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Small-for-gestational-age and eating problems in infants aged 2.5 years: a nationwide population-based study in Japan

Akihito Takeuchi1, Naomi Matsumoto2, Yousuke Higuchi3

  • 1Division of Neonatology, NHO Okayama Medical Center, Okayama, Japan.

Early Human Development
|August 6, 2025
PubMed

Insights

Small-for-gestational-age (SGA) infants show increased risks for eating behavior problems, including small or fluctuating appetites and difficulty eating calmly. Early intervention is crucial for these children.

Area of Science:

  • Pediatric Nutrition
  • Developmental Pediatrics
  • Child Health Outcomes

Background:

  • Small-for-gestational-age (SGA) is associated with various health challenges.
  • Eating behaviors are critical for infant growth and development.
  • Understanding SGA's impact on eating is vital for early intervention.

Purpose of the Study:

  • To investigate the association between small-for-gestational-age (SGA) status and eating behaviors in 2.5-year-old children.
  • To identify specific eating problems linked to SGA.
  • To inform targeted support strategies for SGA infants.

Main Methods:

  • Analysis of a large, nationwide Japanese longitudinal survey (n=32,096).
  • SGA defined as birth weight below the 10th percentile for gestational age (GA).
  • Poisson regression used to calculate risk ratios (RRs) for eating problems in SGA vs. non-SGA children, adjusting for confounders.

Main Results:

  • SGA children exhibited a significantly higher likelihood of small appetite (aRR: 2.08) and fluctuating appetite (aRR: 1.09).
  • SGA was also associated with a greater tendency to be unable to eat calmly (aRR: 1.10).
  • These associations remained significant after controlling for confounding factors.

Conclusions:

  • Small-for-gestational-age (SGA) status is a confirmed risk factor for eating and behavioral problems.
  • Children with SGA require tailored, multifaceted approaches to address eating difficulties.
  • Early identification and support can improve eating behaviors in SGA populations.
Abstract

Keywords:
AppetitePediatric feeding disorderPretermSmall for gestational age

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