Normal Growth, Growth Faltering, and Obesity in Breastfed Infants

Abstract Optimal growth can only be achieved through the interaction of genetic potential and optimal nutrition at the appropriate times (intrauterine, infancy, childhood and adolescence) to immediately effect timely active growth and “program” organogenesis and metabolism to optimize future growth and health. The “first 1000 days” is an essential period of early nutrition and growth intimately connected to breast milk. The WHO growth standards represent appropriate growth references for assessing the optimal growth of breastfeeding infants and children from 0–24 months and the CDC standards for 24–59 months. Growth faltering in a breastfeeding infant when recognized by comparison of an individual child's growth to the WHO growth standards for breastfeeding infants should be a call for assessment of the situation and intervention to optimize nutrition allowing the infant to return to appropriate growth. Direct observation of the breastfeeding mother and child is essential to identifying breastfeeding difficulties and potential solutions. Childhood obesity is a complex condition generated through the interaction of genetics and environment. There are numerous potentially contributing factors acting in the prenatal, intrauterine and postnatal periods. Body mass index (BMI) is the accepted practical estimate of adiposity, overweight and obesity.