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Title of Paper: Determinants of catch-Up growth in international adoptees from Eastern Europe.

Type of Paper: Original Article; Prospective Study

Purpose: To examine catch-up growth during the early post-adoption period and to identify factors associated with catch-up growth in children adopted from Eastern Europe.

Nutrition-Related Measures:

Participants: 148 children adopted from Eastern Europe between the ages of 6 and 59 months at adoption (average age was 20 months).

Methods: Children were seen in two international adoption clinics soon after arrival into the U. S. (within 3 weeks of arrival) and again six months later.

Nutrition Results:

Conclusions & Clinical Implications: Similar to other cohorts, international adoptees have growth failure in height, weight, and head size at adoption followed by significant improvements in all these areas. Special attention may be needed for children with low birth weight, high risk for FAS, greater height suppression, or older age, as they are at risk for increase growth suppression and less catch-up. During the catch-up phase, these children had unusually high caloric intakes. Higher caloric intake was associated with greater catch-up in height and weight. These findings suggest that improved nutrition is important for growth recovery in this population, and there is a need for higher caloric intake beyond typical age requirements. The authors note that nutritional demands depend on the growth rate and any pre-existing nutrient deficits.

Limitations of the Nutritional Results: As the authors discuss, although improved catch-up growth is associated with improved nutrition (i.e., high caloric intake), other changes in the post-adoption environment which were not addressed in this study, such as improved nurturing care, may influence the growth hormone system and catch-up growth. Improved nutrition may be inadequate without concurrent improvements in nurturing care for growth recovery.

Reference: Miller BS, Kroupina MG, Mason P, et al. Determinants of catch-Up growth in international adoptees from Eastern Europe. International Journal of Pediatric Endocrinology. 2010; 2010. http://www.ncbi.nlm.nih.gov/pubmed/21234323

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