Studies on childhood obesity mainly focus on the genetic component and on the lifestyle that may be associated with the development of obesity. However, the study of perinatal factors in their programming effect towards future obesity in children or adults is somewhat more recent and there are still mechanisms to be disentangled.
In this narrative review, a comprehensive route based on the influence of some early factors in life in the contribution to later obesity development is presented. Maternal pre-pregnancy BMI and gestational weight gain has been pointed out as independent determinants of infant later adiposity. Lifestyle interventions could have an impact on pregnant mothers throught epigenetic mechanisms capable of redirecting the genetic expression of their children towards a future healthy weight and body composition and dietary-related microbiome modifications in mothers and newborn might also be related. After birth, infant feeding during the first months of life is directly associated with its body composition and nutritional status. From this point of view, all the expert committees in the world are committed to promote exclusive breastfeeding up to 6 months of age, and to continue at least until the first year of life together with complementary feeding based on healthy dietary patterns such as Mediterranean Diet.
To develop future effective programs to tackle early obesity, is necessary not only by controlling lifestyle behaviors like infant feeding but also understanding the role of other mechanisms like the effect of perinatal factors such as maternal diet during pregnancy, epigenetics or microbiome.

S. Karger AG, Basel.