By Nur Dianah Suhaimi
Heavier does not mean healthier, doctors say
LITTLE Gordon Gooi turned one yesterday and tips the scales at 11kg, making him heavier than most babies his age.
He wears clothes meant for two-year-olds and his grandmother cannot take care of him because she cannot even lift him.
But his mother, Ms Liz Lim, 31, is not worried that Gordon is getting too heavy for his age. 'Doctors say he's okay. I like the way he looks...very chubby and healthy,' she says.
Talk to most parents and chances are that they will agree with Ms Lim, a valuation officer.
Chubby babies are seen as healthier and cuter than skinny ones. People coo over them and like to pinch their cheeks.
While chubby adults can be subjected to merciless teasing, no stigma is attached to chubby infants.
In fact, Gordon won the Kodomo Cheery Baby contest last month.
Public relations manager Karen Lai, mother of a two-year-old and a 10-month-old baby, says: 'The chubbier babies are cuter. They look like little Michelin men.'
But talk to doctors and they say this preference for chubby children is not healthy. Last week, doctors here highlighted a Danish study which found that chubby children are far more likely to suffer heart attacks as adults than thin kids.
Growing affluence has meant that parents can afford to feed their children well and this, in turn, has led to overfeeding in many cases, doctors say.
While the number of fat babies is not known, one in about 10 kids - or 50,000 children up to 16 years old - here is considered fat.
KK Women's and Children's Hospital (KKH) sees 15 new cases each month at its weight management clinic for children up to the age of 16. The youngest patient is three years old.
The hospital has not studied the trend in babies' birth weights, but obstetricians in private practice say that birth weights have remained constant over the years.
Chubby babies are not always born big. Some pile on the kilos in their growing years.
Dr Oh Jean Yin, registrar at KKH's department of general and ambulatory paediatrics service, says 'overweight toddlers are becoming common'.
She says a sedentary lifestyle and a high intake of processed food which is high in fat or sugar - such as fast food - are the main reasons.
Families are smaller and there are fewer caregivers so children now rarely play outdoors. Portion sizes have also increased, she says.
Take the case of two-year-old Ethan Lim, who weighs 15kg.
He would have a slice of cake or bread for breakfast and a bowl of rice with chicken or pork rib soup for lunch and dinner. He also loves steamed egg and eats it nearly every day.
In between meals, he drinks milk and snacks on bread or cornflakes. He also takes cod liver oil and multivitamins.
While Ethan's mother, Ms Jean Wee, 35, sometimes worries that he is eating too much, she admits that she finds it hard to control his food intake.
'If he's hungry, he'll wake up in the middle of the night and cry for milk. In the end, we suffer. So we make sure he gets his fill during the day,' says the academic research associate.
Doctors say many parents mistakenly think that it is good if their babies eat more than their peers.
Associate Professor Quek Swee Chye, a senior consultant at the National University Hospital who specialises in children's heart problems, says: 'A child's ability to eat or drink more than the average child is often seen as healthy.'
This misconception could lead to overfeeding and is bad for health. While a fat child does not necessarily become ill, doctors say the odds are stacked against him.
Dr Joseph Manuel Gomez, a senior consultant at KKH's department of neonatology, says overweight babies are not only likely to become fat adults, but they are also at increased risk of high blood pressure, sleep apnoea and early onset of diabetes.
He cites a study of overweight two-year-olds which found that they were five times more likely than their average-weight peers to be overweight at the age of 12.
The belief that 'bigger is better' could have stemmed from leaner times in the past when chubby children were seen as a status symbol.
Ms Pauline Chan, a nutritionist of 15 years, says: 'It meant their parents could afford to feed them well. That's why people love to see some fat on babies.'
Housewife S. Mohammad's youngest son is three years old and weighs 30kg.
Doctors have suggested he goes on a diet but in the eyes of his mother, he is 'not fat, just big-boned'.
'It's okay for boys to be big,' says the 37-year-old mother of three.
Today, the problem of overweight babies is more likely to stem from the fact that couples have fewer children and simply don't have the heart to say 'no' to them.
When Gordon finishes his bottle of milk and wants more, he would refuse to take his nap. So his mother refills his milk bottle and feeds him again until he is satisfied. Sometimes, she gives him more milk so that he does not have to ask for refills.
Prof Quek has this advice for parents: 'Parents tend to worry that their baby is not eating enough. But if the child is already big, they need to say 'no'.'
Three meals plus lots of milk = overfed baby?
AT 11kg, one-year-old Gordon Gooi (above) is heavier than 90 per cent of babies his age. He drinks close to a litre of breast milk every day, on top of three main meals. Here's his daily diet:
- 6am: Milk, 180ml
- 9am: Milk, 80ml
- 9.30am: Breakfast of mashed potatoes, carrots and spinach; half an avocado for dessert
- 10.30am: Milk, 150ml
- 1pm: A bowl of porridge mixed with tofu, vegetables and egg yolk; fruit for dessert
- 2.30pm: Milk, 200ml
- 6pm: A bowl of chicken porridge
- 8.30pm: Milk, 250ml
Nutritionist Pauline Chan, who recently co-authored a book on baby food titled First Foods, feels Gordon is overfed.
She approves of his three main meals but thinks that he should be drinking less milk. 'He drinks too much milk for a baby who is already eating three full meals a day. He can take his milk two or three times a day but not more than that.'
Ms Chan says Gordon could be asking for so much milk because he is not getting enough solid food. She suggests that Gordon be given snacks such as steamed sweet potatoes and French toast in between meals.
Gordon's mother, Ms Liz Lim, 31, says she gives him more milk because breast milk looks 'watery' and she is worried it is not 'filling'.
'Maybe I'll give him less when he switches to formula milk next year,' she says.
How to feed your toddler right
6 months - 8kg (median weight)
1 year - 9kg
2 years - 12kg
3 years - 14kg
4 years - 16kg
5 years - 18kg
6 years - 20kg
6 months - 7kg (median weight)
1 year - 9kg
2 years - 11kg
3 years - 13kg
4 years - 15kg
5 years - 17kg
6 years - 20kg
- Breastfeed: This teaches babies to control the amount of milk they drink. Also, breast-fed babies tend to be leaner than bottle-fed ones.
- Calorie-fortified milk should be given only to underweight babies or those not eating enough. If given to normal babies, the extra calories will become fat.
- Do not feed babies every time they cry. Most crying babies want to be held or may just be thirsty and need water. Inculcate good eating habits young. Limit intake of sugary food and encourage them to eat their greens.
- Do not force-feed your child if he refuses to eat. Force-feeding may just make him a fussier eater. Let him play with his food and make meal times enjoyable.
- The milk bottle should make an appearance only during feeding time. Children who are allowed to carry a bottle around with them learn to eat frequently and use food for comfort.
- Avoid giving solid food to your child until he is four to six months old.
- Do not give the child food as a way to distract him or keep him occupied.
- Not all children grow at the same pace. If the neighbour's child can eat chicken rice at 18 months but yours cannot, do not fret. Slowly introduce solid food into the diet.
If you think your baby is too fat, do not put him on a diet without first consulting a paediatrician.
Source: Paediatricians and nutritionists
Say 'no' to overeating
'Parents tend to worry that their baby is not eating enough. But if the child is already big, they need to say 'no'.'
- ASSOCIATE PROFESSOR QUEK SWEE CHYE, a senior consultant at the National University Hospital who specialises in children's heart problems