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Infant Feeding and Weight Gain: Separating Breast Milk From Breastfeeding and Formula From Food

Meghan B Azad1,2,3, Lorena Vehling4,2, Deborah Chan4,2

  • 1Departments of Pediatrics and Child Health and meghan.azad@umanitoba.ca.

Pediatrics
|September 26, 2018
PubMed

Insights

Breastfeeding duration and exclusivity impact infant obesity risk. Supplementation with formula after the neonatal period, but not solids, is linked to higher body mass index z-scores.

Area of Science:

  • Pediatrics
  • Public Health
  • Nutrition Science

Background:

  • Breastfeeding is recognized for its health benefits, yet specific feeding practices and their association with infant obesity remain under-documented.
  • Previous studies often lack detailed information on feeding methods, supplementation types, and in-hospital feeding practices.

Purpose of the Study:

  • To investigate the relationship between various breastfeeding and supplementation practices and infant body mass index (BMI) z-scores (BMIzs) at 12 months.
  • To examine how the method of milk feeding (direct breastfeeding vs. expressed milk vs. formula) and timing of supplementation influence infant adiposity.

Main Methods:

  • Utilized data from the CHILD birth cohort, including maternal reports and hospital records for feeding practices.
  • Measured infant weight and BMIzs at 12 months, controlling for maternal BMI and other potential confounders.
  • Employed regression analyses to assess associations between feeding styles and BMIzs.

Main Results:

  • 97% of 2553 mother-infant dyads initiated breastfeeding, with a median duration of 11.0 months.
  • Exclusive direct breastfeeding at 3 months was associated with the lowest BMIzs. Partial breastfeeding, use of expressed milk, and exclusive formula feeding were linked to significantly higher BMIzs.
  • Formula supplementation by 6 months was associated with increased BMIzs, while solid food supplementation was not. Brief in-hospital formula supplementation did not negatively impact BMIzs if exclusive breastfeeding was sustained for at least 3 months.

Conclusions:

  • Breastfeeding demonstrates a dose-dependent inverse association with infant weight gain velocity and BMI.
  • Feeding expressed breast milk from a bottle partially diminishes these protective effects.
  • Formula supplementation after the neonatal period substantially weakens the protective association of breastfeeding against infant obesity.
Abstract

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