Is My Baby Too Fat? Understanding Baby Weight & What’s Normal

Is my baby too fat?

It’s a question many parents quietly worry about—especially when their baby looks bigger than others.

In this episode of Healthy Beginnings, Dr. Edgar Kalimba explains how to understand baby weight and growth in a healthy and balanced way. From growth charts to feeding patterns, this episode helps parents separate normal variation from real concerns.

Many babies go through periods of rapid weight gain, and what may look like “too much” is often part of normal development. Understanding this can reduce anxiety and help you focus on what truly matters.

In this episode we discuss:

•  What healthy weight looks like in babies 
•  Why “chubby” babies are often normal 
•  How growth charts are used—and their limitations 
•  When weight gain may be a concern 
•  Feeding patterns and common misconceptions 

This episode is designed to help parents understand growth without fear, and to approach their child’s health with clarity and confidence.

Healthy Beginnings offers clear and evidence-based conversations about children’s health, family wellbeing, and the systems that shape our lives. 

New episodes every Monday 

Have a question? Email: healthybeginningspodcast@gmail.com

Produced by LF Media

Transcript

SPEAKER_01 0:00

Many parents associate chubby babies with health. And most of us as parents want our babies to be chubby in the assumption that being chubby is equivalent to good health. But when does healthy growth become a concern? And more importantly, how can we set up our children for a lifetime of good health from the very beginning? This has been a focus on our podcast, and I hope you've enjoyed the past few episodes, particularly the recent ones that have focused on nutrition, how to navigate early nutrition for your baby. So today I would like to speak about uh infant and childhood obesity and how to avoid it and how to build good habits and avoid obesity. In fact, in our setup in Africa, in the African setup, often when we speak about malnutrition, people associate it with deficiency or being undernourished, which is true, but that's just a part of it. The other extreme or the other part of the spectrum, which is obesity and overweight, is actually also part of malnutrition. So, in essence, malnutrition covers from the one extreme of deficiencies to the other extreme of excess or imbalance. And to define it, uh how we determine if a baby or an older child is overweight or obese, we generally look at it the same way we look at it in adults, which is looking at the body mass index. And the body mass index really compares your height and weight and um and age and gender, especially for children above two years, where we can use the body mass index as a measure of how you're doing in terms of weight related to your height or your length in children. Now, for children who are below two years, we don't look at body mass index. Rather, we look at weight for age. So let's say, on average, if a one-year-old female baby is supposed to be, let's say, between 9 and 11 kilograms on average, if your baby is below, obviously they are underweight, and if they are above that, they're overweight. And when they are above what we call the 95th percentile, then they are actually obese. And what we mean by percentile is actually the growth charts that we use when you take your baby for follow-up or for routine check. We usually check their weight, their length, and sometimes their head circumference, and then we plot those on a growth chart. And I'm sure you've seen those growth charts for boys and girls, they're different because they have different growth velocity and references. And you usually have a midline, a midline graph or line that is usually the color green, and that is the average. So above a certain point is normal, beyond that point, they become overweight. And then if it's way beyond the overweight part, they actually are obese. And despite all our deficiencies and our lack of sufficient food in some communities, societies, in some areas in our country, in Africa in general, on the other side of excess or extreme or overweight and obesity, actually one in every five children. So that's about 20%. So it's actually fairly frequent. And when you look at, let's say, in Rwanda, particularly in the urban population or peri-urban population, it is certainly an emerging problem that we see in schools, in preschools, that should be addressed. So why does it actually happen or what leads to it? And I'm sure most of our listeners already know that the number one reason is actually overfeeding. And overfeeding often starts very early. And it's also well known that babies that are butterfed tend to be overfed compared to breastfed babies because when they're breastfed, they actually decide when to stop. But when they are butterfed, most of the time, or more frequent than not, uh a certain amount is prepared, and then parents or caregivers have a tendency to push the baby to actually finish that amount, and sometimes it could be excess. The other part that is related to feeding patterns or overfeeding is actually using food to soothe. So our babies cry often for many reasons. Every time a baby cries does not mean they're hungry. And you might say, well, of course, that's a no-brainer. But I've observed that, again, more often than not, there's a tendency to overfeed. Every time a baby cries, you want to give something, whether it's breastfeeding or butterfeeding, as a soothing. And so it is important to intentionally keep in mind that if your baby had a good meal, I've taken a good amount, surely after 30 minutes or one hour, they are not yet hungry. So if they are crying, there could be another reason. Are they tired? Do they want to sleep? Do they need an appi change? Are they feeling too hot? Are they feeling unwell for another reason? So feeding patterns, particularly overfeeding, is the number one reason. Now, when you go to older children, the quality of diet is the other reason. Where you find that, for example, there's a high intake of sugary drinks, particularly processed drinks and processed foods, because there's a very, very common tendency of this being very, very sugary or having a higher sugar content. And so when you take this regularly, frequently, every day, it does lead to giving too much calories and too much sugar. I'll give an example of what I've noticed in terms of the intake and snacks. Here in our society in Rwanda, some listeners might be surprised, but there's many parents that actually, for example, give biscuits every single day. So when I'm taking a history in the clinic and I ask, okay, so tell me about your baby's diet, I often get surprised that frequently parents will tell me, oh, I give biscuits every day. Either I mix it in milk or I mix it in porridge or something very popular with some mothers. And then we start to break it down. So what is biscuits composed of, other than a little bit of wheat and sugar? It's really nutritionally mostly empty and certainly not a good choice. So you find these beautiful chubby babies being fed on biscuits every single day. So instead of that, you would rather replace that with a fresh, fresh produce, fresh snack that are locally sourced. We have plenty of options and that are actually much more affordable than the packed, processed, highly sugar snacks and drinks and foods. The third reason is law of physical activity. Um I think our generation tends to overprotect our children. We don't allow them to go out of the house and play and run and kick the ball and be active and explore the environment. We keep them indoors, and there is way too much screen time. I think in one of the previous conversations, I spoke a little bit about screen time. I think there was a parent who actually sent us a question around this. And screen time is really a huge trap. It's an easy cop out that many of us as parents tend to admit and compromise more than needed. And we all know that too much screen time is harmful. This should be replaced by physical activity and healthy play. So limited active play certainly is a contributor to whether it's children or adults uh being overweight and or obese. And again, just as a reminder, we generally avoid screens in uh children and toddlers below two years. So a baby who is below two years really shouldn't be looking at screens. And then from two years to five, six years, let's say preschool years, most recommendations would say maybe an hour max of educated uh good quality content is permissible. If you can do it every other day instead of every day, even better. The fourth element is generally family and environmental factors. So eating habits, eating choices, um, availability of healthy options at home, these all have to do with our choices as a family and what we choose to buy and keep in our shelves, in our fridges, in our homes. If you buy high sugary um pestries every day, that's what our children is gonna, uh our children are going to eat. But if we don't, and we buy plenty of fruits and we stock them and they're available, then the choice might be different. So generally how we set up our environment also matters. And then lastly, what I would call early life influences, uh, and these have to do with maternal health, let's say during pregnancy. We know, for example, that when a mother is diabetic during pregnancy and their blood sugar is not well controlled, they'll tend to carry a bigger baby. You know, we actually, from the medical perspective, we call them infant of a diabetic mother. So when you speak to a doctor and you tell them this is an infant of a diabetic mother, it actually means something. They are typically big at birth, they have large uh for gestational age, or they are big babies, they would might maybe might be 4 kilos, 4.5, even 5 kilos, sometimes even bigger. So they tend to be big at birth. And then that also could uh follow them up, especially in the first months and first year or two of life. They tend to be bigger than their peers because of that background. And then often than not, there's rapid weight gain during uh infancy and early childhood. So childhood obesity uh doesn't only start in in later childhood, it actually often starts in uh uh during infancy, let's say even the first year of life. Now, when your child is overweight or obese, they're obviously at a higher risk for a couple of things. One, in the short term, these are babies that tend to have breathing problems. They might have snoring, they might have obstructive sleep apnea, they're just heavy and they might struggle. You know, you see that they're really struggling and having some difficulty to breathe because they carry around more weight than they should. And that could could be associated with uh sleep issues as well. The other thing is if your two-year-old, instead of being 12, 13, maybe 14 kilograms at most, if they are 20 kilograms, remember that uh their body structures, their joints, you know, their pelvis, they have to carry around a weight that is maybe double what they should be carrying around. And that can have a profound effect on their physical growth and on their musculoskeletal system as well. And then, of course, there's always the long-term concerns, you know, they're at a higher risk for type 2 diabetes, they might eventually start to have issues around high blood pressure, cardiovascular disease, and understandably having to deal with obesity in adulthood. So, this is why prevention matters a lot. And so the question now is what can parents do? Like what are the practical tips? So, first of all, practicing responsive feeding. So, if your baby is not hungry, don't feed them. If they have had a good meal and you're back to feeding them after half an hour or an hour, you are pushing it. Secondly, if the babies are full, if your baby is full, they will show you that they are full. Don't push, don't force feed. The second important point is the quality. So focus on food quality. And we have many options, whether it's fruits and vegetables, whether it's whole grains, whether it's good quality protein, whether plant-based or animal-based, um, avail good quality options and avoid uh sugary snacks and processed foods that are not um healthy options. And, you know, parents will often ask, so what is a quick nutritious snack that I can pack for my child, whether they go to school, play school, or preschool, uh, or even older infants, let's say between nine months and one year, what should I give them as a snack in between meals? You can give them a fruit, you can give them banana, you can give a plain yogurt, you can do egg, you can do avocado, you can do a piece of cheese, you can do oatmeal. There's plenty, plenty of options on the go. You know, you can cut a fruit. And if you like to bake or prefer something maybe a little bit more exciting, you can do a homemade muffin with low sugar. You can bake something and just avoid to make it very sugary. So plenty of options that you can actually explore. And then again, sugary drinks. Often we count the calories from what we eat and we forget to count the calories from what we drink. And if your baby is having uh packed juice or soda every day, that is not a good thing to do. And then, of course, encourage active play. I mentioned that already, because this is very, very important. So um, I would like to say that building healthy routines early on is very important. Starts very early uh during the first year of life. That's where most of the healthy routines and habits are built. I've also previously mentioned that children often copy what they see. So healthy habits are caught and not taught. Healthy habits are caught and not taught. So we as parents need to really role model for our children, including sitting together around meals and making good choices. So um, again, common mistakes, avoid using food as comfort, don't overrely on snacks, particularly unhealthy options, portion sizes, you know. You shouldn't expect your two-year-old or three-year-old to eat the same portion as your 10-year-old or as the adults in the house. And then keeping track of your child's growth. Every time you're seen by a nurse or by your doctor, the clinic, whether it's doing vaccination clinics or routine follow-ups, you should always discuss this and look at your baby's weight gain over time, see where they fall on the growth chart, and actually keep track of this. I've had it asked uh quite frequently where parents will tell me, I'm concerned that my baby is not big enough. My baby looks very thin or very small. And lo and behold, when we actually plot them on the growth chart, they are high up there on the growth percentile, and they're actually probably overweight and sometimes even obese. And parents don't realize. So it's important to keep track of this. We would like to now look at some of the questions that you sent to us, and my producer is going to share them and we will respond to them.

SPEAKER_00 19:41

First question from Beatrice41 from Uganda. I was raised to believe children should be tough and not complain too much. Now I'm raising my kids differently, but I sometimes wonder, are we making them too soft?

SPEAKER_01 19:54

That's an interesting question. I've heard somebody joking recently saying that, um, and this person is probably in their 40s. So she was saying that during their generation, parents would discipline by spanking. And then the next generation, which is this person's children, were being raised through scolding, where you would discipline your child by speaking to them, sometimes in a tough manner, maybe even harsh, to get them to do the right thing. And now there's a younger generation of parents where the roles have reversed and the child is the boss. You know, the child does what they want. Um if anybody speaks to them in a stern manner, it's a problem. And uh that just tells you that as the years go by, it gets more and more confusing, more and more difficult. I think for me, the approach has always been conservative and reasonable, meaning that for most of the children, you as a parent should make sure that the boundaries are clear. And I often say that if a child clearly rebels, you tell them, okay, so and so, you are not allowed to do this because this is harmful to you. And they still go ahead and do it, they basically rebel outright, there should be consequences to that. Now, the choice of consequences varies and is also age dependent. The way you discipline a two year old is different from the way you discipline a six year old. Either way, the point is that for um a child that rebels or Disrespects outright or challenges authority, parental authority, there should always be consequences. Because if there are no consequences, it's actually harmful to their self-esteem and is also harmful to their growth, part of their growth and understanding and interacting with authority. So my advice would be that raising children too soft is actually detrimental. It doesn't help to build their resilience, it doesn't help to build their self-esteem, and doesn't even help to build the discipline that they need to grow up and perform, whether in school and whether in life in general. So, yes, put boundaries, discipline your child, and make sure there's age-appropriate consequences.

SPEAKER_00 22:57

Second question from Kevin 29 from Nairobi. My son is two, and I keep hearing comments like he's not talking yet, or other kids are already doing this. It's starting to stress me out. How do you know if a child is truly delayed versus just developing at their own pace?

SPEAKER_01 23:14

I think again, that's a very good and frequent question that we see. So you have a two-year-old, they are barely speaking, or compared to their peers, they seem to be behind on their growth in terms of the speech. So, first off, we know that one in five children will be a late speaker. It tends to be more common in boys than girls, where you know your son is two and a half year old and they barely put a two-word sentence together. So, first of all, it's important to get a medical opinion, get a doctor to look at them. Because we always need to differentiate between normal or non-concerning, non-alarming speech delay versus something more sinister. So, for example, autism. You know, autism has become 30 times more frequent globally. And one of the hallmarks of autism is that your child will have speech delay. But it will not be isolated speech delay, they have other problems, often what we call uh social and behavioral dysfunction. There's a whole thing. We'll probably have a whole conversation around that in the near future. So if you have a child that is otherwise growing well in terms of all the other milestones, including social and interaction, including physical growth and development, including behavior, and there's just isolated speech delay, more often than not, it would not be a major concern. However, get a check, get an evaluation. Maybe they need a hearing test. Because often children that have a hearing impairment will not be able to speak. They will not grow their speech, and you will not know until you actually get an auditory test and they test for their hearing. So there might not be a big concern. Uh, because one in five children will speak late. But get a check and make sure that there are no other alarming components that need to be addressed, additional to the speech delay.

SPEAKER_00 25:48

Last question from Mary29 from Kigali. Because of my schedule, I sometimes only eat one proper meal a day. I've gotten used to it, but people tell me it's unhealthy. If I feel okay, is it still a problem?

SPEAKER_01 26:01

Okay, so I'm not an expert on eating habits in adults, but I'm happy to give my opinion. One meal a day is a bit on the lower side, uh, because we as adults, you need to get somewhere in the range of 2,500 to 3,000 uh calories per day. So depending on what meal it is and the content of that meal, there's a high chance that you're probably still getting sufficient nutrition, especially if your day-to-day or your daily routine is minimal physical activity. In fact, for most people that have jobs that require them to sit for long hours every day and not have much physical activity, three meals is probably too much, unless there are three uh two to three moderate-sized meals and healthy options. So that balance between how much calories are you taking in versus how much calories are you expending. I think that's the bigger question. So if you take one meal and you hydrate and that has been your routine, and you feel well, you're not underweight, you're not faint, you're healthy, um, it might not be detrimental, but it is on the lower side, I would still say. I think probably two meals and a whole lot of hydration would probably be better. So I hope this was helpful and I hope this was practical and relatable. And again, I look forward to receiving more of your questions. Uh, I love responding to your questions, and I hope you found this helpful and relatable. Until next time, thank you for listening.

SPEAKER_00 28:00

This podcast is for general informational and educational purposes only. Do not make health decisions without consulting your doctor. This podcast is brought to you by LF Media, home of Great African podcasts.