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    William J. Klish, M.D., is Professor of Pediatrics, Head of Pediatric Gastroenterology at Baylor College of Medicine and Chief of the Nutrition and Gastroenterology Department at Texas Children's Hospital in Houston. Dr. Klish has served as chair of the Committee on Nutrition of the American Academy of Pediatrics.

    Q: My 6-month-old baby is not gaining weight. Do you have suggestions?

    A: Lack of weight gain in an infant should always be taken seriously. First, check that your baby is being weighed properly. Weighing should always be done on the same scale because of differences amongst scales. You also should weigh your baby once a week, because of the daily weight variation due to feedings, urination, bowel movements, etc. If the weight remains accurate and you know that your baby is either gaining no weight or losing weight, baby should be seen and evaluated medically. If baby's weight increases but does not seem adequate, consider if your baby's feeding is appropriate. Are you offering food five or six times a day? Are you feeding breast milk or infant formula? If you're using breast milk, does your baby seem full after a feeding? If you're using formula, are you mixing it properly? At 6 months old, infants need supplementary calories from solid foods. Are you offering solid foods several times a day? Is your baby keeping all the food down or vomiting much of it? If everything appears appropriate, you still might want to get your baby examined, just to be sure that baby's weight is okay.

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