Cohort Study on Physical Growth and Development in Triplets and Quadruplets

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We analyzed the characteristics of weight growth and present the weight growth charts from birth to six years of age in Japanese triplets. The study included 366 mothers and their 1,098 triplet children, who were born between 1978 and 2006. Data were collected through a mailed questionnaire sent to the mothers asking for information recorded in medical records. Birth weight proved to be the strongest contribution on weight of triplets from one to six years of age. In addition, gestational age was also a significant contributing factor to weight from birth to six years of age. Compared to the 50^<th> percentile of the growth standard for the general population of Japan, the weight deficit of the triplets was more than 40% at birth (male, -1.28kg; female, -1.28kg), decreased within the first one year of age, and fluctuated between 4% and 9% until six years of age (male, -1.82kg; female, -1.78kg). In conclusion, triplets have lower birth weight than singletons and in spite of the rapid catch-up growth during first year of life they are behind singletons even in mid-childhood.Moreover, we analyzed a database of medical check-up of infants aged 3 to 6 months between April 2001 and July 2004 in Nishinomiya city in Japan. Exclusive breast-feeding was chosen by 6,680 (43.8%) mothers, mixed-feeding by 4,645 (30.4%) mothers, and bottle-feeding with formula milk only by 3,900 (25.6%) mothers. The rate of exclusive breast-feeding among twins or triplets was significantly lower than among singleton babies: 4.1 % among twins or triplets, and 44.7 % among singletons. Twins and triplets were independently associated with a higher rate of bottle-feeding: the odds ratio indicated that mothers who had twins or triplets were 2.44 times more likely to choose bottle-feeding with formula milk only than those who had singletons.