Catch up growth in low birth weight infants: Striking a healthy balance

Catch-up growth in the first few months of life is seen almost ubiquitously in infants born small for their gestational age and conventionally considered highly desirable as it erases the growth deficit. However, recently such growth has been linked to an increased risk of later adiposity, insulin resistance and cardiovascular disease in both low income and high-income countries. In India, a third of all babies are born with a low birth weight, but the optimal growth pattern for such infants is uncertain. As a response to the high rates of infectious morbidities, undernutrition and stunting in children, the current policy is to promote rapid growth in infancy. However, with socio-economic transition and urbanization making the Indian environment more obesogenic, and the increasing prevalence of type 2 diabetes and cardiovascular disease, affecting progressively younger population, the long term adverse programming effect of fast/excessive weight gain in infancy on later body composition and metabolism may outweigh short-term benefits. This review discusses the above issues focusing on the need to strike a healthy balance between the risks and benefits of catch-up growth in Indian infants.