Healthy growth and weight gain
Children and adults are all shapes and sizes, most of which are healthy. In this section we want to explain the growth charts and help you understand what you can do to help your baby grow up healthy and happy.
In your Personal Child Health Record (PCHR) you will find growth charts. Do read the information pages that come with them. The chart describes the growth patterns of thousands of normal, healthy, breastfed babies and toddlers from around the world and older children from the UK. Healthy bottle fed babies should follow the same growth patterns as breastfed babies. The lines are called 'centiles' and they simply describe how your baby's weight, length and head circumference compares with other children of the same age and sex. For example - if your baby's weight is on the 25th centile this means that if you weighed 100 babies of the same age and sex and ranked them from light to heavy, 75 babies would be heavier than yours and 24 lighter. We expect a baby to gain weight along one of these centiles or in their own channel between two of the centile lines. Which centile is healthy for your baby depends on where they started out - their birth weight - and factors they inherit from their parents. There is no 'best' centile. There will be variation above and below their centile and it is wise not to weigh and measure babies too often because these natural fluctuations can cause unnecessary concern - what matters is the pattern over time. Usually no more than monthly weighs are necessary for the first six months, every two months from six months to a year and every three months after that; unless there are particular concerns and your health care professional requests that you have your baby weighed more often for a period of time.
Generally speaking, a healthy baby's length and weight will be 'in proportion' i.e. will have their length and weight within one of the major centile lines of each other and certainly no more than two.
Weight is fantastic for assessing the health of a baby. Crossing the centiles up and down may be a cause for concern. Historically most emphasis has been on monitoring babies who appear to be gaining weight too slowly - and your midwife and health visitor will watch out for this. It is likely to become apparent quite early on and the most common cause is difficulties with feeding. It is normal - and healthy - for a baby to lose some weight in the first few days of life and only is this exceeds 10% will your midwife be concerned. There is some evidence that this early weight loss helps 'set' appetite and feeding patterns for the rest of the child's life. These days poor weight gain is pretty rare and for this generation we are much more worried about babies who cross the centiles upwards across the chart because this is very unlikely to be healthy. The illustration shows several typical patterns of weight gain - healthy and unhealthy.