Breastfeeding Intensity and Duration and Growth Trajectories in GDM Exposed Infants: The SWIFT Study

Area of Science:

• Pediatric endocrinology
• Infant nutrition
• Maternal-fetal medicine

Background:

• Gestational diabetes (GDM) in utero exposure may impact infant growth.
• The relationship between breastfeeding intensity and infant growth trajectories in GDM-exposed infants is not well understood.

Purpose of the Study:

• To identify distinct infant growth trajectory patterns.
• To examine associations between breastfeeding intensity and these growth trajectories among infants exposed to GDM.

Main Methods:

• Utilized the SWIFT Offspring cohort (n=435) of GDM-exposed infants.
• Assessed monthly summed lactation intensity ratio (sumLIR) as a measure of breastfeeding intensity.
• Employed latent class mixed models to analyze growth z-scores (WAZ, LAZ, WLZ) and skinfold thicknesses, with multinomial logistic regression for association analysis.

Main Results:

• Higher sumLIR throughout the first year was associated with lower odds of accelerated weight-for-length (WLZ) growth trajectories from infancy to 1 year.
• Increased breastfeeding intensity also correlated with a lower likelihood of accelerated weight-for-age (WAZ) growth after 6 months.
• No significant association was found between breastfeeding intensity and skinfold thickness trajectory classes.

Conclusions:

• Higher breastfeeding intensity (sumLIR) is associated with more favorable infant growth trajectories in GDM-exposed infants.
• These findings suggest that sustained breastfeeding, even when supplemented with formula, may offer growth benefits for this population.
• Further research can explore mechanisms linking breastfeeding intensity to improved growth outcomes in GDM-exposed infants.