The worry that your child is underweight, slow to grow, or does not gain weight is a common concern of many parents. This is not only a psychological pressure but also a deep concern for the health and future development of your child. How can your child gain weight healthily, properly, and keep up with the growth rate of their peers? This article provides basic knowledge and scientific monitoring methods, allowing parents to feel more confident in the journey with children to achieve their ideal weight and comprehensive development.

1. Understanding proper weight gain and related issues in children

For effective weight gaining of your child, the first and most important step is for parents to equip themselves with basic knowledge. This allows parents to accurately identify their child’s condition and avoid unnecessary mistakes.

What is underweight and malnourished child?

Children are underweight when their weight for age is below the average, falling below -2 standard deviations.

“Underweight” and “malnutrition” are two commonly used terms, however, they have nuances of meaning that need to be distinguished.

•     Underweight: When a child’s weight-for-age is below the standard average. The World Health Organization (WHO) has developed standard growth charts (weight-for-age, height-for-age, weight-for-height and body mass index – BMI-for-age for older children) as a tool to objectively assess the nutritional status of children. Children are considered underweight when their weight-for-age index is below -2 standard deviations (SD) from the median of the WHO reference population.
•     Malnutrition: A broader term, including undernutrition (underweight, stunting, wasting), overnutrition (overweight, obesity) and micronutrient deficiencies. In the framework of this article, we focus on forms of malnutrition due to deficiencies:

–       Underweight: Low weight for age (as defined above).

–        Stunting: Height for age is -2SD below the median of the WHO reference population. This is a consequence of prolonged undernutrition or recurrent infections.

–        Wasting: Weight for height is -2SD below the median of the WHO reference population. This usually reflects acute and severe weight loss due to starvation or illness.

Consequences of underweight and chronic malnutrition

Underweight and malnutrition, if not treated promptly, can have serious and long-term consequences, affecting the comprehensive development of children:

•     Physical effects: Slow physical development, small stature, poor endurance.
•     Intellectual influence: Malnutrition in the early years of life, especially deficiencies of important micronutrients such as iron, iodine, and zinc, can impair cognition, learning, and brain development.
• Impact on the immune system: A weakened immune system makes children susceptible to respiratory and digestive infections and other infections, creating a vicious cycle: malnutrition increases the risk of infection and infection in turn worsens malnutrition.

2. Common causes of slow weight gain or low weight in children

Understanding the concepts and consequences is essential, however, to have effective intervention solutions, we need to delve into the factors that cause children to fall into this situation. Identifying the right cause is the guiding principle for all efforts to enable weight gaining.

Nutritional causes

Improper nutrition is a common cause of slow weight gain in children

This is the most common group of causes, originating directly from the child’s daily diet. Among them, there are 4 common mistakes from the daily diet that cause children to gain weight slowly that parents often make:

•     Not eating enough quantity or not getting enough energy: Children may eat less due to anorexia, or due to their diet does not meet their age-appropriate energy needs.
•     Poor meal quality: Unbalanced meals, lacking important macronutrients such as protein, fat (lipid), carbohydrates.
•     Micronutrient deficiency: Zinc deficiency can cause anorexia and slow growth; iron deficiency causes anemia, affecting physical and intellectual development; B vitamin deficiency affects children’s energy metabolism and nutrient absorption.
• Improper preparation: Food that is too thick, too liquid or not to the child’s taste also causes the child to eat less.

Pathological causes

Acquired diseases also cause children to gain weight slowly, including mainly the following diseases:

•     Acute or chronic infections: Respiratory, digestive, urinary tract infections… increase the need for energy and nutrients, and also cause anorexia and reduced nutrient absorption in children.
•     Digestive disorders: A healthy digestive system is a solid foundation for weight gain in children. Prolonged constipation makes children uncomfortable, bloated, and has a poor appetite. An imbalance in intestinal bacteria, along with a decrease in beneficial bacteria and an increase in harmful bacteria, leads to a decrease in the ability to digest and absorb food, increasing the risk of diarrhea or other digestive disorders. Malabsorption syndrome due to damage to the intestinal mucosa, often seen after prolonged diarrhea or in Celiac disease, is also an important cause.
• Other chronic diseases: Congenital heart disease, kidney disease, endocrine diseases… can also affect a child’s growth process.

Causes due to psychological factors and habits

In addition, we cannot fail to mention psychological factors and eating habits, things that seem small but leaving a big impact on children’s weight.

•     Psychological anorexia: Often occurs in children who are forced to eat, have a stressful meal atmosphere, or have negative experiences with food.
•     Unfocused eating: Children are too absorbed in other activities such as watching TV, using phones, playing with toys, etc. and ignore the feeling of hunger.
•     Frequent snacking: Eating too many low-nutritious snacks close to main meals makes children feel full and not want to eat main meals.

3. The importance of healthy weight gain

After considering the potential causes of slow weight gain, it is extremely important for parents to set the right goal for their child’s weight loss journey. Many people are often concerned with how to scale up, but in reality, “gaining weight” does not mean simply gaining weight haphazardly. The ultimate goal must be healthy weight gain, a fundamental concept for the comprehensive and sustainable development of children.

What is healthy weight gain?

Healthy weight gain is not about children accumulating a lot of excess fat to look “plump”. Instead, it is a balanced and harmonious growth process that includes:

•     Development of muscle mass and skeletal system: This is the core factor. Weight gain must be accompanied by muscle development, allowing children to be strong, agile and have good endurance. The skeletal system also needs to be strengthened, developing in length and density to ensure optimal stature in the future.
•     Perfection of organs: Organs such as the brain, heart, liver, kidneys… need enough nutrients to develop and function effectively. Gaining weight properly supports this process.
•     Ensure energy and nutrients for all activities: Weight gain means that children have enough energy to study, play, and explore the world around them, while essential micronutrients must be provided adequately to support brain development and strengthen the immune system.

The outstanding benefits of healthy weight gain

Healthy weight gain enables comprehensive development of children

Children gain weight in a healthy way, the benefits are not just limited to body shape.:

•     Solid physical foundation: Children have better health, less illness, higher endurance, are more active and flexible in physical activities, and their stature is also improved, allowing them to be more confident.
•     Optimal intellectual development: The brain needs a lot of energy and nutrients to develop, especially in the early years of life. Healthy weight gain ensures that the brain is supplied with enough “fuel”, helping children enhance their cognitive abilities, learning, memory and concentration.
•     Healthy immune system: A well-nourished body has a stronger immune system, allowing children to fight pathogens and reduce the frequency of infectious diseases.
•     Positive psychology and emotions: When children are healthy, eat well, and sleep well, they are happier, more active, and have a better mood, contributing to their emotional development and social skills.

Conversely, the potential risks of uncontrolled weight gain

Being impatient to get your child to gain weight quickly without paying attention to quality can lead to unwanted consequences:

•     Risk of overweight and obesity: This is the most direct and obvious consequence. Children can gain weight quickly but mainly gain fat, leading to overweight and obesity from an early age.
•     Increased risk of chronic non-communicable diseases: Childhood obesity is a leading risk factor for early metabolic diseases such as dyslipidemia, prediabetes, and even type 2 diabetes and cardiovascular disease when children grow up.
•     Affects the skeletal system: Excessive weight puts pressure on the child’s immature skeletal system, which can cause joint problems and limb deformities.
•     Negative impact on psychology: Overweight and obese children can be teased by friends, leading to low self-esteem and inferiority complex, affecting psychological development and social integration.

Therefore, it is extremely important to understand and aim for healthy weight gain. This requires a scientific approach, patience, and proper understanding from parents, not quick solutions or forcing children to eat.

4. Instructions for properly monitoring your child’s weight at home

Regular and accurate monitoring of your child’s weight at home is an important tool to help parents detect early abnormalities in their child’s growth.

Proper weighing techniques:

Trough scale – a type of scale commonly used to monitor the weight of newborns

To get accurate weight measurements, parents should keep in mind:

•     Weighing time: It is best for parents to weigh their children in the morning, after they have gone to the toilet and before breakfast.
•     Clothes: Remove heavy clothing, diapers (if possible for small children and make sure they are not cold). If clothing must be worn, tare the weight of the clothing or make sure the child is wearing similar clothing each time you weigh them.
•     Weighing posture:

–       Infants and young children who cannot stand: Use a specialized scale or trough scale and place the child lying on his back or sitting in the middle of the scale.

–       Older children who can stand: Use a standing scale. Ask the child to stand straight, eyes looking forward, and arms by the side.

• Type of scale: Parents should use the same scale for each monitoring and ensure that the scale is placed on a stable surface, is calibrated regularly and has a scale error of <0.01kg.

Frequency of monitoring:

The appropriate frequency of weight monitoring should be based on the child’s age:

• Children under 1 year old:

–   Newborn (0 – 6 months): Should be weighed weekly or every 2 weeks.

–   Children 6 – 12 months: Weigh monthly.

• Children 1 – 3 years old: Weigh monthly or every 2 months.
•     Children over 3 years old: Weigh every 3 months.

However, if the child is in a period that requires close monitoring due to low birth weight, malnutrition or medical conditions, the doctor may request more frequent monitoring.

Recording and using growth charts:

Each time you weigh your child, write down the date, weight, and height. Then plot these figures on the WHO standard growth chart (available from the WHO website or the National Institute of Nutrition).

Standard growth chart for babies from birth to 24 months.

It is important to monitor the child’s growth trend (growth curve) over several points in time, rather than relying on a single measurement. A growth curve that is steadily rising, parallel to the normal curves, or trending closer to the median is a positive sign. Conversely, a curve that is flat, downward, or crosses the normal growth channels is a warning sign that needs attention.

Conclusion

Thus, equipping yourself with knowledge to understand the condition of underweight and malnutrition, identifying common causes of slow weight gain in children, understanding the potential consequences as well as the importance of aiming for healthy weight gain is the first and extremely essential step. In addition, the ability to accurately monitor your child’s weight at home through proper weighing, maintaining a reasonable frequency and using a growth chart allows parents to detect abnormalities early, thereby having timely intervention. These are important foundations for parents to be more confident in the journey of taking care of their children’s health. However, identifying the problem and monitoring is only the beginning. In order for children to truly improve their weight, catch up with growth, and develop comprehensively, it requires scientific, specific, and personalized nutritional solutions.

Part 2: “Nutrition tips from experts for children to gain weight properly and develop comprehensively” provides detailed information on how to create a balanced, energy-rich diet, smart food choices and breakthrough nutrition strategies stimulate your baby weight gain in a healthy and sustainable way.