BACKGROUND: There is increasing evidence that in utero growth has both immediate and far-reaching influence on health. Birth weight and length are used as surrogate measures of in utero growth. However, these measures poorly reflect neonatal adiposity. Air-displacement plethysmography has been validated for the measurement of body fat in the neonatal population.OBJECTIVE: The goal of this study was to show the normal reference values of percentage body fat (%BF) in infants during the first 4 days of life.METHODS: As part of a large population-based birth cohort study, fat mass, fat-free mass, and %BF were measured within the first 4 days of life using air-displacement plethsymography. Infants were grouped into gestational age and gender categories.RESULTS: Of the 786 enrolled infants, fat mass, fat-free mass, and %BF were measured in 743 (94.5%) infants within the first 4 days of life. %BF increased significantly with gestational age. Mean (SD) %BF at 36 to 376/7 weeks' gestation was 8.9% (3.5%); at 38 to 396/7 weeks' gestation, 10.3% (4%); and at 40 to 416/7 weeks' gestation, 11.2% (4.3%) (P < .001). Female infants had significantly increased mean (SD) %BF at 38 to 396/7(11.1% [3.9%] vs 9.8% [3.9%]; P = .012) and at 40 to 416/7 (12.5% [4.4%] vs 10% [3.9%]; P < .001) weeks' gestation compared with male infants. Gender-and gestational age-specific centiles were calculated, and a normative table was generated for reference.CONCLUSION: %BF at birth is influenced by gestational age and gender. We generated accurate %BF centiles from a large population-based cohort. Pediatrics 2011; 128: e645-e651