Background: Differences in the growth pattern of breastfed (BF) and formula-fed (FF) infants are well-recognized and have been attributed to differences in nutrient intake. However, the impact of qualitative and quantitative differences in nutrient intake on the body composition of BF and FF infants has been unclear. Furthermore, it is unknown whether putative differences in body composition persist beyond weaning.
Design: Prospective cohort study.
Methods: Repeated anthropometric and body composition measurements were performed on 40 BF and 36 FF infants at 0.5, 3, 6, 9, 12, 18, and 24 months of age. A multicomponent body composition model based on total body water by deuterium dilution, total body potassium by whole body counting, and bone mineral content by dual-energy x-ray absorptiometry was used to estimate fat-free mass (FFM) and fat mass (FM). Independent measurements of FFM and FM were made using total body electrical conductivity and dual-energy x-ray absorptiometry. By design, infants were either exclusively BF or FF from birth to 4 months of age; thereafter, the feeding mode was at the discretion of the parents. Infant food intake was measured at 3, 6, 12, and 24 months of age using 3-day weighed-intake records. Data were analyzed by repeated measures analysis of variance.
Results: Weight velocity was higher in FF than BF infants age 3 to 6 months, and higher in FF than BF girls 6 to 9 months of age. Adjusted for gender and baseline values, BF infants had lower total body water at 3 months, lower total body potassium at 3 to 24 months, and lower bone mineral content at 12 months. The multicomponent model indicated that FFM was lower in BF than FF infants at 3 months, and FM and %FM were higher in BF than FF infants at 3 and 6 months (boys only). Total body electric conductivity confirmed lower FFM in BF than FF infants at 3 months, as well as at 6 and 9 months; FM and %FM were higher in BF than FF at 3 and 6 months, and 9 months (boys only). Intakes of energy, protein, fat, and carbohydrate were lower in BF than FF infants at 3 and 6 months, and were positively correlated with weight gain and FFM gain, but not FM gain. No differences in nutrient intakes were observed at 12 or 24 months.
Conclusion: Infant feeding mode is associated with differences in body composition in early infancy which do not persist into the second year of life.