In the rapidly evolving field of pediatric healthcare, accurately assessing the body composition of full-term infants has emerged as a critical endeavor. The nuances of infant growth carry profound implications for long-term health outcomes, nutritional planning, and early interventions. However, a prevailing challenge persists within both clinical and research communities—identifying an optimal, standardized method for measuring infant body composition that balances precision, feasibility, and accessibility. A new comprehensive systematic review published in Pediatric Research on December 29, 2025, spearheaded by Schiødt et al., embarks on unraveling this complex issue, critically evaluating the spectrum of existing methodologies to discern the most effective approaches for clinical and research applications.
Despite the abundance of technologies available for body composition analysis in infants, ranging from non-invasive to minimally invasive techniques, no universal consensus has been reached regarding which modality should be prioritized. Infants represent a distinct population with unique physiological and anatomical attributes, including rapid developmental changes in fat and lean mass distribution, which pose significant measurement challenges. The study meticulously compares these technologies, surveying the scientific literature to assess their accuracy, reproducibility, cost, and applicability, all through the lens of real-world clinical practicality.
Among the most commonly employed methods examined are dual-energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP), bioelectrical impedance analysis (BIA), and skinfold thickness assessments. DXA, often hailed for its precision in adults and older children, faces limitations in infancy due to concerns over radiation exposure and the infant’s ability to remain still. ADP, utilizing volumetric displacement principles to evaluate body volume and density, offers a radiation-free, non-invasive alternative yet demands stringent compliance and specialized equipment, which may challenge feasibility in typical clinical settings.
Bioelectrical impedance analysis, leveraging the differential conductivity of lean and fat tissues, stands out for its portability and affordability but grapples with inconsistencies owing to hydration status, electrode placement, and calibration discrepancies in the infant population. Similarly, skinfold thickness measurement, rooted in anthropometry, provides an accessible, low-cost means of estimating subcutaneous fat but suffers from operator dependency and limited sensitivity, especially in infants with minimal fat stores.
The review further delves into emerging modalities on the frontier of infant body composition measurement, such as magnetic resonance imaging (MRI) and ultrasound techniques. MRI is lauded for its unparalleled detail, enabling differentiation between various tissue compartments with exceptional accuracy. However, its prohibitive cost, extended procedure duration, and the necessity for infant sedation in many cases restrict its widespread clinical use. Ultrasound, while non-invasive and radiation-free, requires skilled operators and standardized protocols to ensure reproducibility and comparability across studies.
Schiødt and colleagues emphasize that the gold standard for infant body composition must strike a delicate balance between technical precision and real-world implementation factors. They stress that an ideal modality should encompass minimal risk, high reproducibility, reasonable cost, and be relatively quick and comfortable for the infant. Their synthesis of current evidence suggests that no single method perfectly fulfills all these criteria, illuminating the need for ongoing innovation and validation.
Intriguingly, the systematic review underscores the critical role of multi-method approaches, advocating that combining complementary methods may yield more robust, reliable data on infant body composition. This multimodal strategy could offset individual method limitations by triangulating body fat, lean mass, and hydration status data, enhancing confidence in measurements used for both clinical diagnosis and longitudinal research studies. Such composite assessments might ultimately pave the way for personalized pediatric nutrition and care.
The review also illuminates the heterogeneity of study designs in the existing literature, often complicating direct comparisons between techniques. Variations in infant age, sample size, population demographics, and measurement protocols constitute significant barriers to consensus building. The authors call for standardized protocols and larger, multicenter studies to enhance methodological consistency and generalizability, thereby facilitating consensus on best practices.
In addition to clinical practicality, the review explores ethical and safety dimensions inherent to body composition measurement technologies in infants. Radiation exposure, the stress of the procedure on both infants and their caregivers, and the invasiveness of certain methods are crucial considerations, particularly in routine clinical care. Non-invasive and rapid methods tend to be preferable, but thorough validation is paramount to avoid reliance on potentially inaccurate proxies.
Nosological definitions of healthy infant growth are increasingly refined through enhanced body composition assessments. The conventional reliance on weight and length measurements alone cannot sufficiently capture the subtleties of adiposity and lean mass distribution, which are pivotal indicators of metabolic health and risk. The rigor and precision provided by advanced body composition techniques could transform neonatal care paradigms, enabling earlier identification of at-risk infants for obesity, malnutrition, or developmental delays.
Technological evolution continues at an accelerating pace, and next-generation tools harnessing artificial intelligence, machine learning, and advanced imaging algorithms promise to revolutionize infant body composition evaluation. Automating data acquisition and interpretation could reduce operator dependency and enhance reproducibility, allowing greater scalability in diverse clinical environments. The integration of wearable sensors and real-time monitoring modalities also beckons as a futuristic frontier in the domain.
The authors stress the ongoing need for interdisciplinary collaboration among pediatricians, nutritionists, biomedical engineers, and data scientists to drive forward the field. Clinical validity must align with engineering innovation to produce user-friendly, cost-effective, and ethically sound measurement tools. Such collaboration is vital to translate cutting-edge research findings into practical, impactful tools on the front lines of infant care.
In conclusion, this systematic review by Schiødt et al. provides an indispensable resource for clinicians and researchers navigating the complex landscape of infant body composition measurement. While the quest for a perfect gold standard continues, the synthesis of evidence illuminates clear pathways for future study, technological development, and clinical application. Accurate and practical body composition assessment stands as a cornerstone of advancing pediatric health, fostering improved outcomes from the very start of life.
As the neonatal and pediatric fields continue to evolve, the standardization of body composition measurement will play a foundational role in guiding nutrition, growth monitoring, and preventative care strategies tailored to individual infants. This research underscores the profound potential impact of precision measurement technologies, setting the stage for widespread adoption and integration into routine pediatric practice. The ongoing dialogue fostered by this review will undoubtedly shape the trajectory of infant health research and clinical care for years to come.
Ultimately, the integration of validated, accessible, and infant-friendly body composition methodologies promises to unlock new horizons in understanding early life development and health trajectories. As this review highlights, the synergy between technological innovation and clinical necessity is propelling the field toward a future where tailored, evidence-based care for infants begins with accurate, nuanced, and practical body composition assessment.
Subject of Research: Methods for measuring body composition in full-term infants
Article Title: An assessment of methods for measuring body composition in full-term infants: A systematic review
Article References:
Schiødt, S., Hviid, K.V.R., Geiker, N.R.W. et al. An assessment of methods for measuring body composition in full-term infants: A systematic review. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04717-3
Image Credits: AI Generated
DOI: 29 December 2025
Tags: body composition assessment in infantschallenges in measuring infant growth accuratelyclinical applications of body composition analysisdual-energy X-ray absorptiometry in pediatric careevaluating technologies for pediatric body compositionimplications of infant body composition on healthinfant health outcomes and body compositioninfant physiological development and measurement challengesnon-invasive techniques for infant healthnutritional planning for full-term infantsstandardized methods for infant body measurementsystematic review of infant body measurement methods
