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Updated: Jun 7, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Short-term weight variability in infants and toddlers: an observational study
Charlotte Margaret Wright1, Ford Hope-McGill2, Harshine Sivakanthan2
1Department of Human Nutrition, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK charlotte.wright@glasgow.ac.uk.
Insights
Short-term weight fluctuations in toddlers can be significant, potentially exceeding expected growth over short periods. This variability means weight gain measurements over less than 8 weeks may be misleading for toddlers.
Area of Science:
- Pediatric growth monitoring
- Infant and toddler health assessment
- Nutritional anthropometry
Background:
- Accurate tracking of infant and toddler weight gain is crucial for assessing healthy development.
- Short-term weight variability, influenced by factors like diet and excretion, can complicate growth interpretation.
- Understanding these fluctuations is key to reliable growth monitoring in early childhood.
Purpose of the Study:
- To investigate short-term weight variability in young children (infants and toddlers).
- To determine the relationship between weight variability and expected weight gain.
- To analyze the impact of age, time of day, and physiological outputs on weight fluctuations.
Main Methods:
- Home-based weighing of 20 infants (2-10 months) and 21 toddlers (12-35 months) over 3 days.
- Parents recorded dietary intake, fluid intake, and excretory events (urination, defecation) for toddlers.
- Analysis focused on 'noise' (within-subject weight standard deviation) relative to expected growth and associations with time and physiological events.
Main Results:
- Infant weight variability (117g) was less than expected 4-week gain (280-1040g).
- Toddler weight variability (313g) exceeded expected 4-week gain (180-230g) and was ~75% of expected 8-week gain (359-476g).
- Toddler weight decreased overnight, increased during the day, and was influenced by recent eating and stool passage.
Conclusions:
- Toddler weight measurements can fluctuate by as much as 300g due to short-term variability.
- Weight gain assessments in toddlers measured less than 8 weeks apart may be unreliable.
- Clinical interpretation of toddler growth requires consideration of significant short-term weight fluctuations.
Aims:
To explore short-term weight variability in young children; (1) how it relates to expected weight gain and (2) how it is affected by age, time of day and dietary intakes and outputs.
Methods:
Twenty healthy infants aged 2-10 months and 21 healthy toddlers aged 12-35 months were weighed at home by their parents six times over 3 days. The toddlers' parents also recorded whether they had eaten, drunk, urinated or passed stool in the previous 2 hours. The primary outcome was 'noise': the within-subject weight SD pooled separately for infants and toddlers, compared with their expected weight gain over 4 or 8 weeks. Analysis by successive pairs of weights was used to assess the extent of short-term weight gain and loss associated with time of day and eating, drinking and excretion.
Results:
In infants, noise (117 g) was much less than the expected weight gain over 4 weeks (280-1040 g) but in toddlers, noise (313 g) was higher than the expected gain over 4 weeks (180-230 g) and around three-quarters the expected gain over 8 weeks (359-476 g). In toddlers, weight tended to fall overnight and rise by day, and recent eating and passage of stool were associated with increased weight gain, even after adjustment for time of day.
Conclusions:
In toddlers, the recorded weight may be 300 g higher or lower than the underlying weight trajectory, so that their weight gain based on measurements collected fewer than 8 weeks apart will often be misleading.
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