Is the association of breastfeeding with child obesity explained by infant weight change?
Lenie van Rossem1, Elsie M Taveras, Matthew W Gillman
1The Generation R Study Group, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands. l.vanrossem@erasmusmc.nl
Insights
Infant weight change partially mediates the link between breastfeeding and childhood adiposity. Early infant weight changes influence later body mass index (BMI) and obesity risk.
Area of Science:
- Pediatrics
- Public Health
- Childhood Obesity
Background:
- Breastfeeding and infant weight change are linked to childhood adiposity.
- Understanding these relationships is crucial for public health interventions.
Purpose of the Study:
- To investigate the extent to which infant weight change mediates the association between breastfeeding and adiposity at age 3 years.
Main Methods:
- Prospective cohort study of 884 children.
- Assessed breastfeeding status in the first 6 months.
- Measured body mass index (BMI) z score, skinfold thicknesses, and obesity at age 3 years.
- Defined infant weight change as the change in weight-for-age z score between birth and 6 months.
- Utilized multivariable regression analyses.
Main Results:
- Fully breastfed children had lower BMI z scores compared to never breastfed children.
- Infant weight change partially attenuated the association between breastfeeding and BMI z score.
- Infant weight change modestly attenuated associations with skinfold thicknesses and obesity risk.
Conclusions:
- Infant weight change between birth and 6 months partially mediates the association between breastfeeding and BMI.
- The mediation effect is partial for other indicators of child adiposity.
Objective:
Breastfeeding and infant weight change are both associated with adiposity. We examined the extent to which infant weight change mediates the association between breastfeeding and adiposity at age 3 years.
Methods:
We studied 884 children in a prospective cohort study. We determined breastfeeding status in the first 6 months. Our primary outcomes at 3 years were body mass index (BMI) z score and the sum of subscapular and triceps skinfold thicknesses (SS + TR); we also assessed obesity. We defined infant weight change as change in weight-for-age z score between birth and 6 months. We performed multivariable regression analyses.
Results:
At age 6 months, 25.0% of infants were fully breastfed. At age 3 years, mean (standard deviation) BMI z score was 0.45 (1.03). In linear regression analyses adjusted for mother's educational level, race/ethnicity, smoking, BMI, pregnancy weight gain and birth weight (adjusted for gestational age), the BMI z score of fully breastfed children was 0.17 (95% CI: -0.43, 0.09) units lower than never breastfed children. After additional adjustment for infant weight change, the estimate was attenuated (-0.03, 95% CI: -0.27, 0.20). Adjustment for infant weight change only modestly attenuated estimates for SS + TR (from -1.48 mm [95% CI: -2.52, -0.44] to -1.16 mm [95% CI: -2.18, -0.14]), and for the odds of being obese (from 0.21 [95% CI: 0.07, 0.68] to 0.29 [95% CI: 0.08, 1.05]).
Conclusion:
Infant weight change between birth and 6 months mediates associations of breastfeeding with BMI, but only partially with indicators of child adiposity.
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