Greater Breastfeeding in Early Infancy Is Associated with Slower Weight Gain among High Birth Weight Infants

J Pediatr. 2018 Oct:201:27-33.e4. doi: 10.1016/j.jpeds.2018.06.004. Epub 2018 Jul 13.

Abstract

Objective: To examine whether feeding patterns from birth to age 6 months modify the association between birth weight and weight at 7-12 months of age.

Study design: Longitudinal mixed models were used to examine feeding trajectories across categories of birth weight and weight at 7-12 months of age in 1799 mother-infant dyads enrolled in the Infant Feeding Practices Study II. The percentage of breast milk received and the average daily formula consumption were calculated from birth to 6 months of age. Birth weights were classified as high (≥4000 g) and normal (≥2500 g and <4000 g). Weights at 7-12 months of age were categorized as high (z score >1) or normal (z score ≤1). A secondary analysis was performed using categories defined by birth weight adjusted for gestational age percentiles (>90% and 10th-90th percentile).

Results: High birth weight (HBW) infants with high weights at 7-12 months of age demonstrated a rapid decline in the percentage of breast milk feedings compared with HBW infants with normal weights at 7-12 months of age. Normal birth weight infants with high weights at 7-12 months of age received a lower percentage of breast milk and had greater absolute intakes of formula than those with normal weights at 7-12 months of age; these associations did not vary over time. Results were similar when infants were categorized by birth weight percentiles.

Conclusions: A lower proportion of breast milk feedings was associated with excess weight at 7-12 months of age in HBW infants. These findings suggest an initial target for obesity prevention programs focusing on the first 6 months after birth.

Keywords: high birth weight; infant growth; large-for-gestational age; macrosomia; normal birth weight; pediatric obesity.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Birth Weight*
  • Breast Feeding / statistics & numerical data*
  • Female
  • Humans
  • Infant
  • Infant Formula / statistics & numerical data
  • Infant Nutritional Physiological Phenomena
  • Infant, Newborn
  • Linear Models
  • Longitudinal Studies
  • Male
  • Pediatric Obesity / prevention & control
  • Surveys and Questionnaires
  • Weight Gain*