Background Little is known about whether patterns of early growth are associated with altered respiratory and immune development. This study relates prenatal and infant growth patterns to wheeze and atopy at age 3 years. Methods Birth weight and length were measured in 1548 children born at term. Conditional fetal head and abdominal circumference growth velocities were calculated from antenatal ultrasound measurements. Conditional postnatal growth velocities were calculated from infant weight, length and adiposity data. Measures of size and conditional growth were related to parentallyreported infant and early childhood wheeze and to atopic status at age 3 years. Results The risk of atopy increased by 46% per SD increase in abdominal circumference growth velocity from 11 to 19 weeks gestation but by 20% per SD decrease in abdominal growth velocity from 19 to 34 weeks (p¼0.007 and p¼0.011, respectively). The risk of atopic wheeze increased by 20% per SD decrease in 19e34-week abdominal growth (p¼0.046). The risk of non-atopic wheeze increased by 10% per SD decrease in 11e19-week head circumference growth. Greater relative infant weight and adiposity gains were associated with both atopic and non-atopic wheeze. Conclusions A rapid growth trajectory during 11e19 weeks gestation followed by late gestation growth faltering is associated with atopy, suggesting that influences affecting fetal growth may also alter immune development. A lower early fetal growth trajectory is associated with non-atopic wheeze, possibly reflecting an association with smaller airways. An association between postnatal adiposity gain and wheeze may partly reflect prenatal influences that cause fetal growth to falter but are then followed by postnatal adiposity gain. INTRODUCTIONChildren and adults who were small at birth tend to have reduced lung function and an increased risk of respiratory mortality and morbidity.1e3 Smaller birth size is associated with reduced lung function from early infancy, 1e7 and genetic and environmental influences on early lung development appear to have lasting effects on later respiratory health.8 It has been proposed that an adverse intrauterine environment might induce fetal adaptations which restrict somatic growth and also have adverse functional consequences for the developing immune system and lungs. 3 Studies examining the association between birth anthropometry and later asthma have, however, had inconsistent findings, 2 and children who had experienced intrauterine growth retardation had decreased lung function but no difference in wheeze compared with children of appropriate birth weight for gestational age. 1 The inconsistency may partly reflect methodological differences including adequacy of correction for gestation and other confounding factors. In twin studies, birth weight exerts a greater influence on later asthma in monozygotic twins than in dizygotic twin pairs, suggesting fetal growth and childhood asthma may be associated independently of shared genetic factors. 9 10 In healthy te...

This study aimed to determine whether age at introduction of solid foods was associated with feeding difficulties at 3 years of age. The present study was carried out using data from the Southampton Women's Survey (SWS). Women enrolled in the SWS who subsequently became pregnant were followed-up during pregnancy and postpartum, and the offspring have been studied through childhood. Maternal socio-demographic and anthropometric data and child anthropometric and feeding data were collected through interviews and self-administered questionnaires. When the children were 3 years of age, mothers/carers rated six potential child feeding difficulty questions on a four-point Likert scale, including one general question and five specific feeding difficulty questions. Age at introduction of solids as a predictor of feeding difficulties was examined in 2389 mother-child pairs, adjusting for child (age last breast fed, sex, gestation) and maternal characteristics (parity, pre-pregnancy BMI, age, education, employment, parenting difficulties, diet quality). The majority of mothers/carers (61 %) reported some feeding difficulties (general feeding difficulty question) at 3 years of age, specifically with their child eating enough food (61 %), eating the right food (66 %) and being choosy with food (74 %). Children who were introduced to solids ≥6 months had a lower risk of feeding difficulties (RR 0·73; 95 % CI 0·59, 0·91, P = 0·004) than children who were introduced to solids between 4 and 6 months. No other significant associations were found. There were few associations between feeding difficulties in relation to age at introduction of solid foods. However, general feeding difficulties were less common among infants introduced to solid foods ≥6 months of age.