to identify nutrient deficiencies, food sensitivities, or thyroid imbalances.
Stool analysis to evaluate gut health and detect malabsorption issues.
Imaging (if needed) for anatomical or structural concerns.
2. Nutritional Optimization
Proper nutrition is the cornerstone of growth. We create individualized dietary plans to ensure adequate caloric and nutrient intake. Some approaches include:
Encouraging nutrient-dense, whole foods
Introducing hypoallergenic diets if food sensitivities are suspected.
Recommending supplementation when deficiencies are detected or suspected.
3. Sleep and Stress Support
Sleep plays a critical role in growth hormone production. Poor sleep or excessive stress can inhibit proper growth. The psychological impact of poor weight gain on both children and their families is often overlooked. Naturopathic doctors provide:
Gentle sleep hygiene strategies.
Therapy or stress-reduction techniques can foster a supportive environment that promotes healing for both parents and children.
4. Movement and Physical Activity
Although exercise is essential for overall health, some children may require tailored activity plans to conserve calories for growth.
5. Addressing Environmental Exposures
Environmental toxins, such as mold or heavy metals, can interfere with nutrient absorption and metabolism. Testing for and addressing these exposures can significantly improve outcomes.
Partnering for Your Child’s Growth
As parents, it's easy to feel overwhelmed by the complexities of weight gain issues. Early intervention and a tailored plan can make all the difference in helping your child thrive.
If you’re concerned about your child’s growth, let’s meet!
Dr. Meg
