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Objective: Comparing the long-term neurodevelopmental and growth outcomes of lower and higher cumulative dexamethasone exposure in preterm infants ventilated for a minimum cumulative duration of 7 days.Design: A retrospective cohort medical chart review of infants born in Western Australia <29 weeks' gestation between January 2007 and May 2016 who were mechanically ventilated >7 days.Intervention: No dexamethasone (controls) or a total cumulative dexamethasone dose of <2 mg/kg (lower) and ≥2 mg/kg (higher).Main Outcome Measures: Long-term disability at 2 and 5 years and growth measurement outcomes at 2 years of age.Results: Dexamethasone was given to 104 infants (66 with cumulative dose <2 mg/kg; 38 with cumulative dose ≥2 mg/kg), and 324 infants were controls. There was no difference in odds of long-term disability in infants with any dexamethasone exposure compared with controls (aOR: 0.90, 95% CI 0.34 to 2.02, p=0.784). No difference in long-term disability was found between the lower and higher groups (p=0.494). The prevalence of cerebral palsy (Gross Motor Functional Classification System level ≥2) between the control, lower and high-dose groups did not differ significantly (5.8% vs 4.0% vs 0%). The higher dose group had lower mean weight z-score (mean effect: -0.83, 95% CI: -1.54 to -0.01, p=0.023), height z-score (mean effect: -0.63, 95% CI: -12.5 to -0.01, p=0.048) and head circumference z-score (mean effect: -0.65, 95% CI: -1.25 to -0.05, p=0.035) compared with controls.Conclusions: In our cohort, dexamethasone use was not associated with increased odds of long-term disability. Dexamethasone use was associated with lower growth measurements compared with controls. [ABSTRACT FROM AUTHOR]

Introduction: Growth impairment has often been described in children who develop coeliac disease (CD). Based on data from the multicentre, longitudinal PreventCD study, we analysed the growth patterns of infants at genetic risk of CD, comparing those who developed CD by 6 years of age (CD 'cases', 113 infants) versus those who did not develop CD by 6 years (no CD 'controls', 831 infants).Methods: Weight and length/height were measured using a longitudinal protocol. Raw measurements were standardised, computing z-scores for length/height and weight; a linear mixed model was fitted to the data in order to compare the rate of growth in the two cohorts.Results: Neither cases nor controls had significant growth failure. However, when the mean z-scores for weight and height were analysed, there was a difference between the two groups starting at fourth month of life. When the growth pattern in the first year was analysed longitudinally using mixed models, it emerged that children who develop CD had a significantly lower growth rate in weight z-score (-0.028/month; 95% CI -0.038 to -0.017; p<0.001) and in length/height z-score (-0.018/month; 95% CI -0.031 to -0.005; p=0.008) than those who do not develop CD. When the whole follow-up period was analysed (0-6 years), differences between groups in both weight and length/height z-scores were confirmed.Conclusion: The growth of children at risk of CD rarely fell below 'clinical standards'. However, growth rate was significantly lower in cases than in controls. Our data suggest that peculiar pathways of growth are present in children who develop CD, long before any clinical or serological signs of the disease appear. [ABSTRACT FROM AUTHOR]

Objective: We aimed to identify gestational-age corrected prenatal ultrasound markers of complex gastroschisis, and to compare physical growth and neurodevelopment between children with simple and complex gastroschisis.Design: We included prenatally diagnosed gastroschisis patients from 2000 to 2012 who joined our longitudinal follow-up programme. Associations between complex gastroschisis and prenatal ultrasound markers collected at 30 weeks' gestation and prior to delivery were tested using logistic regression. Physical growth (SD scores (SDS)), mental and psychomotor developmental index (MDI, PDI; Bayley Scales of Infant Development) were recorded at 12 and 24 months. Data were analysed using general linear models and compared with population norms.Results: Data of 61 children were analysed (82% of eligible cases). Extra-abdominal bowel dilatation at 30 weeks' gestation was significantly associated with complex gastroschisis (OR (95% CI): 5.00 (1.09 to 22.98)), with a high negative (88%) but low positive (40%) predictive value. The mean (95% CI) height SDS at 12 months (-0.46 (-0.82 to -0.11)), and weight SDS at 12 and 24 months (-0.45 (-0.85 to -0.05), and -0.44 (-0.87 to -0.01), respectively) fell significantly below 0 SDS. MDI and PDI were significantly below 100 at 24 months; 93 (88 to 99) and 83 (78 to 87), respectively). Children with complex gastroschisis had a significantly lower PDI (76 (68 to 84)) than those with simple gastroschisis (94 (90 to 97), p<0.001).Conclusions: Prenatal ultrasound markers could not reliably distinguish between simple and complex gastroschisis. Children with complex gastroschisis may be at increased risk for delayed psychomotor development; they should be monitored more closely, and offered timely intervention. [ABSTRACT FROM AUTHOR]

In many countries, routine data relating to growth of infants are collected as a means of tracking health and illness up to school age. These have potential to be used in research. For health monitoring and research, data should be accurate and reliable. This study aimed to determine the agreement between length/height and weight measurements from routine infant records and researcher-collected data. Methods: Height/length and weight at ages 6, 12 and 24 months from the longitudinal UK birth cohort (born in Bradford; n=836-1280) were compared with routine data collected by health visitors within 2 months of the research data (n=104-573 for different comparisons). Data were age adjusted and compared using Bland Altman plots. Results: There was agreement between data sources, albeit weaker for height than for weight. Routine data tended to underestimate length/height at 6 months (0.5 cm (95% CI -4.0 to 4.9)) and overestimate it at 12 (-0.3 cm (95% CI -0.5 to 4.0)) and 24 months (0.3 cm (95% CI -4.0 to 3.4)). Routine data slightly overestimated weight at all three ages (range -0.04 kg (95% CI -1.2 to 0.9) to -0.04 (95% CI -0.7 to 0.6)). Limits of agreement were wide, particularly for height. Differences were generally random, although routine data tended to underestimate length in taller infants and underestimate weight in lighter infants. Conclusions: Routine data can provide an accurate and feasible method of data collection for research, though wide limits of agreement between data sources may be observed. Differences could be due to methodological issues; but may relate to variability in clinical practice. Continued provision of appropriate training and assessment is essential for health professionals responsible for collecting routine data. [ABSTRACT FROM AUTHOR]

Inadequate nutrient intakes in the first postnatal weeks play a crucial role in the aetiology of postnatal growth restriction of very low birthweight (VLBW) infants. Efforts to improve early nutrition in these infants led to a significant reduction in postnatal growth failure. Initiation of enhanced parenteral nutrition immediately after birth and utilisation of the large potential of early enteral nutrition seem pivotal. Nevertheless, it remains challenging to further reduce the initial drop in weight and head circumference z-score and to improve body composition and linear growth. This review will summarise data on how near-fetal postnatal weight gain in VLBW infants can be achieved and makes suggestions for early nutrition of VLBW infants. [ABSTRACT FROM AUTHOR]

Background Guidelines recommend extensively hydrolysed cow's milk protein formulas (eHF) in the treatment of infants diagnosed with cow's milk protein allergy (CMPA). Extensively hydrolysed rice protein infant formulas (eRHFs) have recently become available, and could offer a valid alternative. Methods A prospective trial was performed to evaluate the clinical tolerance of a new eRHF in infants with a confirmed CMPA. Patients were followed for 1 month. Clinical tolerance of the eRHF was evaluated with a symptom-based score (SBS) and growth (weight and length) was monitored. Results Thirty-nine infants (mean age 3.4 months, range 0.5-6 months) diagnosed with CMPA were enrolled. All infants tolerated the eRHF and experienced a normal growth. Conclusions In accordance with current guidelines, this eRHF is tolerated by more than 90% of children with proven CMPA with a 95% CI, and is an adequate alternative to cow's milk-based eHF. [ABSTRACT FROM AUTHOR]

Background: Monitoring infant growth is essential for evaluation of development and is an important indicator of health and illness. Length is an essential indicator of infant growth, however, length measurement methods suffer from limitations which restrict their use. Objective: To improve infant length measurement by development of a novel, accurate, precise and practical measurement technique. Methods: A new system based on stereoscopic vision was developed. The system is comprised of two digital still cameras combined with software that calculates the infant's length from two simultaneously taken pictures. Length measurements of 54 healthy newborns were performed using a standard length board and the stereoscopic system. The two measurement methods were compared. Results: Mean infant length was 473.1 (SD=29.1) mm versus 473.3 (SD=29.3) mm by length board and by the stereoscopic system, respectively. The mean difference between measurements was 0.2 (SD=2.5) mm and the mean of the absolute values of differences was 2.0 (SD=1.4) mm. Bland-Altman analysis showed good agreement between the two measurement methods. Precision of the new technique was demonstrated by a technical error of measurement of 2.57 mm. Conclusions: The stereoscopic system is accurate, reliable, easy to use, and involves less handling and discomfort to the newborns. It has the potential to measure premature infants or sick neonates through incubators. [ABSTRACT FROM AUTHOR]

Objective: To describe feeding and gastrointestinal outcomes in growth-restricted infants <29 weeks' gestation and to determine the rate of feed advancement which they tolerate. Design: Analysis of prospectively collected data from a randomised feeding trial, the Abnormal Doppler Enteral Prescription Trial (ADEPT). Setting: 54 neonatal units in the UK and Ireland. Participants 404 preterm, growth-restricted infants with abnormal antenatal Doppler studies from ADEPT. 83 infants <29 weeks and 312 infants ≥29 weeks' gestation were included in this analysis. Interventions: In ADEPT, infants were randomised to start milk 'early' on day 2 after birth, or 'late' on day 6. Subsequent feed advancement followed a regimen, which should have achieved full feeds by day 16 in the early and day 20 in the late group. Main outcome measures: Full feeds were achieved later in infants <29 weeks; median age 28 days {IQR 22-40} compared with 19 days {IQR 17-23} in infants ≥29 weeks (HR 0.35, 95% CI 0.3 to 0.5). The incidence of necrotising enterocolitis was also higher in this group; 32/83 (39%) compared to 32/312 (10%) in those ≥29 weeks (RR 3.7, 95% CI 2.4 to 5.7). Infants <29 weeks tolerated very little milk for the first 10 days of life and reached full feeds 9 days later than predicted from the trial regimen. Conclusions: Growth-restricted infants born <29 weeks' gestation with abnormal antenatal Doppler failed to tolerate even the careful feeding regimen of ADEPT. A slower advancement of feeds may be required for these infants. Trial registration number: ISRCTN87351483. [ABSTRACT FROM AUTHOR]

Objective To describe the growth pattern from birth to 2 years of UK-born white British and Pakistani infants. Design Birth cohort. Setting Bradford, UK. Participants 314 white British boys, 383 Pakistani boys, 328 white British girls and 409 Pakistani girls. Main outcome measures Weight and length trajectories based on repeat measurements from birth to 2 years. Results Linear spline multilevel models for weight and length with knot points at 4 and 9 months fitted the data well. At birth Pakistani boys were 210 g lighter (95% CI -290 to -120) and 0.5 cm shorter (-1.04 to 0.02) and Pakistani girls were 180 g lighter (-260 to -100) and 0.5 cm shorter (-0.91 to -0.03) than white British boys and girls, respectively. Pakistani infants gained length faster than white British infants between 0 and 4 months (+0.3 cm/month (0.1 to 0.5) for boys and +0.4 cm/month (0.2 to 0.6) for girls) and gained more weight per month between 9 and 24 months (+10 g/month (0 to 30) for boys and +30 g/month (20 to 40) for girls). Adjustment for maternal height attenuated ethnic differences in weight and length at birth, but not in postnatal growth. Adjustment for other confounders did not explain differences in any outcomes. Conclusions Pakistani infants were lighter and had shorter predicted mean length at birth than white British infants, but gained weight and length quicker in infancy. By age 2 years both ethnic groups had similar weight, but Pakistani infants were on average taller than white British infants. [ABSTRACT FROM AUTHOR]

Preterm infants, especially very preterm infants, are usually growth-restricted at the time of hospital discharge. Proposed interventions to promote catch-up growth following hospital discharge include multinutrient fortification of expressed breast milk for breastfed infants and nutrient-enriched formula milk for formula-fed infants. The current evidence to support these strategies is limited. Fortification of expressed breast milk may increase weight gain and skeletal and head growth during infancy, but more research is needed to define which nutrients confer most benefit, and which population of infants is likely to receive most benefi t. Trials that have assessed feeding preterm infants with commercially available nutrient-enriched formula milk ('preterm' or 'postdischarge' formulae) compared with standard formula milk have not found consistent evidence of an effect on growth parameters or development, probably because ad libitum fed infants reduce their intake relative to the calorie-density of the milk. Future studies should focus on the effect of formulae enriched with protein and minerals rather than energy and assess the effect on lean mass and skeletal growth. INSET: Box 1 Predictors of postnatal growth restriction …. [ABSTRACT FROM AUTHOR]

Objective: In 2006 the World Health Organization (WHO) published new optimal growth standards for all healthy infants worldwide. To assess their general applicability to a recently transitioned Chinese population, we compared them with infant growth patterns in a representative sample of Hong Kong infants. Design and settings: Weight at birth and at 1, 3, 9, 12, 18 and 36 months, length at 3 and 9 months and height at 36 months were obtained for over 80% of all infants born in April and May 1997 (3880 boys and 3536 girls). Age and sex specific z scores were calculated relative to the WHO growth standards for term singletons. Results: Weight for age was close to the 50th percentile of the WHO growth standards for both boys (mean z score: 0.00) and girls (0.04) at most time points before 3 years of age. However, our participants were shorter at 3 years, where the z scores in height were -0.34 and -0.38 for boys and girls, respectively. Restricting the analysis to a subset matching the WHO criteria for healthy infants without restrictions on growth gave similar results. Conclusions: Although the WHO study group concluded there was a striking similarity in length/height among different populations, Hong Kong Chinese toddlers are, on average, shorter. Epigenetic constraints on growth coupled with the rapid epidemiological transition in Hong Kong may not have allowed sufficient generations for infants and children to reach their full genetic height potential, and with it the WHO standards. A universal infant growth standard may not be appropriate across all populations. [ABSTRACT FROM AUTHOR]

Objectives: To understand lay views on infant size and growth and their implications for a British population. Methods: A systematic review of parental and other lay views about the meanings and importance of infant size and growth using Medline, Psycinfo, CINAHL, Sociological Abstracts, IBSS, ASSIA, British Nursing Index ChildData, Caredata, SIGLE, Dissertation Abstracts (US), Index to Theses. 19 studies, most of which reported the views of mothers, from the US, Canada, the UK and Finland were reviewed. Results: Notions of healthy size and growth were dominated by the concept of normality. Participants created norms by assessing and comparing size and growth against several reference points. When size or growth differed from these norms, explanations were sought for factors that would account for this difference. When no plausible explanation could be found, growth or size became a worry for parents. Conclusions: Parents consider the importance of contextual factors when judging what is appropriate or healthy growth. For public health advice to be effective, lay, as well as scientific, findings and values need to be considered. [ABSTRACT FROM AUTHOR]

Background: Poor growth after preterm birth, particularly poor head growth, is associated with impaired neurodevelopmental outcome. Objective: To evaluate weight gain and head growth between birth and term in a contemporary cohort of preterm infants, taking into account breast milk intake and illness severity. Methods: Subjects were inborn infants ⩽ 32 weeks gestation who remained in the neonatal unit up to ⩾37 weeks postmenstrual age. Weight and head circumference (HC) were expressed as standard deviation score (SDS), growth between birth and discharge as SDS gain (SDSG), and illness severity and breast milk exposure as the number of days of level 1 (full) intensive care (%L1 IC) and the number of days on which breast milk was received (%BM) as a percentage of days from birth to discharge. Results: Infants showed poor postnatal weight gain but accelerated head growth. There was a highly significant fall in mean (SD) weight SDS between birth and discharge (-0.31 (0.96) and -1.32 (1.02) respectively, p<0.001) and a highly significant increase in HC SDS (-0.52 (0.95) and -0.03 (1.25) respectively, p = 0.003). %L1 IC had a highly significant negative impact on weight SDSG (p = 0.006), and %BM had a significant positive impact on HC SDSG (p = 0.043). Conclusions: Accelerated postnatal head growth suggests catch up after antenatal restraint. This raises the possibility that poor neurocognitive outcomes after extremely preterm birth may in part be consequent on poor intrauterine brain growth. As postnatal head growth may be facilitated by breast milk, there is an urgent need to evaluate the optimal use of breast milk in preterm neonates. Illness severity is a significant determinant of poor postnatal weight gain. [ABSTRACT FROM AUTHOR]

Background: National and international recommendations for the age of introducing solid foods (weaning) are founded on insufficient evidence and little is known about the short and medium term consequences associated with early or late weaning. Aims and Methods: Data from over 1600 infants from five prospective randomized trials conducted in the UK between 1993 and 1997 were used to determine the influence of weaning &les; 12 weeks or > 12 weeks on growth and health outcomes (diarrhea and vomiting, lower respiratory chest infections, atopy, sleep patterns) up to 18 months post-term, in term appropriate for gestational age (AGA), term small for gestational age (SGA), and preterm infants. Results: Term infants weaned &les; 12 weeks were heavier at 12 weeks of age than those weaned after 12 weeks, but showed slower gain in weight, length, and head circumference between 12 weeks and 18 months than those weaned after 12 weeks; by 18 months, there were no significant differences in size between the two groups. A similar pattern was seen in preterm infants. Breast fed term infants were more likely to be sleeping though the night at 9 months if they were weaned before 12 weeks. No weaning effects or interactions were observed for health outcomes. Conclusions: We found little evidence that weaning before or after 12 weeks influences health outcomes up to 18 months. Early weaned infants were larger at 12 weeks than later weaned infants but the growth trajectories of the two groups "converged" by 18 months. These findings do not exclude the later emergence of programmed effects of weaning practices. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relation between maternal fish intake in late pregnancy and the frequency of low birth weight and intrauterine growth retardation (IUGR). Participants: 11 585 pregnant women in south west England. Methods: Information on Fish intake was obtained from a food frequency questionnaire sent to the women at 32 weeks' gestation, and used to calculate n-3 fatty acid (n-3FA) intake from fish. IUGR was defined as o birth weight for gestational age and sex below the 10th centile. Confounding variables considered included maternal age, height, weight, education, parity, smoking and drinking in pregnancy, and whether the mother was living with a partner. Only singleton, live born infants were included. Main results: Mean daily intakes of fish and n-3FAs were 32.8 g and 0.147 g respectively. In unadjusted analyses there were positive associations between mean birth weight and fish intake or n-3FA intake, but these disappeared on adjustment for potential confounders. The frequency of IUGR decreased with increasing fish intake-the OR (95%CI) of IUGR in those eating no fish was 1.85 (1.44 to 2.38) compared with those in the highest fish intake group. On adjustment this relation was attenuated (adjusted OR 1 .37 (1.02 to 1.84)), but the decline in the frequency of IUGR with increasing fish intake remained statistically significant. No relation was observed between mean gestation and fish or n-3FA intake. Conclusions: These results lend some support to the hypothesis that raising fish or n3-FA intake during pregnancy may increase fetal growth rate. However, they provide no evidence that increasing fish consumption is associated with an increase in mean gestation. [ABSTRACT FROM AUTHOR]

Background: Infants born of low birth weight often have poor subsequent growth (especially if they were born very preterm), which has been shown to relate to later motor and cognitive development. Aims: To assess a cohort of preterm infants at the age of 7 years for growth, motor, and cognitive measures, and investigate the effects of growth impairment on school performance. Methods: A cohort of 280 children born before 32 completed weeks of gestation were tested, together with 210 term controls. Results: Pretem children were significantly lighter and shorter than term controls and had smaller heads and lower body mass index (BMI). Median centiles for weight, height, head circumference, and BMI were 25, 25, 9, and 50 for boys and 50, 25, 9, and 50 for girls compared with 50, 50, 50, and 75 for controls. They performed significantly less well on all tests with a mean score of 91 (9.2) on the Developmental Test of Visual-Motor Integration, 89 (14.5) on the Wechsler-III IQ test, and 30.7% scoring at or below the 5th centile on the Movement Assessment Battery for Children. In boys, short stature and small heads were the best predictors of poor performance; in girls, a small head alone was a predictor for poor motor and cognitive performance. Conclusion: Poor postnatal growth in preterm infants, especially of the head, is associated with increased levels of motor and cognitive impairment at 7 years of age. This growth restriction appears to occur largely in the postnatal rather than antenatal period and may be amenable to intervention and subsequent improvement in outcome. [ABSTRACT FROM AUTHOR]

Background: Postnatal depression is a recognised cause of delayed cognitive development in infants in developed countries. Being underweight is common in South Asia. Aims: To determine whether postnatal depression contributes to poor growth and development outcomes in Goa, India. Methods: Cohort study for growth outcomes with nested case-control study for developmental outcomes. A total of 171 babies were weighed and measured at 6-8 weeks following birth. The following measures were used: Edinburgh Postnatal Depression Scale for maternal mood, and sociodemographic and infant health variables. Outcome measures were: weight (< 5th centile), length (< 5th centile), and Developmental Assessment Scale for Indian Infants scores at six months. Results: Postnatal depression was a strong, and independent, predictor of Iow weight and length and was significantly associated with adverse mental development quotient scores. Conclusions: This study provides evidence for the first time that postnatal depression, a potentially treatable disorder, is a cause of poor growth and development in South Asia. [ABSTRACT FROM AUTHOR]

Objectives: To report 18 month outcome of a randomised trial of two courses of dexamethasone to prevent chronic lung disease of prematurity. Study design: Babies of birth weight 1 250 g or less ventilated at 7 days of age were randomised to a 42 day reducing course (long) or a 3 day pulsed (pulse) course of dexamethasone. Growth, cardiovascular status, and respiratory and neurodevelopmental outcomes were assessed at 1 8 months. Results: Seventy six babies were enrolled. Nine died and three were lost to follow up. Babies receiving the long course were weaned off oxygen more quickly than those receiving the pulse course (47% v 69% on oxygen at 28 days; p = 0.01), but there were no differences in 18 month outcomes. How- ever, children averaged -1 SD for growth parameters, half had moderate or severe disability, and 35% and 1 9% respectively required oxygen at 36 weeks and discharge. Conclusions: The dexamethasone course used did not influence long term outcome. However, entry criteria for this study selected a group of babies at high risk of poor long term outcome. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To determine whether men who grew slowly in utero or during infancy are more vulnerable to the later effects of poor living conditions on coronary heart disease. Design: Follow up study of men for whom there were data on body size at birth and growth and social class during childhood, educational level, and social class and income in adult life. Setting: Helsinki, Finland. Participants: 3676 men who were born during 1934-44, attended child welfare clinics in Helsinki, were still resident in Finland in 1971, and for whom data from the 1980 census were available. Main outcome measures: Hospital admission for or death from coronary heart disease. Results: Men who had low social class or low household income in adult life had increased rates of coronary heart disease. The hazard ratio among men with the lowest annual income (<£8400) was 1.71 (95% confidence interval 1.18 to 2.48) compared with 1.00 in men with incomes above £15 700. These effects were stronger in men who were thin at birth (ponderal index < 26 kg/m³): hazard ratio 2.58 (1.45 to 4.60) for men with lowest annual income. Among the men who were thin at birth the effects of low social class were greater in those who had accelerated weight gain between ages 1 and 12 years. Low social class in childhood further increased risk of disease, partly because it was associated with poor growth during infancy. Low educational attainment was associated with increased risk, and low income had no effect once this was taken into account. Conclusion: Men who grow slowly in utero remain biologically different to other men. They are more vulnerable to the effects of low socioeconomic status and low income on coronary heart disease. [ABSTRACT FROM AUTHOR]

Examines whether cardiovascular risk factors in women are related to fetal and infant growth. Insulin resistance; Raised blood pressure; High serum triglyceride; Coronary risk factors.

Examines the association between fetal and infant growth and impaired glucose tolerance in adult life in England. Proportion of men with impaired glucose tolerance and diabetes; Geometric mean plasma glucose concentration; Long-term effects of poor nutrition.

The article highlights L. L. Hui and C. Wright as they discuss their perspectives on the new growth standards by the World Health Organization (WHO). The main inspiration of the WHO came from the observation that clinically important differences exist between the growth patterns of healthy breastfed infants and the NCHS/WHO international growth references. The key hypothesis underlying the work is that growth of infants is driven by the environment. Hue believes that the growth standards could be invalid or deceiving for the one fifth of the global population in East Asia. He concludes that the growth standards are not suitable for Hong Kong Chinese. On the other hand, Wright supports the new growth standards but remark that they may not be transferable to the Great Britain.

The authors reflect on the perceptions of parents and medical professionals on infant size and growth. They discuss the association of child's size and growth to the high morbidity and mortality in childhood. They also address situations where problems of perception of growth and size of the child arise.

Objectives To assess the association between infant size or growth and subsequent obesity and to determine if any association has been stable over time. Design Systematic review. Data sources Medline, Embase, bibliographies of included studies, contact with first authors of included studies and other experts. Inclusion criteria Studies that assessed the relation between infant size or growth during the first two years of life and subsequent obesity. Main outcome measure Obesity at any age after infancy. Results 24 studies met the inclusion criteria (22 cohort and two case-control studies). Of these, 18 assessed the relation between infant size and subsequent obesity, most showing that infants who were defined as "obese" or who were at the highest end of the distribution for weight or body mass index were at increased risk of obesity. Compared with non-obese infants, in those who had been obese odds ratios or relative risks for subsequent obesity ranged from 1.35 to 9.38. Ten studies assessed the relation of infant growth with subsequent obesity and most showed that infants who grew more rapidly were at increased risk of obesity. Compared with other infants, in infants with rapid growth odds ratios and relative risks of later obesity ranged from 1.17 to 5.70. Associations were consistent for obesity at different ages and for people born over a period from 1927 to 1994. Conclusions Infants who are at the highest end of the distribution for weight or body mass index or who grow rapidly during infancy are at increased risk of subsequent obesity. [ABSTRACT FROM AUTHOR]

The article discusses the use of smartphone technology to monitor pediatric growth and feeding patterns. It informs that smartphone applications (apps) could be used apps as an interactive and dynamic adjunct to parenting and health surveillance, thus enhancing the role of internet. Great Britain Department of Health has launched an online resource to increase innovation and information for apps related to health care.

The article highlights L. Orfei and colleagues as they discuss the effect of fetal environment on the adult outcomes. Two historical birth cohorts in the Great Britain that correlate birth-weight and lung function measurements at middle age were analyzed by Orfei and colleagues. They examined the effects of air pollution, social class, postnatal growth and birth weight on the function of adult lung and report an important effect of birth weight in adult lung-function parameters. It discusses that the study conducted by Orfei and colleagues strengthens the hypothesis that adult pathology have roots in fetal programming.

Discusses growth charts used to assess infant growth. Description of the first growth chart from the National Center for Health Statistics in the United States nearly forty years ago; Summary of a newer chart from the United Kingdom and the U.S. Centers for Disease Control in 1990; Discussion of a new chart not yet released from the World Health Organization which relies solely on a standard using breast fed infants; Use of the charts by paediatricians in the United Kingdom.

Among 4630 boys, irrespective of the social class into which they were born, those grew slowly during infancy had poor poor educational achievement and had lower incomes than those who grew rapidly. One interpretation of this is that biological processes linked to slow infant growth may lead to lifelong impairment of cognitive function. [ABSTRACT FROM AUTHOR]

The article focuses on a study done in order to determine whether purposely designed nutritional guidelines for extremely low birthweight (ELBW) babies result in protein intakes that meet international consensus recommendations. It informs that the study was done on 100 ELBW babies in a tertiary neonatal intensive care unit in New Zealand. The study found that standardized nutritional guidelines on recommended protein intakes for ELBW babies can result in increased weight.

The article reports that Great Britain is the first in Europe to adopt infant growth charts based on the data collected by World Health Organization related to both breastfed and bottle-fed infants, to raise breastfeeding rates in the country.

The article offers news briefs related to evidence-based medicine in Great Britain. A medical study shows that cognitive behavior therapy is a useful intervention for insomnia or heart failure. The prevention of cardiovascular disease is considered the biggest debate tackled in developed-world medicine. History has been recorded the findings on the tendency of some babies to bring up their knees and cry incessantly after their evening feeds for the first three months of life.

The article focuses on the systematic review of the link of small size and slow growth in infancy with increased risk of coronary disease in adult life. The review included 19 studies relating to the leading causes of adult disease published in the 1997 issue of "The Lancet" periodical. It found that infant size or growth is not associated to other important adult diseases.

Presents an abstract of the study entitled "Terminal Deletion of Chromosome 15q26—Clinical Features in a Further Cases," by Huw Dorkins, Bev Bewes, Carolyn Campbell and Katie Waters, presented during the British Human Genetics Conference held at the University of York in England from September 13 to 15, 2004.