Low birth weight and early weight gain in the metabolic syndrome: Consequences for infant nutrition

Emerging data indicate that being born small for gestational age (SGA) and rapid infant catch-up growth may play a significant role in the risk of developing type 2 diabetes (T2DM) and the metabolic syndrome (MS) many years later in life. The impact of these perinatal T2DM and MS risk factors may be more important than genetics in some parts of the world, including low-income countries. Breastfeeding for 3–6 months is associated with reduced risk of developing insulin resistance and the metabolic syndrome. Promotion of fast growth in SGA infants by nutrient-enriched formula increases risk of hypertension and the metabolic syndrome. While waiting for better knowledge of how to combat T2DM and MS with early-life interventions, breastfeeding should be recommended and enforced whenever possible, keeping in mind the health and nutritional status of the mother. Furthermore, promotion of fast weight gain in SGA infants by nutrient-enriched formula feeding should be used with caution. However, growth limitation by restriction of nutrition in SGA infants below general recommendations should not be recommended.