Weight Faltering in Infancy and IQ Levels at 8 Years in the Avon Longitudinal Study of Parents and Children

OBJECTIVE. Our goal was to investigate the association between failure to thrive (defined as weight faltering in the first 9 months of life) and IQ levels 8 years later. METHODS. Weight gain (conditional on initial weight) from birth to 8 weeks, 8 weeks to 9 months, and birth to 9 months was measured on term infants from the Avon Longitudinal Study of Parents and Children. Cases of weight faltering were defined as those infants with a conditional weight gain below the 5th centile who were compared with the rest of the cohort as the control group. At the age of 8 years, 5771 infants born at term with no major congenital abnormalities had IQ measured by using the Wechsler Intelligence Scale for Children, Third Revision. RESULTS. Mean (SD) IQ scores were 104.7 (16.3) (total), 107.6 (16.5) (verbal), and 100.2 (16.9) (performance). Children whose weight faltered from birth to 9 months had a total IQ that was significantly lower by an average of −2.71 points at 8 years, equivalent to 0.17 SD. Weight gain from birth to 8 weeks had a positive linear association with child IQ at 8 years. This remained significant in a multivariate regression despite controlling for correlates of both infant growth and child IQ; 1 SD of weight gain was associated with a difference of 0.84 points in the total IQ score. In contrast to early weight faltering, weight gain from 8 weeks to 9 months was not related to IQ at 8 years. CONCLUSIONS. Failure to thrive in infancy was associated with persisting deficits in IQ at 8 years; the critical period for growth faltering was birth to 8 weeks. The relationship between infant growth from birth to 8 weeks and later intellectual development was approximately linear over the whole range of weight velocities.

[1]  A. Emond,et al.  Postnatal factors associated with failure to thrive in term infants in the Avon Longitudinal Study of Parents and Children , 2006, Archives of Disease in Childhood.

[2]  K. Parkinson,et al.  How Does Maternal and Child Feeding Behavior Relate to Weight Gain and Failure to Thrive? Data From a Prospective Birth Cohort , 2006, Pediatrics.

[3]  M. Rudolf,et al.  What is the long term outcome for children who fail to thrive? A systematic review , 2005, Archives of Disease in Childhood.

[4]  I. Deary,et al.  Birth weight and cognitive ability in childhood: a systematic review. , 2004, Psychological bulletin.

[5]  A. Ness,et al.  Family, socioeconomic and prenatal factors associated with failure to thrive in the Avon Longitudinal Study of Parents and Children (ALSPAC). , 2004, International journal of epidemiology.

[6]  R. Drewett,et al.  To what extent is failure to thrive in infancy associated with poorer cognitive development? A review and meta-analysis. , 2004, Journal of child psychology and psychiatry, and allied disciplines.

[7]  Susan L. Johnson,et al.  Disease severity at time of referral for pediatric failure to thrive and obesity: time for a paradigm shift? , 2002, The Journal of pediatrics.

[8]  D. Wolke,et al.  Malnutrition and mental development : is there a sensitive period? A nested case-control study. , 2001 .

[9]  D. Skuse,et al.  The developmental sequelae of nonorganic failure to thrive. , 2000, Journal of child psychology and psychiatry, and allied disciplines.

[10]  James W. Anderson,et al.  Breast-feeding and cognitive development: a meta-analysis. , 1999, The American journal of clinical nutrition.

[11]  M. Mendez,et al.  Severity and timing of stunting in the first two years of life affect performance on cognitive tests in late childhood. , 1999, The Journal of nutrition.

[12]  R. Drewett,et al.  Cognitive and educational attainments at school age of children who failed to thrive in infancy: a population-based study. , 1999, Journal of child psychology and psychiatry, and allied disciplines.

[13]  D. Skuse,et al.  Oral‐motor dysfunction in children who fail to thrive: organic or non‐organic? , 1999, Developmental medicine and child neurology.

[14]  T. Tulchinsky,et al.  A community based study of failure to thrive in Israel. , 1996, Archives of disease in childhood.

[15]  A. Kaufman,et al.  Correlations between Two Short Cognitive Tests and a WISC-III Short Form Using a Sample of Adolescent Inpatients , 1996, Psychological reports.

[16]  T J Cole,et al.  Conditional reference charts to assess weight gain in British infants. , 1995, Archives of disease in childhood.

[17]  T J Cole,et al.  Cross sectional stature and weight reference curves for the UK, 1990. , 1995, Archives of disease in childhood.

[18]  M. Black,et al.  Parenting style and developmental status among children with nonorganic failure to thrive. , 1994, Journal of pediatric psychology.

[19]  A. Aynsley-Green,et al.  What is a normal rate of weight gain in infancy? , 1994, Acta paediatrica.

[20]  D. Skuse,et al.  Postnatal growth and mental development: evidence for a "sensitive period". , 1994, Journal of child psychology and psychiatry, and allied disciplines.

[21]  E. Gisel,et al.  NON‐ORGANIC FALURE TO THRIVE; GROWTH FAILURE SECONDARY TO FEEDING‐SKILLS DISRODER , 1993 .

[22]  I Russell,et al.  Statistics--with confidence? , 1991, The British journal of general practice : the journal of the Royal College of General Practitioners.

[23]  D. Simeon,et al.  Nutritional Deficiencies and Children's Behaviour and Mental Development , 1990, Nutrition Research Reviews.

[24]  D. Skuse,et al.  Growth retardation and developmental delay amongst inner-city children. , 1987, Journal of child psychology and psychiatry, and allied disciplines.

[25]  D. Drotar,et al.  Early Psychological Outcomes in Failure to Thrive: Predictions from an Interactional Model , 1985 .

[26]  A. Hammarström,et al.  An epidemiological study of the influence of adolescence and early adulthood factors upon the social class inequity of musculuskeletal pain in young adults. , 2004 .

[27]  M. Pembrey,et al.  ALSPAC--the Avon Longitudinal Study of Parents and Children. I. Study methodology. , 2001, Paediatric and perinatal epidemiology.

[28]  F. Tessema,et al.  Malnutrition and mental development: is there a sensitive period? A nested case-control study. , 2001, Journal of child psychology and psychiatry, and allied disciplines.

[29]  M. Smithson Statistics with confidence , 2000 .

[30]  D. Kessler Failure to thrive and pediatric undernutrition: Historical and theoretical context. , 1999 .

[31]  D. Skuse Epidemiologic and Definitional Issues in Failure to Thrive , 1993 .

[32]  E. Gisel,et al.  Non-organic failure to thrive: growth failure secondary to feeding-skills disorder. , 1993, Developmental medicine and child neurology.