Updated

Chubby babies and toddlers are adorable, but with the childhood obesity epidemic on the minds of most parents, paying attention to those few extra pounds is more important than ever.

One in three children is either overweight or obese, and it’s a problem that is showing up before babies even start to walk.  In fact, approximately one-third of children at 9 months old were either at risk for obesity or already obese, according to a study in the American Journal of Health Promotion.

So if your baby has extra rolls and folds, is it simply baby fat or something more?

It all depends, according to Dr. Dyan Hes, medical director at Gramercy Pediatrics in New York City and a board member of the American Board of Obesity Medicine who said there are several reasons why a baby might be overweight.

Some babies who are overweight slim down once they become toddlers while others are simply born big. “If you’re born 10 pounds, you’re going to always be in the 90th percentile most of your life,” Hes said.

If one or both parents are overweight or obese, it’s likely that a child will be the same. Whether it’s because of genetics or lifestyle, it is hard to determine, but Hes said it’s usually a combination of both.

Moms who had gestational diabetes are also more likely to give birth to big babies and have overweight children. In fact, according to a study in the journal Diabetes Care, 31 percent of children whose moms developed gestational diabetes were overweight by the time they were 11 years old.

But the main thing doctors look at is growth curves. So if your baby’s weight suddenly jumps from the 25th percentile to the 90th, it’s time to chat with the pediatrician.

“We want to make sure that the rate of weight gain is not too rapid; we want them to stay on their growth curves,” Hes said.

If you’re concerned about your baby or toddler’s weight, here’s what you can do:

Talk to the doctor

Your child’s pediatrician can take a look at his or her growth charts to make sure weight gain is occurring on a consistent basis.  It’s also a great opportunity to chat about your child’s diet and activity – and make changes if necessary.

Breastfeed

“Breastfeeding is protective against obesity,” according to Hes, who said formula-fed babies are often overfed.  Even though breastfed babies are at lower risk for obesity, new research shows that extended breastfeeding is no better than a shorter duration, according to a recent American Medical Association study.

Start solids at the right time

Although pediatricians recommend introducing solids between 4 and 6 months, 40 percent of moms do so earlier, according to a recent study in the journal Pediatrics. And formula-fed babies who start early are significantly more likely to be obese by 3 years old, a separate American Academy of Pediatrics study found.

Experts agree that when deciding on solids, it’s important to look for signs of readiness. “I think that there is a cultural need that parents feel that they need to start their babies on food, but medically they don’t have to,” Hes said.

Choose healthy foods

“All babies and toddlers need to be fed the same way,” according to Melinda Johnson, a registered dietitian and spokesperson for the Academy of Nutrition and Dietetics, who said an overweight little one should never be put on a diet. Instead, make sure your child is getting regular meals of fruits and vegetables, lean proteins and whole grains. Also, cut down on restaurant fare, fast food and processed foods.

Establish healthy behaviors

At this stage, your child is learning how to eat in response to his or her hunger, yet “this is one of the areas we as parents can get way too pushy, and we mess them up,” according to Johnson.  She added that well-meaning parents sometimes take the plate away when a child is still hungry, which can encourage food seeking behaviors that could lead to obesity.

Plus, eating because he or she is bored, sad or cranky isn’t the right approach. “This is a very important time to really teach kids how to honor their hunger, how to eat only when they’re hungry, and how to stop when they’re comfortably full,” she said.

Get moving

Toddlers love to run, jump and play, and making exercise a part of your child’s daily routine now is crucial for an active lifestyle later.  So turn off the TV and head to the park, a gymnastics class, or the pool.