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

Saralyn F Foster1, Elizabeth M Widen1, Joan C Lo2

  • 1The University of Texas at Austin, Austin, Texas, USA.

Pediatric Obesity
|August 8, 2026
PubMed

Insights

Higher breastfeeding intensity in the first year is linked to healthier growth trajectories for infants exposed to gestational diabetes (GDM). Continued breastfeeding, even with formula, may benefit GDM-exposed infants.

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.
Abstract

Keywords:
LCMMbreastfeedinggestational diabeteslactation intensity

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