1 Is your child less than 1 year old?

2 Is your baby entirely breast-fed?

3 Is your baby entirely bottle-fed?

4 Is your child under 2 years old, and was he or she smaller than expected at birth?

5 Has your child gained weight rapidly over the last 2 months?

6 Is your child taking any prescribed drugs?

7 Does your child have any of the following?

• Swollen ankles
• Puffy face, especially in the morning
• Swollen abdomen

8 Has your child been overweight since early childhood?

9 Are other members of the family overweight?

10 Is your child always made to finish all the food on his or her plate?

11 Has your child been overweight for less than 6 months?

12 Could your child be comfort eating, for example, because of stressful events at home or school?

13

Possible cause and action Breast-fed babies often gain weight quickly between 2 and 4 months. This is perfectly normal, and there is no need to worry. It is extremely uncommon for breast-fed babies to be overweight. However, if you are concerned, consult your nurse or doctor.

14

Possible cause Bottle-fed babies sometimes gain too much weight because they drink a lot of milk as a result of thirst rather than hunger.

Action Try giving your baby cooled, boiled water between feeds. You may find that your baby now takes less milk each feed. If he or she still seems to be putting on excess weight, consult your nurse or doctor.

15

Possible cause Children who are smaller than expected at birth need to put on extra weight initially in order to catch up to the normal weight of children of their age.

Action Your child's weight will be monitored to make sure that he or she is catching up to the normal weight for his or her age but not putting on excess weight. He or she should be at the normal weight by about age 5.

16

Possible cause and action Certain drugs, such as corticosteroids, can cause weight gain as a side effect. Consult your doctor. Meanwhile, your child should not stop taking his or her prescribed drugs.

17 See your doctor within 24 hours

Possible causes Fluid retention due to a potentially serious kidney disorder may be the cause. A heart or liver disorder, causing a build-up of fluid, is a less likely possibility.

Action Your doctor will examine your child and will probably arrange for blood and urine tests. He or she may also refer your child to hospital for further tests to determine the underlying cause. Drugs are usually prescribed to treat both the symptoms and the cause.

18

Possible cause and action Your child's weight gain is probably due to eating more than he or she needs. Try the self-help measures for helping your child reach a healthy weight, and consult your doctor if these measures do not help or if your child is severely overweight.

19

Possible cause Overeating within the whole family is the most likely cause, although genetic factors may also play a part.

Action Look at the way the whole family eats. By changing your own eating patterns, you can encourage your child to lose weight. Follow the advice for helping your child achieve a healthy weight, and consult your doctor if these measures do not help or if your child is severely overweight.

20

Possible cause Your child is probably eating more than he or she needs.

Action Never force your child to eat. Allow him or her to stop eating, even if there is some food left, and serve smaller portions to avoid waste. Follow the advice for helping your child reach a healthy weight, and consult your doctor if these measures do not help or if your child is severely overweight.

21

Possible cause and action Your child's weight gain is probably due to eating more than he or she needs. Try the self-help measures for helping your child reach a healthy weight, and consult your doctor if these measures do not help or if your child is severely overweight.

22

Possible cause Overeating when under stress is common and can cause weight gain.

Action Try to discover and deal with any underlying worries that your child has. If necessary, talk to your child's teachers. Follow the advice for helping your child reach a healthy weight, and consult your doctor if these measures do not help or if your child is severely overweight.

23

Possible cause Erratic weight gain is common just before a growth spurt, especially in girls.

Action Monitor your child's weight. If he or she does not grow in height to balance the weight gain, follow the advice for helping your child reach a healthy weight. Consult your doctor if these measures do not help or if your child is severely overweight.

24

Possible cause and action Your child's weight gain is probably due to eating more than he or she needs. Try the self-help measures for helping your child reach a healthy weight, and consult your doctor if these measures do not help or if your child is severely overweight.