Is no weight gain from 12 to 18 months considered normal?

From the Guidelines

No weight gain from 12 to 18 months is considered normal in breastfed infants, as slower growth during this period is expected, according to the 2006 WHO international growth charts 1. When evaluating the growth of children, it's essential to consider the recommended growth charts and standards. The 2006 WHO international growth charts, which are based on the growth of healthy breastfed infants, describe slower growth among breastfed infants during ages 3–18 months as normal 1. Key points to consider include:

• The WHO growth charts are growth standards, describing the growth of healthy children in optimal conditions, whereas the CDC charts are a growth reference 1.
• The CDC recommends using the 2006 WHO international growth charts for children aged <24 months, rather than the CDC growth charts 1.
• When using the WHO growth charts, the 2.3rd and 97.7th percentiles (or ±2 standard deviations) are recommended to screen for possible abnormal or unhealthy growth, rather than the 5th and 95th percentiles 1.
• Fewer U.S. children will be identified as underweight using the WHO charts, and gaining weight more rapidly than is indicated on the WHO charts might signal early signs of overweight 1. In clinical practice, it's crucial to use the WHO growth charts as standards rather than references, and to be aware of the expected slower growth among breastfed infants during ages 3–18 months. If concerned about lack of weight gain, consulting with a healthcare provider is recommended, especially if accompanied by other symptoms like fatigue, loss of appetite, or unintentional weight loss.

From the Research

Normal Weight Gain in Infants

• No weight gain from 12 to 18 months may be considered abnormal, as it is a critical period for growth and development 2
• Poor weight gain is a common symptom of celiac disease, and it is recommended to investigate celiac disease in patients with inadequate weight gain or poor control of malabsorption symptoms despite adequate nutritional and enzyme replacement treatment 2

Celiac Disease and Weight Gain

• Celiac disease can cause malabsorption of nutrients, leading to poor weight gain and other symptoms 3, 4, 5
• A gluten-free diet can help improve weight gain and reduce symptoms of celiac disease 2, 4, 6

Screening for Celiac Disease

• Targeted screening for celiac disease is recommended in children with cystic fibrosis, as they are at higher risk of developing celiac disease 2, 6
• Micronutrient deficiencies are common in adults with celiac disease, and assessment of micronutrient levels is recommended at the time of diagnosis 5