Infants with Excessive Weight Gain while Exclusively Breastfeeding: Follow-Up at 36 Months
Anni Larnkjær1, Melanie W Larsson1,2, Jonathan Wells3
1Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
Insights
Infants experiencing excessive weight gain (EWG) during exclusive breastfeeding (EBF) showed normalization of body composition by 36 months. Their body mass index-for-age z-scores and fat mass decreased, while lean mass increased.
Area of Science:
- Pediatrics
- Human Nutrition
- Growth and Development
Background:
- Rapid infant weight gain is linked to later adiposity.
- Excessive weight gain (EWG) during exclusive breastfeeding (EBF) is rare but can occur.
- Understanding long-term outcomes of EWG during EBF is crucial for infant health.
Purpose of the Study:
- To investigate growth and body composition at 36 months in infants with EWG during EBF.
- To analyze changes in body mass index-for-age z-scores (BAZ), fat mass, and lean mass.
- To assess plasma leptin concentrations in relation to body composition changes.
Main Methods:
- Followed ten infants with EWG during EBF from 5 months to 36 months.
- Conducted anthropometry and body composition analysis using bioimpedance.
- Collected blood samples for plasma leptin concentration measurements.
Main Results:
- From 5 to 36 months, mean BAZ decreased from 2.33 to 1.48, with only one child remaining overweight.
- Fat mass and fat mass index (FMI) decreased significantly between 18 and 36 months.
- Lean mass increased more than total weight gain, indicating fat loss, accompanied by a 45% decrease in leptin.
Conclusions:
- Infants with EWG during EBF demonstrated a normalization trend in body weight and composition by 36 months.
- The observed increase in fat-free mass suggests ongoing metabolic adaptation.
- These findings highlight a potential self-correcting mechanism in rare cases of infant EWG.
Abstract:
Rapid weight gain in infancy is associated with an increased risk of later adiposity. Very rarely, however, exclusively breastfed infants experience excessive weight gain (EWG) during the period of exclusive breastfeeding (EBF) when breast milk is the only source of nutrition. We investigated growth and body composition at 36 months in children experiencing EWG during EBF. Ten infants with EWG during the first 6 months of EBF were followed up at 36 months. The infants had been followed from age 5 months. Examinations included anthropometry, body composition by bioimpedance, and blood samples. Body composition and plasma leptin concentrations were available for eight and five children, respectively. From 5 to 36 months, body mass index-for-age z-scores (BAZ) decreased from (mean ± standard deviation) 2.33 ± 0.94 to 1.48 ± 0.57, and only one child still being overweight (BAZ >2). Fat mass and fat mass index (FMI) decreased from 18 to 36 months (4.71 ± 0.56 to 3.57 ± 0.67 kg and 6.50 ± 0.34 to 3.66 ± 0.72 kg/m2, respectively) with a concurrent 45% decrease in leptin. The increase in lean mass was higher than the increase in weight (5.27 versus 3.65 kg, respectively) due to fat loss. There was substantial conformity within the sample in the patterns of body composition change. This unusual group of children continued to decrease in BAZ and FMI with a concomitant increase in fat-free mass, indicating an ongoing normalization of body weight and composition.
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