Catch Up Growth in Preemies

Newborn baby sleeping in incubator
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Catch up growth, also called compensatory growth or compensatory gain, is rapid growth in infants or young children who were born prematurely, small for their gestational age, or who had a health problem severe enough to prevent normal growth for a period of time. Catch-up growth usually starts between the ages of 1 and 2 and goes up to 3 years of age. If you have witnessed your child go through an unusual growth spurt, it may be catch-up growth.

Patterns

According to the Journal of Pediatrics, roughly 85% of babies born small compared to their gestational age show signs of catch-up growth in childhood. Rapid growth is usually marked by abnormal height increase, but can also include body weight, body composition, head circumference or body segments such as sitting height or leg length. In preemies, an increase in adiposity, or fat composition, has been observed, rather than increases in height. This accelerated growth can occur in a short period of time surprising parents. Catch up growth has both positive and negative consequences.

The Upside 

Infants who do not show catch-up growth tend to be shorter adults and may have more cognitive problems than other children. Eliminating growth deficit is desirable for having a baby born prematurely to reach normal numbers on growth charts. Studies also show that babies born with a low birth weight have better motor skills if they have experienced vigorous catch-up growth at a young age.

The Downside 

However, infants who do show catch-up growth have higher risks of childhood obesity and adult health problems related to obesity and other metabolic disorders such as type II diabetes due to impaired glucose tolerance. Children born prematurely who have an extreme growth spurt may also be at an increased risk for heart disease.

Striking a Balance

Because there are risks and rewards to catch up growth in preemies, think about striking a balance. While catch up growth happens naturally in some babies born prematurely, others may not. Do what's best for your child and don't look to overfeed, or overexert your child to promote catch-up growth. These strategies may actually hinder your child's development and overall health. As long as your child is well-taken care of, their size and weight should not matter. But if it does to you, know that over time the issue can and may take care of itself.

View Article Sources
  • Caroline C. de Wit, MD, Theo C.J. Sas, MD, Ph.D.,  Jan M. Wit, MD, Ph.D., et al. Patterns of Catch-Up Growth. Journal of Pediatrics. February 2013 Volume 162, Issue 2, pp 415–420.
  • Erica E. Alexeev, Bo Loumlnnerdal, and Ian J. Griffin. Effects of postnatal growth restriction and subsequent catch-up growth on neurodevelopment and glucose homeostasis in rats. BMC Physiology. June 5, 2015. Online
  • Vandana Jain, Atul Singhal. Catch up growth in low birth weight infants: Striking a healthy balance. Reviews in Endocrine and Metabolic Disorders June 2012, Volume 13, Issue 2. pp 141-147.