Breastfeeding, Prepubertal Adiposity, and Development of Precocious Puberty

Area of Science:

• Pediatric Endocrinology
• Public Health Nutrition
• Childhood Development

Background:

• Central precocious puberty (CPP) incidence is rising globally, prompting concern about long-term health impacts.
• The relationship between early feeding practices and CPP development remains unclear.

Purpose of the Study:

• To examine the association between breastfeeding in the first 4-6 months and CPP incidence in children.
• To determine if prepubertal adiposity mediates this association.

Main Methods:

• A nationwide retrospective cohort study utilizing South Korean National Health Insurance Service data (2007-2020).
• Inclusion of children with routine checkups at 4-6 months and 66-71 months.
• Analysis of feeding patterns via caregiver questionnaires and CPP diagnosis using ICD-10 codes and GnRH agonist treatment.

Main Results:

• Compared to exclusive breastfeeding, formula feeding was associated with increased CPP risk in boys (AHR, 1.16) and girls (AHR, 1.60).
• Mixed feeding also showed increased CPP risk in boys (AHR, 1.14) and girls (AHR, 1.45).
• Prepubertal adiposity mediated 7.2% of the association in boys and 17.8% in girls.

Conclusions:

• Breastfeeding in early infancy is associated with a lower risk of CPP.
• The findings underscore the importance of early nutrition for regulating pubertal timing.
• Part of the protective effect of breastfeeding is mediated through the prevention of childhood adiposity.