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Feeding the hospitalized large-for-gestational-age infant: Clinical dilemmas and the need for growth standards

Nichole R Cortez1,2, Holly R Hull3, Danielle N Christifano2

  • 1Clinical Nutrition, Saint Luke's Health System, Boise, Idaho, USA.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|March 12, 2026
PubMed

Insights

Infants born large-for-gestational-age (LGA) face feeding challenges due to a lack of specific growth standards. New research is urgently needed to develop evidence-based guidelines to prevent overfeeding and reduce long-term obesity risk.

Area of Science:

  • Pediatrics
  • Neonatology
  • Public Health

Background:

  • Rising rates of maternal obesity and diabetes contribute to an increase in infants born large-for-gestational-age (LGA).
  • Hospitalized LGA infants often require specialized nutrition support.
  • Current feeding guidelines are based on appropriate-for-gestational-age infants, potentially leading to inappropriate nutrition for LGA infants.

Purpose of the Study:

  • To explore the challenges associated with feeding hospitalized infants born LGA.
  • To highlight the critical need for developing specific growth standards for LGA infants.

Main Methods:

  • This is a clinical dilemma discussion, not a primary research study.
  • It reviews existing literature and clinical observations regarding LGA infant nutrition.

Main Results:

  • No established growth standards currently exist to guide the nutrition management of hospitalized LGA infants.
  • Existing feeding practices may inadvertently lead to overfeeding in LGA infants.
  • There is an increased risk of long-term obesity associated with current feeding practices.

Conclusions:

  • Hospitalized LGA infants represent an at-risk population requiring tailored nutritional strategies.
  • The development of evidence-based growth standards for LGA infants is urgently required.
  • Further research is essential to inform optimal feeding practices and mitigate future health risks.

Keywords:
enteral nutritionmetabolic diseasesneonatesnutrition assessmentobesity

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