Breast feeding, infant growth, and body mass index at 30 and 35 years
David M Fergusson1, Geraldine F H McLeod, L John Horwood
1Department of Psychological Medicine, Christchurch Health and Development Study, University of Otago, Christchurch, New Zealand.
Insights
Longer breastfeeding is linked to lower adult body mass index (BMI), but this effect is mediated by early infant growth. Early growth, not breastfeeding duration, predicts adult BMI, suggesting interventions targeting infant growth may prevent obesity.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Investigated the long-term associations between breastfeeding duration, infant growth, and adult body mass index (BMI).
- Utilized data from a birth cohort study extending to age 35.
Purpose of the Study:
- To examine the relationship between breastfeeding, early growth, and adult BMI.
- To determine if early growth mediates the association between breastfeeding and adult BMI.
Main Methods:
- Collected data on breastfeeding duration (exclusive and non-exclusive), early growth (0-9 months), and BMI at ages 30 and 35.
- Employed population-averaged generalized estimating regression models.
- Adjusted for perinatal, family, and social background factors.
Main Results:
- Longer breastfeeding duration was initially associated with lower adult BMI.
- Increasing early infant growth was associated with higher adult BMI.
- Early growth mediated the association between breastfeeding and adult BMI; breastfeeding was not independently significant after accounting for growth.
Conclusions:
- The protective association of breastfeeding against adult obesity is mediated by its effect on early infant growth.
- Interventions targeting early infant growth may be crucial for long-term obesity prevention.
- Breastfeeding can be a component of comprehensive obesity prevention programs.
Background:
This study examined the associations between duration of breast feeding, early infant growth, and body mass index (BMI) at 30 and 35 years, in a birth cohort studied to age 35.
Methods:
Data were gathered on duration of exclusive and non-exclusive breast feeding (months), early growth (kg; 0-9 months), and BMI at ages 30 and 35 from the Christchurch Health and Development Study. The Christchurch Health and Development Study is a study of a birth cohort of 1265 children, born in Christchurch in 1977.
Results:
Population-averaged generalised estimating regression models showed statistically significant associations between: duration of breast feeding and mean BMI; and early growth and mean BMI. After adjustment for perinatal, family, and social background factors, statistically significant associations were found between: longer duration of breast feeding and lower adult BMI (B = -0.424 [95% confidence interval (CI) -0.708, -0.140]); and increasing early growth and higher adult BMI (B = 0.393 [95% CI 0.080, 0.707]). When breast feeding and infant growth were entered into the regression model and adjusted for covariates, breast feeding was no longer statistically significantly associated with BMI (B = -0.250 [95% CI -0.553, 0.054]), while early growth remained statistically significantly associated with BMI (B = 0.355 [95% CI 0.039, 0.671]). A test for mediation showed that the association between breast feeding and BMI was mediated by early growth (P = 0.01).
Conclusions:
The association between longer duration of breast feeding and later lower BMI scores in adulthood was mediated by lower early growth. Breast feeding may be included as one component of multicompartment programmes targeted at early growth and later obesity.
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