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Early postnatal growth predictors of catch-up growth in term small-for-gestational-age infants: a nationwide

Jinjoo Choi1, Yun Jin Kim2, Myoung-Jin Yoo1

  • 1Department of Pediatrics, Hanyang University Hospital, Seoul, Republic of Korea.

Frontiers in Endocrinology
|March 30, 2026
PubMed

Insights

Early infant feeding type does not impact catch-up growth (CUG) in small for gestational age (SGA) infants. Instead, early anthropometric measurements at 4-6 months are key predictors of CUG in SGA infants.

Area of Science:

  • Pediatrics
  • Neonatology
  • Growth and Development

Background:

  • Infants born small for gestational age (SGA) face risks of impaired growth and metabolic issues.
  • The long-term impact of infant feeding type on catch-up growth (CUG) in SGA infants is debated, with no clear predictive anthropometric thresholds.
  • This study addresses the controversy surrounding feeding types and CUG in SGA infants.

Purpose of the Study:

  • To investigate the association between early feeding type (breastfeeding vs. formula-feeding) and catch-up growth (CUG) in term SGA infants.
  • To identify anthropometric predictors of CUG in term SGA infants.
  • To inform nutritional support strategies for SGA infants.

Main Methods:

  • Analysis of a population-based cohort of term SGA infants from the Korean National Health Screening Program (2007-2014).
  • Classification of feeding type as exclusive breastfeeding or exclusive formula-feeding, excluding mixed feeding.
  • Propensity-score matching (1:1) for sex, birth weight, socioeconomic status, and residence; CUG defined as height > 3rd percentile by 42-48 months.

Main Results:

  • A cohort of 1,832 infants was analyzed after matching.
  • Formula-fed infants showed faster initial growth, but CUG rates at four years were comparable between feeding groups.
  • Feeding type was not significantly associated with CUG (aOR 1.38). Weight and height Z-scores at 4-6 months strongly predicted later CUG (AUC 0.77 and 0.84, respectively).

Conclusions:

  • Early weight and height Z-scores at 4-6 months are critical determinants of CUG in term SGA infants.
  • Breastfeeding supports comparable long-term outcomes to formula feeding, suggesting a potentially favorable physiological trajectory.
  • Growth monitoring in early infancy (4-6 months) can identify SGA infants at risk for persistent growth failure, guiding timely nutritional interventions.
Abstract

Keywords:
birth weightbreast feedinggrowthinfantsmall for gestational age

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