Purpose: Early rapid weight gain (RWG) is associated with overweight and abdominal adiposity in children, and these factors are in turn related to adverse health consequences later in life. Early nutrition has been identified as an important risk factor. In Sweden, milk cereal drink (MCD) is recommended to be introduced at 6 months and continued during introduction of complementary foods, often longer. The aim of this study was to investigate if MCD consumption was associated with RWG in infancy and elevated waist-to-height ratio (WHtR) later in childhood. 

Methods: This study is based on longitudinal data in the Swedish cohort of the IDEFICS study between birth and 15 years. Early growth data from archival health records and information from parents regarding MCD consumption, maternal BMI and family income was available for 1391 children. After excluding 58 children born prematurely, n=1333. RWG was defined as a change > 0.67 in weight standard deviation scores between 6–12 months. Follow-up data regarding waist circumference and height were available in around half of the children who were re-examined at ages 7–15 years. Logistic and linear regressions were used to study associations between MCD and early RWG and subsequent predictive value of RWG on WHtR later in childhood. 

Results/findings: MCD was consumed by 61% of the children and 59% of them consumed it for more than three months. RWG, which was observed in 17% of the children between 6–12 months was associated with MCD consumption ever/never (OR: 1.52 95% CI: 1.19–2.07 p: <0.01), when corrected for maternal BMI, birth weight, sex and household income. When investigating WHtR in the 626 children at follow-up, RWG between 6–12 months was associated with WHtR (3.98, 1.15–13.83 and p<0.05) when corrected for birth weight, sex, maternal BMI, age at follow-up, parental education and breastfeeding. In the full model considering the total observation time the MCD effect was not independent of RWG. 

Conclusions: Our results indicate that early RWG is associated with higher WHtR later in childhood. Our results also raise the possibility that MCD consumption may be involved in later development of centralized adiposity.