Infant feeding practices and body mass index up to 7.5 years in the French nationwide ELFE study
Aurore Camier1, Aminata Hallimat Cissé1, Barbara Heude1
1Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France.
Insights
Early complementary feeding (<4 months) is linked to higher childhood BMI, while breastfeeding benefits are mainly seen in infancy. These infant feeding practices impact long-term growth trajectories.
Area of Science:
- Pediatric Nutrition
- Growth and Development
- Public Health
Background:
- Infant diet is a key modifiable factor influencing early childhood growth.
- Understanding infant feeding practices is crucial for preventing childhood obesity.
Purpose of the Study:
- To investigate the long-term associations between infant feeding practices and body mass index (BMI) up to 7.5 years of age.
- To analyze the impact of breastfeeding and complementary feeding on childhood BMI trajectories.
Main Methods:
- Utilized data from the French ELFE birth cohort study.
- Employed principal component analyses and hierarchical ascendant classification to characterize infant feeding patterns.
- Linear regression models adjusted for confounders examined associations between feeding practices and BMI z-scores from infancy to 7.5 years.
Main Results:
- Breastfeeding duration showed a link to lower BMI at 1 year but not later in childhood.
- Early complementary feeding introduction (<4 months) was associated with higher BMI up to 7.5 years.
- Specific feeding patterns, like early cereal introduction, were linked to lower BMI throughout childhood.
Conclusions:
- Breastfeeding's positive impact on BMI is primarily observed in infancy.
- Early complementary feeding (<4 months) is a significant risk factor for elevated childhood BMI.
- Infant feeding strategies play a critical role in shaping long-term body mass index.
Background/Objectives:
The infant diet represents one of the main modifiable determinants of early growth. This study aimed to investigate the associations of infant feeding practices with body mass index (BMI) until 7.5 years.
Subjects/Methods:
Analyses were based on data from the French nationwide ELFE birth cohort. Data on breastfeeding (BF) and complementary feeding (CF) were collected monthly from 2 to 10 months. Infant feeding practices were characterized using principal component analyses (PCA) and hierarchical ascendant classification. BMI z-score was computed at 1, 2, 3, 5 and 7.5 years, from data collected in the child's health booklet; 7.5-year overweight was defined according to IOTF references. Associations between infant feeding practices and BMI were investigated by linear regression models adjusted for main confounders.
Results:
Ever breastfeeding was not associated with BMI up to 7.5 years. Compared to intermediate breastfeeding duration (1 to <3 months), longer breastfeeding duration (≥6 months) was related to lower 1-year BMI, but not at older ages. Compared to the recommended age at CF introduction (4-6 months), early CF (<4 months) was related to higher BMI up to 5 years with a similar trend at 7.5 years, but not to the risk of overweight. The PCA patterns characterized by early baby cereal introduction and late food pieces introduction or by frequent intake of main food groups were related to a lower BMI up to 7.5 years.
Conclusion:
Breastfeeding was related with a lower BMI in infancy but not thereafter, whereas an early CF initiation (<4 months) was associated with a higher BMI in childhood.
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