Growth False Alarms

Having your baby weighed regularly is one way to confirm that he’s growing well. If he achieves an expected weight gain this provides reassurance. But what if he doesn’t? Does this mean there’s a problem? Not necessarily! It could be a false alarm.

What causes false alarms?

A false alarm means a parent or health professional becomes concerned about a baby’s growth when in reality his growth is fine. Concern stems from the method involved in weighing a baby or mistaken assumptions when interpreting the results. The following are examples of growth false alarms.

Fluctuations in body fluids.
Using different scales.
Weighing baby in different clothing.
Growth plateau.
Variation in normal growth.
Unrealistic expectations.

1. Fluctuations in body fluids

Scales measure total body weight. This includes body fluids, which constantly fluctuate. Included in the measurement of your baby's weight is ...

How much milk is in his tummy.
How much urine is in his bladder; and
How full his intestinal tract is at the time.

If you were to weigh your baby multiple times on the same day you would see fluctuations in weight. In general, weight in the morning will be lower compared to weight in the afternoon and evening.

When weighing a baby from week to week, fluctuations in body fluids alone have the potential to cause a variance of up to 4 ounces (112 grams) for small babies, or up to 8 ounces (225 grams) for large babies. If for example one week you weighed your baby after a feed and at the time he had a full bladder and bowel, it might appear like he had a large weight gain. If the following week he was weighed before being fed and he had emptied his bladder and bowel it might appear like he gained very little, not gained at all, or lost a little weight during the week when this may not have been the case.

2. Different scales

What can appear to be a decline in a baby's weight gain could simply be due to using different scales. Scales require calibration and regular maintenance to ensure accuracy.

Using the same scales each time a baby is weighed will generally provide a consistent measurement, even if the scales are a little out of kilter. However, using different scales can provide very different results due to the possibility that one or both scales are in need of calibration.

3. Different clothing

If your baby is not weighed naked then variations in the weight of his clothing need to be considered. What might appear like a large or low weight gain would simply be that baby is wearing more or less clothing at the time.

4. Growth plateau

Babies’ pattern of growth is not consistent. While all babies grow over time, they don’t become a little longer and heavier each day. Growth occurs in a step-wise pattern. Just as babies go through growth spurts where they eat well, add extra weight and grow length-wise, there are periods where babies' growth plateaus. During this time baby's growth might remain stagnant and his appetite appear to be small.

5. Variation of normal growth

Babies are individuals. They don’t all grow at the same rate or follow the same pattern of growth. A baby’s weight gain or growth pattern could differ from what is generally considered as a typical growth pattern for babies without this being a problem. See Variations of normal growth for more.

6. Unrealistic expectations

It could be that you or baby’s healthcare professional are expecting him to gain average weight for age when this may be unrealistic for your baby. Another reason why a baby might not gain as expected could be due to one of a number of common mistakes made when assessing a baby's growth. See Top 10 baby growth assessment mistakes for examples.

What to do!

If you’re concerned about your baby’s growth, check if he shows signs of being a well-fed baby. If he displays signs that indicate he’s well fed, there’s probably nothing to worry about. It’s likely that the appearance of poor growth is a false alarm. In this case, have him weighed again in other another week.

Avoid jumping to conclusions. Making changes to your baby’s diet, or your feeding management in response to a false alarm has the potential to complicate the situation, and in some cases create infant feeding and growth problems that might not have previously existed. See Consequences of growth mistakes.

Written by Rowena Bennett.