We can often tell by just looking at the baby plus seeing the history of the 
weight gain (or loss) and tell alot. After a few weeks of life, a healthy 
baby who is on the low end of weight will still look good, be bright eyed, 
happy, and calmly alert. There will be fat somewhere on the body, maybe the 
upper arms, around the stomach, or the thighs. The skin seems to be filled 
out. (I am not saying they have to be huge just be nicely padded and "soft" 
looking.)

A history of weight loss and then extremely slow weight gain, say not 
regaining to birth weight until a month of age, along with fussiness, skinny 
looking, no fat pads, circles under eyes, perhaps long periods of sleep 
without waking to demand to eat -- would be alarming signs. Oh, yes, the 
skin seems to "sag" on the arms and legs and maybe the face.

This is why phone calls or emails often aren't enough. Mom's description of 
the problem may make it sound like a growth spurt or colic.

Kathy Eng, BSW, IBCLC 

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