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Original Research Communication |
1 From the MRC Childhood Nutrition Research Centre, Institute of Child Health, London; the Menzies Centre for Population Research, Tasmania, Australia; the Clinical Epidemiology & Biostatistics Unit, the Department of Paediatrics, the University of Melbourne; the Royal Children's Hospital Research Institute, Melbourne; the Queensland Institute of Technology, Brisbane, Australia; the Academic Division of Child Health, University Hospital, Nottingham, United Kingdom; and the Paediatric Department, the Stirling Royal Infirmary NHS Trust, Stirling, United Kingdom.
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 
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.
Key Words: Term infants • small-for-gestational-age infants • catch-up growth • postnatal nutrition • randomized trial • infant formulas • United Kingdom
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