Size at birth and early childhood growth in relation to maternal smoking, parity and infant breast-feeding: longitudinal birth cohort study and analysis

Pediatr Res. 2002 Dec;52(6):863-7. doi: 10.1203/00006450-200212000-00009.


There is remarkably wide variation in rates of infancy growth, however, its regulation is not well understood. We examined the relationship between maternal smoking, parity, and breast- or bottle-feeding to size at birth and childhood growth between 0 and 5 y in a large representative birth cohort. A total of 1,335 normal infants had weight, length/height, and head circumference measured at birth and on up to 10 occasions to 5 y old. Multilevel modeling (MLwiN) was used to analyze longitudinal growth data. Infants of maternal smokers were symmetrically small at birth (p < 0.0005) compared with infants of nonsmokers, however, showed complete catch-up growth over the first 12 mo. In contrast, infants of primiparous pregnancies were thin at birth (p < 0.0005), showed dramatic catch-up growth, and were heavier and taller than infants of nonprimiparous pregnancies from 12 mo onwards. Breast-fed infants were similar in size at birth than bottle-fed infants, but grew more slowly during infancy. Among infants who showed catch-up growth, males caught up more rapidly than females (p = 0.002). In conclusion, early postnatal growth rates are strongly influenced by a drive to compensate for antenatal restraint or enhancement of fetal growth by maternal-uterine factors. The mechanisms that signal catch-up or catch-down growth are unknown but may involve programming of appetite. The importance of nutrition on early childhood growth is emphasized by the marked difference in growth rates between breast- and bottle-fed infants. The sequence of fetal growth restraint and postnatal catch-up growth may predispose to obesity risk in this contemporary population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Birth Weight*
  • Body Height
  • Body Weight
  • Breast Feeding
  • Child, Preschool
  • Cohort Studies
  • Female
  • Growth*
  • Humans
  • Infant
  • Infant, Newborn
  • Longitudinal Studies
  • Male
  • Maternal-Fetal Exchange*
  • Parity
  • Pregnancy
  • Prenatal Exposure Delayed Effects
  • Sex Characteristics
  • Smoking / adverse effects*
  • United Kingdom