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

Pauline McDougall ¹, Robert Francis Drewett ^1*, Pali Hungin ¹ and Charlotte M Wright ²

¹ University of Durham, United Kingdom
² Yorkhill Hospitals, United Kingdom

^* To whom correspondence should be addressed. E-mail: r.f.drewett{at}durham.ac.uk.

Accepted 11 November 2008

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 two-year period, the weight gain of all infants born under the care of 18 family practices in NE 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 5th centile on the thrive index were identified. 74 cases and 86 controls were followed up over the first year. Development was assessed at 4 and 9 months using the Bayley Scales and their mothers interviewed.

Results: Of 1996 infants born, weights at birth and 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 MDI and -3.6, -0.2 to - 6.9 for 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 measures.

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 weeks check.