Literature review for - Flourish Paediatrics

the amount and cellularity of adipose tissue (Koletzko, von Kries et al. 2009). The increased
rate of growth and propensity towards obesity in formula fed infants has been the subject of a
major European trial (Koletzko, von Kries et al. 2009). An infant formula with a lower level
of protein resulted in a lower rate of growth that was closer to the growth pattern of breastfed
infants.
Growth rates in infancy are related to disease later in life according to, the Developmental
Origins of Adult Disease Hypothesis (DOAD or DOHAD), which has been the subject of
extensive reviews (Barker 2007; Barker, Gelow et al. 2010; Groom, Elliott et al. 2010). The
rate of growth in early infancy is related to health as an adult, including the incidence of
hypertension, obesity, metabolic syndrome and hypertension (Singhal, Cole et al. 2007;
Tzoulaki, Sovio et al. 2010)
On the other hand slow growth (undernutrition) results in increased rates of infectious
disease. An extensive literature on undernutrition in developing countries going back to the
pioneering work of Schrimshaw and Jelliffe has recently been re-confirmed in an
economically-advanced society (Hui, Schooling et al. 2010)
Appropriate growth is essential for health and optimal development, both short term and
throughout the lifespan. As with many other nutritional parameters the risk appears to be U-
shaped.
In the infant, growth that is too slow confers high risk for morbidity and mortality in
the short term and developmental problems in the longer term
Growth that is too rapid predisposes to later adult disease.
There is also risk attached to antenatal development as reflected in infant birthweight
Birthweights 4500 grams (macrosomia) are also at increased risk
Again this appears to be a U-shaped distribution of risk.
Numerous studies affirm that growth of breastfed infants differs in trajectory from growth of
formula fed infants (Dewey, Peerson et al. 1992; Dewey 1998). Evidence is accumulating
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