The care of infants with rapid weight gain: Should we be doing more?

Abstract

Rapid weight gain (RWG) during infancy is a known risk factor for later childhood obesity. It can be measured using a range of definitions across various time periods in the first 2 years of life. In recent years, some early childhood obesity prevention trials have included a focus on preventing RWG during infancy, with modest success. Overall, RWG during infancy remains common, yet little work has examined whether infants with this growth pattern should receive additional care when it is identified in health-care settings. In this viewpoint, we contend that RWG during infancy should be routinely screened for in health-care settings, and when identified, viewed as an opportunity for health-care professionals to instigate non-stigmatising discussions with families about RWG and general healthy practices for their infants. If families wish to engage, we suggest that six topics from early life obesity prevention studies (breastfeeding, formula feeding, complementary feeding, sleep, responsive parenting, and education around growth charts and monitoring) could form the foundations of conversations to help them establish and maintain healthy habits to support their infant's health and well-being and potentially lower the risk of later obesity. However, further work is needed to develop definitive guidelines in this area, and to address other gaps in the literature, such as the current lack of a standardised definition for RWG during infancy and a clear understanding of the time points over which it should be measured.

Latent Classes of Anthropometric Growth in Early Childhood Using Uni- and Multivariate approaches in a South African Birth Cohort

“…To identify children that experienced rapid weight gain, a change in zWeight equal or greater than 0.67 within the first nine months of life was used, as per convention, although there is disagreement on the optimal time frame to use (23).…”

Rapid infant weight gain or point‐in‐time weight status: Which is the best predictor of later obesity and body composition?

“…Reviews indicate that children who show increases in weight-for-age z scores of at least 0.67 over some time frame between birth and 2 years of age have two to four times the risk of having overweight later in childhood compared with children who do not display such rapid increases in growth [1][2][3]. Although these data suggest that identification of rapidly growing infants might offer a potential intervention window, this identification is complicated by the lack of a standardized definition of RIWG and time frame/s over which weight gain should be assessed [4,5].…”

“…To date, RIWG has most frequently been defined as an increase in weight‐for‐age z score of at least 0.67 standard deviations (SD) between two time points [5]. The use of weight alone, without consideration of length, likely occurs because it is weight that is more often routinely collected as part of usual growth monitoring at this age and because of the higher reliability of weight measurements compared with length/height.…”