Breastfeeding versus formula-feeding and girls' pubertal development
Aarti Kale1, Julianna Deardorff, Maureen Lahiff
1School of Public Health, University of California, Berkeley, Berkeley, CA, USA, kale.aarti@gmail.com.
Insights
Breastfeeding, particularly exclusive or predominant breastfeeding, is associated with a later onset of breast development in girls. The duration of breastfeeding also correlates with delayed pubertal timing, suggesting infant feeding influences pubertal onset.
Area of Science:
- Pediatric Endocrinology
- Reproductive Health
- Public Health Nutrition
Background:
- Early pubertal onset is linked to increased risks for adverse health outcomes in adulthood.
- Understanding factors influencing pubertal timing is crucial for public health interventions.
- Infant feeding practices, including breastfeeding, are potential modifiable factors affecting pubertal development.
Purpose of the Study:
- To investigate the relationship between breastfeeding (type and duration) and the timing of pubertal onset in girls.
- To explore the mediating role of Body Mass Index (BMI) in the association between breastfeeding and pubertal timing.
- To identify potential modifiable risk factors for pubertal maturation.
Main Methods:
- Prospective cohort study involving 1,237 socio-economically and ethnically diverse girls aged 6-8 years.
- Breastfeeding practices assessed via caregiver questionnaires; pubertal development (breast and pubic hair) monitored annually.
- Statistical analysis using parametric survival analysis, adjusting for covariates including BMI, ethnicity, and socioeconomic factors.
Main Results:
- Mixed-fed and predominantly breastfed girls exhibited a later onset of breast development compared to formula-fed girls.
- A significant positive association was found between breastfeeding duration and the age of breast development onset (p trend = 0.008).
- No significant associations were observed between breastfeeding and pubic hair onset; site-specific variations in findings were noted.
Conclusions:
- Breastfeeding, especially longer durations, appears to be associated with delayed breast development onset in girls.
- The influence of breastfeeding on pubertal timing may vary by geographic location and other environmental factors.
- Further research is needed to elucidate the complex interplay between infant feeding, environmental contexts, and pubertal development, potentially impacting long-term health.
Abstract:
To examine the association of breastfeeding or its duration with timing of girls' pubertal onset, and the role of BMI as a mediator in these associations. A population of 1,237 socio-economically and ethnically diverse girls, ages 6-8 years, was recruited across three geographic locations (New York City, Cincinnati, and the San Francisco Bay Area) in a prospective study of predictors of pubertal maturation. Breastfeeding practices were assessed using self-administered questionnaire/interview with the primary caregiver. Girls were seen on at least annual basis to assess breast and pubic hair development. The association of breastfeeding with pubertal timing was estimated using parametric survival analysis while adjusting for body mass index, ethnicity, birth-weight, mother's education, mother's menarcheal age, and family income. Compared to formula fed girls, those who were mixed-fed or predominantly breastfed showed later onset of breast development [hazard ratios 0.90 (95 % CI 0.75, 1.09) and 0.74 (95 % CI 0.59, 0.94), respectively]. Duration of breastfeeding was also directly associated with age at onset of breast development (p trend = 0.008). Associations between breastfeeding and pubic hair onset were not significant. In stratified analysis, the association of breastfeeding and later breast onset was seen in Cincinnati girls only. The association between breast feeding and pubertal onset varied by study site. More research is needed about the environments within which breastfeeding takes place in order to better understand whether infant feeding practices are a potentially modifiable risk factor that may influence age at onset of breast development and subsequent risk for disease in adulthood.
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