Psychosocial and educational outcomes of weight faltering in infancy in ALSPAC

Objectives: To investigate whether infants with weight faltering have impaired psychosocial and educational outcomes in later childhood.

Design: Follow-up of infants with weight faltering in a large UK cohort study.

Setting: The Avon Longitudinal Study of Parents and Children (ALSPAC).

Participants: 11 534 term infants from ALSPAC with complete weight records. Weight gain (conditional on initial weight) was calculated for three periods: from birth to 8 weeks, 8 weeks to 9 months, and birth to 9 months. Cases of weight faltering were defined as those infants with a conditional weight gain below the
5th centile, and these were compared with the rest of the cohort as the control group.

Outcomes: Between 6 and 11 years, social, emotional and behavioural development was measured by direct assessment of the children and parental and teacher report. Educational outcomes included Standardised Assessment Test results at 7 and 11 years and Special Educational Needs status at age 11.

Results: Differences seen on univariate analysis in attention, non-verbal accuracy, educational attainment and special educational needs became non-significant after adjustment for confounding. Children with weight faltering in infancy did not differ from controls on any measures of self-esteem, peer relationships, experience of bullying, social cognition, antisocial activities, anxiety, depression or behavioural problems.

Conclusions: Weight faltering in early infancy was associated with poorer educational outcomes in later childhood, but these associations were explained by confounding. The subsequent psychosocial development of infants with slow weight gain was not different from that of their peers.