Excessive Weight Gain Followed by Catch-Down in Exclusively Breastfed Infants: An Exploratory Study

Nutrients. 2018 Sep 12;10(9):1290. doi: 10.3390/nu10091290.


Some infants experience excessive weight gain (EWG) during exclusive breastfeeding, but causes and consequences are unknown. The objective was to identify factors associated with early EWG. Infants with EWG (HW-group) were examined at 5, 9 and 18 mo and compared to a breastfed group with normal weight gain (NW-group). Anthropometry, body composition, milk and blood samples, and milk intake were measured. Mean body-mass-index-for-age z-scores (BAZ) increased 1.93 from birth to 5 mo in the HW-group (n = 13) while the NW-group (n = 17) was unchanged (-0.01). The HW-group had 70% more fat mass at 5 mo, and then showed marked catch-down in BAZ from 5 to 18 mo (-0.84). Milk intake at 5⁻6 mo did not differ between the groups. In the HW-group milk-leptin was lower at 5 mo and serum-leptin was considerably higher at 5 and 9 mo compared to the NW-group. Serum-leptin at 5 mo was positively associated with weight-for-age z-score (WAZ) and fat mass and negatively with WAZ change from 5 to 9 mo. In conclusion, breastfed infants with EWG had catch-down growth when other foods were introduced. Low milk-leptin in the HW-group may have stimulated appetite and milk intake when weight gain was high. High serum-leptin in the HW-group suggests early leptin resistance, which could impact cerebral regulation of energy intake. Larger studies are needed to confirm these results.

Keywords: body composition; breastfeeding; exclusively breastfed infants; human milk composition; human milk intake; infant growth; leptin; pediatrics; weight-gain.

Publication types

  • Observational Study

MeSH terms

  • Adiposity
  • Age Factors
  • Appetite Regulation
  • Breast Feeding*
  • Child Development*
  • Feeding Behavior
  • Female
  • Humans
  • Infant
  • Infant Behavior
  • Infant Nutritional Physiological Phenomena*
  • Leptin / blood
  • Male
  • Nutritional Status*
  • Prospective Studies
  • Weight Gain*


  • Leptin