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Aim: This study aimed to address the critical need for more accurate growth reference charts for preterm infants, with a particular focus on low‐ and very low‐birth‐weight infants. Methods: The subjects were recruited at a single tertiary centre. The cohort comprised singleton and twin infants born before 37 weeks of gestation, with data collected from 2000 to 2016. Standardised measurements of body parameters were recorded in this mixed longitudinal survey. LMS method was utilised for data analysis. Statistical analysis was performed using SPSS Statistics Version 21. The validation with another new cohort was executed. Results: A total of 1781 infants (52.5% boys) met the inclusion criteria. The median gestational age at birth was 30 weeks, with a median birth weight of 1350 grams. The main findings included the construction of ImaGrow charts for low‐ and very low‐birth‐weight infants and significant differences in growth trajectories compared to Fenton+WHO charts. Conclusion: Our comprehensive growth references, ImaGrow, are based on a long‐term auxological assessment of preterm infants and differ from charts derived from size‐at‐birth standards or charts for term babies. These charts have significant implications for clinical practice in monitoring and assessing the growth of preterm infants. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to evaluate an early discharge programme with video consultations for preterm infants. Methods: A homecare programme for preterm infants was developed. Prospective data on readmissions, length of stay, growth, breastfeeding rates, and parent self‐reports about satisfaction were collected from April 2021 to August 2023. Additionally, retrospective data were collected from the Norwegian Neonatal Network Central Database from 2020. Results: Preterm infants, 72 and parents, 128 were included. The infants were discharged from the hospital at a median of 35 + 6 (34 + 0–42 + 4) weeks postmenstrual age. The median length of stay in the program was 18 days (3–37). There were four readmissions. The Z‐score of infant weight slightly increased during the follow up, with a mean of 0.16. By discharge, 75% of the infants were exclusively breastfed. Growth and breastfeeding rates were in line with retrospective data (85 infants). The response rate of the parents to the survey was 61 (52%). Overall, the parents (n = 54) were highly satisfied (96%). The video consultations contributed to ensuring parents to feel safe in caring for their infant at home. Conclusion: Follow up by video consultations is a viable healthcare service for preterm infants, the infants' growth is sufficient, breastfeeding rates are maintained, and parents feel safe and satisfied. [ABSTRACT FROM AUTHOR]

Aim: We aimed to describe clinical practices and criteria for discharge of very preterm infants in Nordic neonatal units. Methods: Medical directors of all 89 level‐2 and level‐3 units in Denmark, Finland, Iceland, Norway and Sweden were invited by e‐mail to complete a web‐based multiple‐choice survey with the option to make additional free‐text comments. Results: We received responses from 83/89 units (93%). In all responding units, discharge readiness was based mainly on clinical assessment with varying criteria. In addition, 36% used formal tests of cardiorespiratory stability and 59% used criteria related to infant weight or growth. For discharge with feeding tube, parental ability to speak the national language or English was mandatory in 45% of units, with large variation among countries. Post‐discharge home visits and video‐consultations were provided by 59% and 51%, respectively. In 54% of units, parental preparation for discharge were not initiated until the last two weeks of hospital stay. Conclusion: Discharge readiness was based mainly on clinical assessment, with criteria varying among units despite similar population characteristics and care structures. This variation indicates a lack of evidence base and may unnecessarily delay discharge; further studies of this matter are needed. Earlier parental preparation and use of interpreters might facilitate earlier discharge. [ABSTRACT FROM AUTHOR]

Aim: Congenital heart disease (CHD) is one of the most common birth defects affecting around 1:100 infants. In this systematic review, we aimed to determine impact of growth on neurodevelopmental outcomes of infants with CHD. Methods: Studies that reported association of growth with developmental outcomes in infants with CHD who had surgery, were included. The search strategy was prospectively registered. Relevant studies were identified by electronic searches. The Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE were searched from their earliest date to February 2022. Results: Twenty studies met inclusion criteria. Choice of growth measures, developmental assessment tools and timing of assessment varied widely precluding conduct of a meta‐analysis. Seventeen studies reported on infants who had cardio‐pulmonary bypass. Birth weight was reported in thirteen studies and was associated with adverse outcome in nine. Head circumference at birth and later predicted developmental outcomes in five. Impaired postnatal growth was associated with adverse developmental outcome in seven studies. Conclusion: Growth in infants with congenital heart disease, specifically single ventricle physiology can predict adverse neurodevelopmental outcome. Included studies showed significant clinical heterogeneity. Uniformity should be agreed by various data registries with routine prospective collection of growth and developmental data. [ABSTRACT FROM AUTHOR]

Aim: To gain insight into nutritional practices and expected growth outcomes of infants born between 34 and 36 gestational weeks defined as late preterm infants (LPT). Methods: An anonymous online survey among paediatricians and neonatologists from Bangladesh, Indonesia, Mexico, Nigeria, Malaysia, Singapore and Taiwan was conducted from March until October 2020. The questionnaire consisted of 40 questions on the nutritional management and expected growth outcomes of LPT in and after‐hospital care. Results: Healthcare professionals from low to high Human Development (HDI) countries (n = 322) and very high HDI countries (n = 169) participated in the survey. Human milk was the preferred feeding, resulting in an adequate growth of LPT (weight, length and occipitofrontal circumference), according to a majority of respondents (low to high HDI, 179/265, 68% vs. very high HDI, 73/143, 51%; p = 0.002). The expected growth outcome was higher after‐hospital discharge. Less than half of healthcare professionals started enteral feeding during the 1st hour of life. Lactation difficulties, limited access to human milk fortifiers and donor human milk, especially among low to high HDI countries, were reported as major hurdles. Conclusion: Human milk is the first feeding choice for LPT. The diverse opinions on nutritional practices and expected growth outcomes among healthcare professionals indicate the necessity to develop general nutritional guidelines for LPT. [ABSTRACT FROM AUTHOR]

Aim: There has been a lack of population-based longitudinal data on serum ferritin in very low birthweight (VLBW) infants during hospitalisation. Our aim was to fill this gap in the knowledge and investigate risk factors for elevated serum ferritin and associations between erythrocyte transfusions and longitudinal growth.Methods: We retrospectively reviewed longitudinal data on 126 VLBW infants treated at Umeå University Hospital, Sweden, between 2010 and 2013.Results: The infants' mean gestational age and birthweight were 26.9 weeks and 899 g. Most (91%) received erythrocyte transfusions, and the majority had multiple erythrocyte transfusions. There was a significant correlation between serum ferritin and the volume of transfusions. Almost two-thirds had at least one serum ferritin measurement of more than 350 µg/L, indicating iron overload. In those with complete anthropometric data (n = 78), there was no significant effect of serum ferritin concentrations in relation to longitudinal growth, but there was a positive association between the erythrocyte transfusion dose and longitudinal growth in VLBW infants born before 25 weeks.Conclusion: This is the first population-based study to investigate longitudinal data on serum ferritin in VLBW infants during hospitalisation. The unexpected positive finding in the subgroup born at less than 25 weeks needs further research with a larger cohort. [ABSTRACT FROM AUTHOR]

Aim: To test the hypothesis that enteral zinc intake is associated with improved preterm infant growth during neonatal intensive care unit (NICU) hospitalisation.Methods: This prospective cohort study enrolled 105 preterm infants at a tertiary referral centre. Enteral zinc intake was calculated at day of life 14, and growth was measured as change in weight, length and head circumference from birth to discharge. Nonparametric tests assessed the contribution of breast milk vs formula and enteral zinc intake on weight, length and head circumference growth. Partial correlations evaluated the impact of baseline health status and caloric intake on growth. Multiple regression analysis was then completed to determine the unique contribution of zinc intake to weight gain and head circumference growth.Results: Total enteral zinc intake was positively associated with weight gain (r = 0.4, p < 0.01) and head circumference growth (r = 0.3, p < 0.01) during NICU hospitalisation. Further, multiple regression analysis showed higher zinc intake is linked to weight gain during NICU hospitalisation after accounting for postmenstrual age at birth.Conclusion: Increased early enteral zinc intake is linked to weight gain during NICU hospitalisation, highlighting the importance of enteral zinc intake in early infant nutrition. [ABSTRACT FROM AUTHOR]

Aim: We explored if fluid restriction in very low birthweight (VLBW) infants with a haemodynamically significant patent ductus arteriosus (PDA) affected energy and protein intakes and growth.Methods: Retrospectively, we identified 90 VLBW infants that were admitted to Umea University Hospital, Sweden, between 2009 and 2012: 42 with and 48 without haemodynamically significant PDA (hsPDA). Anthropometric, fluid, energy and protein intake data during the first 28 days of life were expressed as z-scores.Results: In the 42 infants diagnosed with hsPDA, fluid intake was restricted after diagnosis, resulting in a decrease in energy and protein intake. No decrease was observed in the other 48 infants in the cohort. Multivariate analysis showed that the z-score of weight change depended on both ductus arteriosus status and energy intake; thus, infants with hsPDA did not grow as expected with the energy provided to them.Conclusion: Energy and protein intake was diminished in prematurely born infants with hsPDA when fluid was restricted after diagnosis. The initial reduction in intakes may have contributed to the lower postnatal growth observed in these infants. [ABSTRACT FROM AUTHOR]

Aim: Evaluation of early growth in preterm infants receiving kinesthetic stimulation with massage in Kangaroo position or in incubator. Methods: A cohort of 66 infants between 30 and 33 weeks of gestational age (GA), born at a university hospital in 2013 in Bogota, were randomised when eligible to intervention. We measured weight gain (g/kg/day) at five days and 15 days postrandomisation and weight at 40 weeks, according to chronological age at randomisation. Results: Daily weight gain was significantly higher (p = 0.02) with kinesthetic stimulation in Kangaroo position with a growth at five days of 11.0 g/kg/day (95% CI 5.7;16.3) and at 15 days of 12.1 g/kg/day (95% CI 10.4;13.7) versus 2.1 g/kg/day (95% CI −3.1;7.4) at five days and 9.4 g/kg/day (95% CI 7.7;11.1) at 15 days in incubator. Weight at 40 weeks was higher (p = 0.05) in Kangaroo position group (2.904 g) than in incubator group (2.722 g) (95% CI 2.784;3.007). Daily weight gain according to chronological age at randomisation was higher when kinesthetic stimulation initiates before five days of life in Kangaroo position with 1.53 g/kg/day (95% CI 5.9;9.0) versus −11.9 g/kg/day (95% CI −19.0;−4.8) in incubator. Conclusion: Early kinesthetic stimulation in Kangaroo position reduces the initial weight loss in infants between 30–33 weeks born without major health problems. [ABSTRACT FROM AUTHOR]

Aim: This birth cohort study investigated longitudinal infant growth and associated factors in a multiethnic population living in a low-resource district surrounding the town of Paarl in South Africa.Methods: Between March 2012 and October 2014, all mothers attending their second trimester antenatal visit at Paarl Hospital were approached for enrolment. Mother-infant pairs were followed from birth until 12 months of age. Comprehensive socio-demographic, nutritional and psychosocial data were collected at birth, two, six and 12 months. Infant anthropometry was analysed as z-scores for weight and height. Linear regression was used to investigate predictors of birthweight, and linear mixed-effects models were used to investigate predictors of infant growth.Results: Longitudinal anthropometric data from 792 infants were included: 53% were Black African, 47% were mixed race, and 15% were born preterm. Stunting occurred in 13% of infants at 12 months. Maternal height, antenatal alcohol and tobacco use, ethnicity and socioeconomic status were significant predictors of birthweight. In the adjusted mixed-effects model, birthweight was a significant predictor of growth during the first year of life.Conclusion: Birthweight was an important predictor of growth trajectory during infancy. Birthweight and growth were influenced by several important modifiable factors. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the effects of skin-to-skin contact on breastfeeding attainment, duration and infant growth in preterm infants, as this has not been sufficiently explored.Methods: A prospective longitudinal study on Kangaroo mother care was carried out, comprising 104 infants with a gestational age of 28 + 0 to 33 + 6 and followed up to one year of corrected age. Parents and staff recorded the duration of skin-to skin contact during the stay in the neonatal intensive care unit (NICU). Medical data were collected through patient records, and follow-up questionnaires were filled in by parents.Results: The 53 infants who attained full breastfeeding in the NICU did so at a median (range) of 35 + 0 (32 + 1 to 37 + 5) weeks of postmenstrual age, and skin-to-skin contact was the only factor that influenced earlier attainment in the regression analysis (R(2) 0.215 p < 0.001). The daily duration of skin-to-skin contact during the stay in the NICU did not affect the duration of breastfeeding or infant growth after discharge. Furthermore, infant growth was not affected by the feeding strategy of exclusive, partial breastfeeding or no breastfeeding.Conclusion: A longer daily duration of skin-to-skin contact in the NICU was associated with earlier attainment of exclusive breastfeeding. [ABSTRACT FROM AUTHOR]

Aim: Benefits of human breast milk (HM) in avoiding rapid infancy weight gain and later obesity could relate to its nutrient content. We tested the hypothesis that differential HM total calorie content (TCC) or macronutrient contents may be associated with infancy growth.Methods: HM hindmilk samples were collected at ages 4-8 weeks from 614 mothers participating in a representative birth cohort, with repeated infancy anthropometry. HM triglyceride (fat), lipid analytes and lactose (carbohydrate) were measured by (1) H-NMR, and protein content by the Dumas method. TCC and %macronutrients were determined.Results: In 614 HM samples, fat content was as follows: [median(IQR)]: 2.6 (1.7-3.6) g/100 mL, carbohydrate: 8.6 (8.2-8.8) g/100 mL, protein: 1.2 (1.1-1.2) g/100 mL; TCC: 61.8 (53.7-71.3) kcal/100 mL. HM of mothers exclusively breast feeding vs. mixed feeding was more calorific with higher %fat, lower %carbohydrate and lower %protein. Higher HM TCC was associated with lower 12-months body mass index (BMI)/adiposity, and lower 3-12 months gains in weight/BMI. HM %fat was inversely related to 3-12 months gains in weight, BMI and adiposity, whereas %carbohydrate was positively related to these measures. HM %protein was positively related to 12-months BMI.Conclusion: HM analysis showed wide variation in %macronutrients. Although data on milk intakes were unavailable, our findings suggest functional relevance of HM milk composition to infant growth. [ABSTRACT FROM AUTHOR]

Unlabelled: Poor postnatal growth after preterm birth does not match the normal rapid growth in utero and is associated with preterm morbidities. Insulin-like growth factor 1 (IGF-1) axis is the major hormonal mediator of growth in utero, and levels of IGF-1 are often very low after preterm birth. We reviewed the role of IGF-1 in foetal development and the corresponding preterm perinatal period to highlight the potential clinical importance of IGF-1 deficiency in preterm morbidities.Conclusion: There is a rationale for clinical trials to evaluate the potential benefits of IGF-1 replacement in very preterm infants. [ABSTRACT FROM AUTHOR]

Aim: Body mass index (BMI)-for-age curves have been developed in the USA, but not compared with other populations. This study created gender-specific intrauterine BMI-for-age curves for Italian preterm infants and compared them with the USA version.Methods: Data on 92 262 newborn infants, born at 26-42 weeks of gestational age in the north-eastern Italian region of Friuli Venezia Giulia between 2005 and 2013, were analysed to create gender-specific BMI-for-age curves. Gender-specific and age-specific BMI Z scores for Italian infants were calculated using the parameters of the USA growth curves and the World Health Organization charts.Results: Gender-specific BMI-for-age at birth curves were developed for premature Italian infants from 26 gestational weeks. The comparison with the USA charts showed no significant difference in BMI percentiles in Italian infants born at ≤33 gestational weeks, but infants born at ≥34 gestational weeks had a significantly higher BMI than the USA population, by 0.2 standard deviations.Conclusion: We developed the first European BMI-for-age at birth curves for premature infants. According to our findings, the Italian curves were comparable to the USA curves for the subgroup of infants born at ≤33 gestational weeks, but not ≥34 gestational weeks. [ABSTRACT FROM AUTHOR]

Whilst the weight gain ratio method identified 72 (92.3%) infants with growth failure, the I z i -score and the growth velocity methods2 both identified a much lower number of infants with inadequate growth: 57 (73%) and 53 (67.9%) respectively. We thank Dr Manzar for his interest in our publication1 and his interesting comments.2 He suggested that defining poor growth in very preterm infants should not be based on I z i -scores alone. [Extracted from the article]

Aim: To provide updated growth references for Japanese children from birth to 6 years of age, for use in both growth monitoring and child care.Methods: We analysed data from two national representative surveys that provided cross-sectional data on 3000 areas in the 2005 national census and longitudinal data from 136 hospitals. Growth references for length/height, weight, head circumference and chest circumference were constructed using the lambda-mu-sigma (LMS) method, with estimates of the L, M and S parameters. These updated values were then compared with growth references published by the World Health Organization.Results: The 3rd, 50th and 97th smoothed percentile values of length/height, weight, head circumference and chest circumference for boys and girls from birth to 6 years are presented. The comparisons show some large differences in median measurements between the charts.Conclusion: Our growth references are based on a current, nationally representative sample of Japanese children. The results provide deep insight into child growth from a historical, ethnic and environmental point of view. [ABSTRACT FROM AUTHOR]

Aim To explore the simultaneous impact of parental adiposity and education level on infant growth from birth to 12 months, adjusting for known early-life risk factors for subsequent childhood obesity. Methods Baseline data for 197 one-year-old children and their parents, participating in a longitudinal obesity intervention, were used. Obesity risk groups, high/low, were defined based on parental body mass index (n = 144/53) and parental education (n = 57/139). Observational data on infant growth between 0 and 12 months were collected. The children's relative weight (body mass index standard deviation score) at 3, 6 and 12 months and rapid weight gain 0-6 months were analysed in regression models, with obesity risk as primary exposure variables, adjusting for gestational weight gain, birth weight, short exclusive breastfeeding and maternal smoking. Results Relative weight at 3, 6 and 12 months was associated with low parental education but not with parental adiposity. No significant associations were observed with rapid weight gain. None of the early-life factors could explain the association with parental education. Conclusion Low parental education level is independently associated with infant growth, whereas parental obesity does not contribute to a higher weight or to rapid weight gain during the first year. [ABSTRACT FROM AUTHOR]

Aim To examine the impact of postnatal nutrition on long-term growth in extremely low birth weight infants. Method Retrospective analysis of postnatal nutrition and observational study of growth in 52 ELBW infants until the age of six. Results Changes (Δ) in weight and length standard deviation scores ( SDS) between birth to term correlated with protein intake (rw = 0.36; p = 0.009; rL = 0.35; p = 0.01), whereas Δ HC correlated with lipid intake (rHC = 0.38; p = 0.005). Analysis of various intervals (0-2, 3-5, 6-8 and 9-11 weeks) only showed significant impact on growth for energy (r = 0.3; p < 0.05) and lipids (r = 0.23; p < 0.05) at 6-8 weeks. No significant correlations were found between postnatal nutritional parameters and long-term growth. However, postnatal growth restraint was negatively associated with length SDS (r = −0.34; p = 0.015) and body mass index SDS (r = −0.34; p = 0.018) at the age of six. Infants with postnatal growth restraint (n = 25) caught up more in length (+1.78 SDS) than in weight (+0.43 SDS), whereas small for gestational age infants (n = 8) caught up more in weight (+1.35 SDS) than in length (+1.07 SDS). This difference remained significant at the age of six. Conclusion Although no direct association between postnatal nutrition and long-term growth was found, weight at discharge was a strong predictor for long-term growth. [ABSTRACT FROM AUTHOR]

Aim To describe growth pattern from full-term age to 10 years in infants born before 26 weeks of gestation. Method This retrospective longitudinal cohort contained 123 children from Karolinska Hospital, Stockholm, during 1990-2002. Length/height (Ht), weight (Wt) and head circumference ( HC) were recorded monthly during the first year, every 3 months until 2 years and yearly thereafter, but HC at 15 months and at median age of 8.1/9.7 years (range 2-14) in boys/girls. Results For boys/girls at birth, the mean Z-score for Ht was −0.2/−0.2, for Wt 0.0/−0.2 and for HC 0.0/−0.3. At term, the mean Z-score for Ht was −3.8/−3.1, for Wt −3.0/−2.5 and for HC −1.7/−1.2. At 1 year, the mean Z-score for Ht was−1.3/−1.3, for Wt −1.9/−1.7 and for HC −1.2/−1.0. At 2 years, the mean Z-score for Ht was −1.3/−1.1, for Wt −1.6/−1.2 and at 10 years for Ht −0.7/−0.4; that was on average −0.3 below mid-parental height; for Wt −0.2/−0.2. Long-term sequelae were found in 48% of the boys and 34% of the girls. Conclusion By 10 years of age, the attained mean Ht was in accordance with their genetic potential and almost half of these children had significant long-term sequelae. [ABSTRACT FROM AUTHOR]

Aim To study the effects of live maternal speaking and singing on physiological parameters of preterm infants in the NICU and to test the hypothesis that vocal stimulation can have differential effects on preterm infants at a behavioural level. Methods Eighteen mothers spoke and sang to their medically stable preterm infants in their incubators over 6 days, between 1 and 2 pm. Heart rate ( HR), oxygen saturation ( OxSat), number of critical events (hypoxemia, bradycardia and apnoea) and change in behavioural state were measured. Results Comparisons of periods with and without maternal vocal stimulation revealed significantly greater oxygen saturation level and heart rate and significantly fewer negative critical events (p < 0.0001) when the mother was speaking and singing. Unexpected findings were the comparable effects of maternal talk and singing on infant physiological parameters and the differential ones on infant behavioural state. Conclusion A renewed connection to the mother's voice can be an important and significant experience for preterm infants. Exposure to maternal speech and singing shows significant early beneficial effects on physiological state, such as oxygen saturation levels, number of critical events and prevalence of calm alert state. These findings have implications for NICU interventions, encouraging maternal interaction with their medically stable preterm infants. [ABSTRACT FROM AUTHOR]

Aim To investigate iron status and developmental scores at 6 years of age in a population with decreased prevalence of iron deficiency in infancy. Iron status at 6 years and tracking from 12 months were also studied. Methods Children (n = 143) born in Iceland in 2005 were followed up at the age of six. Motor and verbal development was assessed by a parental questionnaire, and iron status was assessed by Hb, MCV and serum ferritin ( SF). Iron depletion was defined as SF <15 μg/L and deficiency as MCV <76 fL and SF <15 μg/L. Results Iron depletion was observed in 5.6% of 6-year-olds, and 1.4% were iron deficient. Self-help (subset in motor development) differed by −4.14 (95% CI = −7.61, −0.67), between those iron depleted at 12 months (n = 6) and those nondepleted (n = 102), adjusted for maternal education. The combined motor developmental score seemed lower in iron depleted infants, although of borderline significance (p = 0.066). MCV concentration tracked from 12 months to 6 years (r = 0.31, p < 0.002), but Hb and SF did not. Conclusion Improved iron status at 12 months and 6 years has diminished the public health threat associated with iron depletion in the population studied, but iron depletion and development still associate weakly. Action to prevent iron depletion in infancy remains important. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to compare the growth of Japanese infants that were exclusively breastfed to those of national references and World Health Organization ( WHO) standards. Methods Mothers, who delivered a normal term baby and had been exclusively breastfeeding for at least 4 months, were enrolled. The lengths, body weights and head circumferences of 647 children, aged 0-24 months, were obtained and compared to national references and WHO standards. Results Comparisons of the national references for both length and body weight indicated that breastfed infants were significantly shorter and lighter almost throughout the first 24 months. Conversely, head circumferences of breastfed infants were significantly larger at 1 and 6 months of age in boys and 6 months in girls. Compared to WHO standards, similar trends to the comparisons with national references were found. Conclusion There were significant differences identified between the growth of breastfed infants and existing national references and WHO standards. [ABSTRACT FROM AUTHOR]

The aim was to evaluate growth and breastfeeding up to 18 months corrected age (CA) among preterm appropriate for gestational age (AGA) infants whose mothers initiated breastfeeding during the infants' hospital stay. One hundred and twenty-seven preterm AGA infants with a median birth weight of 2320 (769-3250) g and gestational age 34.29 (25.00-35.86) weeks were evaluated up to a CA of 18 months. A retrospective, descriptive and comparative design was used. Data were obtained by chart review of hospital medical records and a questionnaire completed by the mothers. The changes in standard deviation scores (SDS) during the infants' hospital stay were −0.9 for weight, −0.3 for length and −0.5 for head circumference (HC). Infants with higher SDS at birth showed more negative changes from birth to discharge. Median increments in SDS from discharge to a CA of 2 months were as high as, or higher than, the loss from birth to discharge. Preterm AGA infants with higher SDS for weight, length and HC at birth are at higher risk of inadequate growth during their hospital stay. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to describe first-year growth among very low birth weight infants and the effect of growth restriction at hospital discharge on first year growth. Method: Anthropometric measures and background information for 118 very low birth weight infants were collected from medical records. Z-scores were calculated based on recent Norwegian growth references. Results: Significant catch-up growth for weight and length was observed during the first year with mean z-score change (SD) of 0.40 (1.05) and 1.01 (1.25) respectively. However, the very low birth weight infants remained lighter and shorter than full-term peers until 12 months corrected age with mean z-score of −0.93 (1.09) and −0.48 (1.06) respectively. Head circumference followed a normal growth pattern after 2 months. Infants discharged from hospital as growth restricted had increased catch-up in weight and length, but remained smaller than infants not subjected to early growth restriction and full-term peers. Multiple regression showed that weight below the 10th percentile at discharge is important for weight and length during the first year of life. Conclusion: Very low birth weight infants showed catch-up growth during the first year, but their weight and length remained less than full-term peers. Growth deficiencies were more pronounced among infants subjected to early growth restriction, despite increased catch-up growth. [ABSTRACT FROM AUTHOR]

Aim: To describe the characteristics, developmental status and severity of head shape deformation in infants presenting to a plagiocephaly clinic. Methods: Head shape was measured and neck function assessed in 287 consecutive infants presenting to a plagiocephaly outpatient clinic. Information was obtained on demographic and obstetric factors, plagiocephaly history and current positioning strategies. Development was assessed by the Ages and Stages Questionnaire (ASQ). Results: After clinical examination, craniosynostosis was suspected in seven infants (2%) and a skull computed tomography (CT) scan was performed; five showed suture abnormalities. Fifty-eight percent of cases had a history of limitation of neck function; this was more likely in plagiocephalic infants than brachycephalic infants. Males, firstborn infants, instrument-delivered infants, supine sleep position and right-sided flattening were predominant. One or more delays on the ASQ were seen in 36% of infants. Conclusion: Physical examination of infants with head shape deformities is essential in order to rule out craniosynostosis. Infants with deformational plagiocephaly frequently have neck muscle dysfunction. We postulate that the higher than expected number of developmental delays may be related to the effects of supine sleep position, low or variable tone, lower activity levels, male gender and neck muscle dysfunction. [ABSTRACT FROM AUTHOR]

Aim: Mother's milk is optimum for preterm infants, but human milk fortifier is required at times, because some nutrients are sometimes insufficient for infant growth. It is important to measure the nutrients in breast milk at bedside so that the amount of nutrients that need to be supplemented can be determined. A human milk analyser (HMA, Miris®) is currently available. We examined if the macronutrient values measured by human milk analyser are comparable with those measured by conventional methods. We also sought to discover whether we could dilute the milk sample used for the human milk analyser measurement if the amount of milk available for testing was insufficient. Subjects and Methods: First, the results of protein, fat and lactose content in breast milk samples obtained using the human milk analyser and conventional methods were compared. Second, we measured diluted samples and compared the values with nondiluted samples. Results: When comparing the human milk analyser and conventional methods, all three nutrients exhibited a significantly positive correlation (p < 0.001); lactose content was reliable on the condition that it is 6–7 g/dL. The lactose content measured by the HPLC method was obtained by 3.05 × human milk analyser value − 13.4. When comparing diluted and nondiluted samples, fat and protein had expected values after dilution whereas lactose did not. Conclusion: The human milk analyser can inform us about the amount of major nutrients in breast milk: fat, protein and lactose. However, when human milk is diluted, the lactose content measured by the human milk analyser is overestimated. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the association between infant fussing and crying and developmental outcome in very low birth weight (VLBW) infants. Methods: Hundred and seventeen VLBW infants were followed up to 24 months of corrected age. The duration of fussing and crying and frequency of fuss/cry bouts were measured at term 6 weeks and 5 months of corrected age. Cognitive and motor development was assessed at 24 months of corrected age. Results: The increased duration of combined fuss/cry at term associated with lower psychomotor developmental index (PDI), [regression coefficient (b) =−0.83, p = 0.025]. Crying at term associated negatively with mental developmental index (MDI) (b =−0.91, p = 0.040) and PDI (b =−1.10, p = 0.015). The associations between fuss/cry and PDI, and crying and PDI persisted in multiple regression analysis (b =−0.89, p = 0.030 and b =−1.23, p = 0.018, respectively). Excessive fuss/cry (≥180 min/day) at term associated with lower PDI (p = 0.005) and at 6 weeks with lower MDI (p = 0.024) and PDI (p = 0.012). Increase in the frequency of fuss/cry bouts at 5 months associated with higher PDI in both simple (b = 2.90, p = 0.045) and in multiple regression analysis (b = 3.60, p = 0.019). Conclusions: In VLBW infants, longer duration of fussing and crying in very early infancy, but not at 5 months, is associated with less optimal development at 24 months of age. [ABSTRACT FROM AUTHOR]

Aim: The Alberta Infant Motor Scale (AIMS) is an infant developmental test, which can be used to evaluate motor performance from birth to independent walking. Between 1990 and 1992 Piper and Darrah determined reference values in a cohort in Canada. To our knowledge no study has been carried out to determine whether the Canadian data are representative for other countries. In the present study we aimed to establish whether the AIMS test needs new reference values for Dutch children. Methods: Motor performance of 100 Dutch children, aged 0–12 months, was measured using the AIMS test. Results: The mean percentile score of the Dutch children was 28.8 (±22.9, range 1–85). The percentile scores of the group were significantly lower than scores of the Canadian norm population (p < 0.001), whereby 75% of the Dutch children scored below the 50th percentile. These lower scores were not be explained by sex, racial differences or congenital disorders and were seen in all age groups. Conclusion: We conclude that new reference values on the AIMS test for the age group of 0–12 months need to be established for Dutch children. It is recommended that the need for new normative data is also determined in all other European countries. [ABSTRACT FROM AUTHOR]

Aim: To assess the association between weight gain at different time periods during childhood and measures of adiposity in late adolescence.Methods: A population-based birth cohort carried out in Pelotas, a 320 000-inhabitant city in a relatively developed area in Southern Brazil. All newborns in the city's hospitals were enrolled in 1982. Weight gain from 0-1, 1-2, 2-4 and 4-15 years were expressed as changes in weight-for-age Z-scores relative to the NCHS/WHO reference. In 2000, 79% (2250) of all males were located when enrolling at the national Army. Weight and height were assessed. Body composition indicators (fat mass/height(2), lean mass/height(2), fat mass/lean mass(2.3)) were estimated through bioimpedance. Analyses were adjusted for maternal and social factors, as well as for gestational age.Results: In the adjusted analyses, birthweight and weight gain in the first year of life were positively associated with attained height at age 18 years. Except for the fat mass/lean mass(2.3) ratio, all weight-related outcomes were positively associated with weight gain in different periods of life. Children who gained weight rapidly in more than one time period became fatter at age 18 years, independently of when fast growth took place.Conclusions: Height was primarily determined by fetal and infant growth. Weight-related indices, including the fat/lean mass ratio, were more strongly influenced by later growth. No clear critical windows of growth during which absolute tissue masses are programmed could be identified. [ABSTRACT FROM AUTHOR]

Aim: To describe the development of head circumference, from birth to age 48 mo, of infants in Sweden. Methods: Every infant born on the 15th of any month in the 1981 birth cohort, living in Sweden as of 31 December 1989, was studied from birth to age 48 mo (n=3158). By collecting data from child healthcare records and then analysing these data using piecewise linear regression, means and other statistics were produced for every age. Data were analysed for all and with exclusions for low birthweight and those born outside Sweden. Results: From the sample of 3158, data for 3107 infants were collected, making the percentage of missing individuals 1.6%; thus, non-response bias is minimized and high national representativeness is achieved. Summary statistics for head circumference are presented. Comparisons are made to international reference materials, and to previous and current Swedish reference curves.Conclusion: For the first time in Sweden, and without selection bias, means and distribution of head circumference measurements are documented longitudinally for a nationally representative sample of infants. [ABSTRACT FROM AUTHOR]

Aim: Twin gestations are associated with disturbed fetal growth. The aim of this study was to compare body composition measurements of twins to those of singletons. Methods: Anthropometric and dual energy X-ray absorptiometry (DXA) measurements were performed in twins and in matched singleton neonates. There were 48 pairs of twins in which 76 infants were appropriate for gestational age (AGA) with birth weights between the 10th and 90th percentile and 20 were small for gestational age (SGA) with birth weights Conclusion: For clinically normally grown neonates, with comparable weight, the body composition with respect to bone, fat and lean mass components are similar regardless whether they are products of singleton or twin pregnancies. [ABSTRACT FROM AUTHOR]

Unlabelled: Stunting is common among children under 5 y of age in sub-Saharan Africa. Several risk factors have been associated with poor growth but few studies have prospectively addressed the development of linear growth faltering and stunting during the first year of life. The present study was designed to analyse typical growth among rural Malawian infants, focusing particularly on the impact of birth size, adherence to feeding guidelines and morbidity in the development of severe stunting during infancy. A community-based cohort of 613 singleton newborns was prospectively followed by monthly home visits. Data were collected on the children's socioeconomic background, maternal size and weight gain during pregnancy, birth events, morbidity, breastfeeding and complementary feeding, growth and mortality. Univariate and multivariate analyses were used to determine associations between predictor variables and poor linear growth. The proportions of stunted infants (Height-for-age Z-score < -2) at 3, 6 and 9 mo of age were 27%, 51%, and 63%, respectively. At I y of age, over two-thirds (71%) of the infants were at least moderately (HAZ < -2) and 31% severely stunted (HAZ < -3).Conclusion: The strongest predictor of severe stunting at 12 mo of age was small birth size. Other variables independently associated with this outcome included inappropriate complementary feeding, high morbidity, maternal short stature, male gender, and home delivery. Faltering of linear growth started soon after birth and continued throughout infancy. Interventions increasing birth size could have a significant role in the prevention of early childhood stunting. The ideal strategy should also emphasize the importance of appropriate infant feeding and decreasing the number of illness episodes amongst the infants. [ABSTRACT FROM AUTHOR]

Aim: To produce a modification of the British 1990 weight reference reflecting the growth of long-term breastfed infants.Methods: 120 infants from the Cambridge Infant Growth Study fed breast milk (with no formula) for at least 24 wk, with solids introduced at a mean age of 15 wk, were weighed every 4 wk from birth to 52 wk. Weights were converted to standard deviation scores (SDS) for gender and age post-term based on the revised British 1990 reference, averaged and smoothed across age, and then converted back to weights to provide modified median weight curves by gender. Other centile curves were constructed assuming the same variability and skewness by age as for the British reference.Results: Long-term breastfed infants were slightly heavier than the reference at birth and crossed centiles upwards to reach +0.3 SDS at 2 mo, but subsequently crossed centiles downwards to -0.2 SDS by 12 mo.Conclusion: The British 1990 reference, although better than previous growth standards, reflects the growth of long-term breastfed infants only imperfectly, with mean weight falling by 0.5 SDS from 2 to 12 mo. The provision of breastfeeding-specific centiles, either as a transparent overlay or as an alternative chart, should be useful for professionals and parents to monitor the weight of long-term breastfed infants. [ABSTRACT FROM AUTHOR]

Long-chain polyunsaturated fatty acids are essential for growth and development, and their crucial role in the development of the central nervous system and in retinal function has been the subject of many studies. As the balance between n-6 and n-3 fatty acids has to be optimal, their concentrations in the milk given to infants who are exclusively breastfed is of major importance. In this study, the composition of fatty acids in mothers' milk and the growth rate of the infant brain were analysed. Nineteen mother-term infant pairs from Stockholm, Sweden, were studied from birth to 1 mo and 3 mo of age, during which time the infants were breastfed exclusively. The dietary intake of the mothers was calculated and found to concur with the recommended daily dietary allowances of Swedish lactating women as regards energy, protein, fat and carbohydrates. The amounts of linoleic acid and alpha-linolenic acid in the diet were similar to those reported for European and North American women. The ratio between arachidonic acid (AA) and docosahexaenoic acid (DHA) in the milk from Swedish mothers is approximately the same as in the brain of infants, and was found to be positively correlated with the rate of gain of the occipito-frontal head circumference and of the calculated brain weight at 1 mo (p < 0.01) and 3 mo (p < 0.01) of age, respectively. However, further studies are needed to establish the exact requirements of AA and DHA for optimal growth and development during early infancy in exclusively breastfed infants. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the nature of the association between breastfeeding, complementary feeding and growth in a random sample of infants from Denmark, where the prevalence of breastfeeding is high. A semiquantitative food frequency questionnaire and a questionnaire on breastfeeding duration and on weight and length measurements taken at the infant welfare visit at 5 and 10 months were sent to 590 families with 10-month-old infants. A total of 339 infants with complete growth data were included in the analyses. When controlling for mid-parental height and birth weight infants breastfed for > or =7 months gained 198 g less in weight (p < 0.01) and 7 mm less in length (p < 0.01) during the period from 5 to 10 months than infants breastfed for < 7 months. Controlling for these effects, the 10% of the sample with the highest protein intake (i.e. > or =16 energy percentage) gained 262 g more than those with a lower protein intake (p = 0.03). Infants breastfed for > or =7 months received significantly less cow's milk (p < 0.01), and fewer meat-containing dishes (p < 0.05) and sweets or cakes (p < 0.01), which may partly explain the effect of breastfeeding. The long-term consequences of this moderate difference in growth velocity are unknown and the findings should not be used to advocate against breastfeeding during late infancy. [ABSTRACT FROM AUTHOR]

The author reflects on the effort of pediatricians on supporting breastfeeding for healthy growth of infants and on preventing obesity. He notes that breastfeeding is standard in growth curves but requires proper introduction especially milk substitutes. He is critical that the child growth standards of the World Health Organization (WHO) must be used to monitor child's growth in the 0-2 age range. Also discussed the report of Tanaka and colleagues on the growth of breastfed infants in Japan.

Child obesity is becoming a serious public health concern, and major research effort is being devoted both to understand its aetiology and to improve the effectiveness of prevention strategies. Early growth patterns, both prenatally and postnatally, are emerging as important markers of later obesity risk, with rapid neonatal weight gain a clear risk factor for later obesity and metabolic syndrome. Thus, in two distinct senses child obesity is a growing problem. The paper summarises current evidence on growth pattern and obesity, relating it to infant feeding practice and appetite regulation, and highlights the areas in which public health interventions are feasible. Of the conclusions drawn, one involves a futuristic solution to child obesity where neonates are given an infusion of the hormone leptin to reset their appetite regulation. [ABSTRACT FROM AUTHOR]

Unlabelled: The content of long-chain polyunsaturated fatty acids (LC-PUFAs) in human milk has been connected with infant growth and developmental indices. The LC-PUFA content of human milk usually reflects the dietary habits of mothers, so questions have been raised regarding the possibility of enriching maternal diet with LC-PUFAs during lactation (or even before) in order to improve infant outcome. Nevertheless, environmental and genetic factors have independent roles in affecting both maternal milk composition and infant development.Conclusion: Diet-related differences in the LC-PUFA composition of human milk are under active investigation for their possible contribution to infant development, but environment- and gene-related differences in both human milk composition and maternal diet should be considered in evaluating the adaptive mechanisms of infants and the effects of specific LC-PUFA dietary supplementations. [ABSTRACT FROM AUTHOR]

Focuses on the common methods of monitoring growth patterns of breastfed infants. Weaknesses of the National Center for Health Statistics growth references for infants; Influence of dietary formulas on infant growth patterns; Effect of ethnic variation on monitoring growth patterns of breastfed infants.

A letter to the editor is presented in response to the article "Parenteral phosphate/amino acids supply in extreme prematurity: importance of optimized growth measurements and statistical analysis" by D. Virella and colleagues, in a 2015 issue.

The future revised WHO growth references for infancy and early childhood will have an international basis rather than just an American one, as is the case with the current NCHS/WHO ones. The anthropometric data for analysis will be collected from babies breastfed in accordance with WHO guidelines. An important stipulation, however, is that their growth must have been unrestricted by environmental factors. A paper from Ghana describes a quantitative provisional study that has revealed how such a condition can be satisfied within a developing country. Family income and especially the higher education of the father up to university level can still be important variables in the achievement of optimal growth of babies, even those brought up in situations of relative affluence. [ABSTRACT FROM AUTHOR]

Discusses the importance of diet-specific growth charts for infants. Condition when growth charts are important in following up the growth of infants; Assessment of the difference between the growth of exclusively breastfed babies and that of infants given modern formula milks in accordance with present-day pediatric device.

Presents a growth reference chart based on breastfed babies. Purpose of the chart; Prediction of inadequacy of energy supply from growth faltering at about three months of age; Difference between formula-fed and breastfed babies.

A letter to the editor is presented in response to the article "Longitudinal Study of the Growth of Infants With Isolated Robin Sequence Considered Being Severe Cases," by I. L. Marquez, H. Bettiol, L. de Souza, M. A. Barbieri and M. I. Bachega, which was published in issue 97.