The detection of early weight faltering at the 6-8 week check and its association with family factors, feeding and behavioural development

Abstract

Aims: To identify infants with early weight faltering at the 6–8-week check and examine their family circumstances, feeding and behavioural development. Methods: Over a 2-year period, the weight gain of all infants born in an area of North East England was screened. z Scores for weights at birth and at 6–8 weeks were used to calculate a "thrive index" (z score for weight gain). In a nested case–control study within the larger cohort, infants below the fifth centile on the thrive index were identified. 74 cases and 86 controls were followed up. Their development was assessed at 4 and 9 months using the Bayley Scales and their mothers interviewed. Results: Of 1996 infants, weights at birth and at 6–8 weeks were available for 1880 (94%), and 6.1% of term-born infants were identified as weight faltering over the first 6–8 weeks. These infants had more feeding problems and showed some developmental delay as assessed using the Bayley Scales (at 4 months, mean difference and 95% CI –3.5, –0.6 to –6.4 for the Mental Developmental Index (MDI) and –3.6, –0.2 to – 6.9 for the Psychomotor Developmental Index (PDI); at 9 months –2.3, 1.3 to –5.8 for MDI and –2.2, 2.5 to –7.0 for PDI). Their families were not significantly different from those of controls on any economic or educational measure. Conclusion: Infants whose early weight gain is slow show more feeding problems than controls, and some developmental delay. They can be identified using a thrive index at the 6–8-week check.