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Catch‐up Growth in Small‐for‐Gestational‐Age Term Infants: A Randomized Trial
Author(s) -
Fewtrell MS,
Morley R,
Abbott RA
Publication year - 2002
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0115426502017002126a
Subject(s) - medicine , gestational age , small for gestational age , pediatrics , birth weight , linear growth , randomized controlled trial , gestation , pregnancy , biology , genetics , mathematics
Background: Small‐for‐gestational‐age (SGA) term infants are at risk of long‐term growth deficits. Objective: The objectives were to test the hypothesis that postnatal growth in SGA term infants can be altered by dietary intervention and to examine whether there is a critical window for nutritional programming of the growth trajectory during the first 9 mo postnatally. Design: Healthy term (gestation > or =37 wk) infants with birth weights below the 10th centile were randomly assigned to receive standard term formula (TF; n = 147) or nutrient‐enriched formula (EF; n = 152) for the first 9 mo; 175 breast‐fed SGA term infants formed a reference group. The main outcome measures were weight, length, and occipitofrontal head circumference (OFC) at 9 and 18 mo. Results: The infants fed the EF showed greater gains in length by 9 (1.1 cm; 95% CI: 0.38, 1.79) and 18 (1.0 cm; 0.25, 1.83) mo and in OFC by 9 (0.5 cm; 0.1, 0.9) and 18 (0.6 cm; 0.2, 1.1) mo than did infants fed the TF; the differences were larger in females. The dietary effects were independent of the pattern of growth retardation. Breast‐fed infants showed greater gains in weight and OFC by 18 mo than did infants fed the TF; however, these differences disappeared after adjustment for age, parental size, and birth order. Conclusions: Linear growth and OFC gains in SGA term infants improve after nutritional intervention during the first 9 mo of life and the effects persist for ≥9 mo beyond the intervention period. Further information on whether catch‐up growth is beneficial or detrimental to long‐term outcomes is required before public health interventions can be recommended.