Abstract
The aim of this study was to assess the association between amount (below or above recommendations), preparation (liquid vs. powder), and type (regular vs. hydrolysate) of infant formula consumed and weight in infants participating in the Women, Infant and Children (WIC) Program in Hawaii (HI) and Puerto Rico (PR). This was a secondary analysis of 162 caregivers with healthy term 0–2-month-old infants. Socio-demographics, infant food frequency questionnaires, and weight and length were assessed at baseline and after four months. Infant feeding practices were associated with weight-for-length z-scores using multivariable logistic regression. In total, 37.7% were exclusively breastfed and 27.2% were exclusively formula-fed. Among formula users, regular (63.6%) and powder (87.0%) formula were the most common; 43.2% consumed formula above recommendations. Most infants had rapid weight gain (61.1%). Infants fed regular formula had higher odds of overweight after four months (adjusted OR = 8.77, 95% CI: 1.81–42.6) and higher odds of rapid weight gain (adjusted OR = 3.10, 95% CI: 1.12, 8.61). Those exclusively formula fed had higher odds of slow weight gain (adjusted OR = 4.07, 95% CI: 1.17–14.2). Formula preparation and amount of formula were not associated with weight. These results could inform the WIC program’s nutrition education messages on infant feeding. Studies with longer follow-up are needed to confirm these results.
Highlights
Prevalence of infant obesity in the US has been estimated at 8.1% [1]
The present study evaluated the association between the type of feeding, formula amount, formula type, and formula preparation during the first two months of life with the risk of overweight and rapid weight gain four months later among infants participating in the WIC program in Hawaii and Puerto Rico
We found that infants fed regular formula had 8.77 higher odds of being overweight at the follow-up visit compared to those fed hydrolysate formula, even after adjusting for important confounders
Summary
Prevalence of infant obesity in the US has been estimated at 8.1% [1]. This is higher among infants participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)(12.3%) [2], among Hispanic (16.4%) and Native Hawaiian (19.3%) compared to AfricanAmerican (13.0%) and White (13.9%) infants [2].Early life growth patterns and behaviors have been recognized as playing an important role in obesity, even though these might not be evident during the early stages of life [3]. Prevalence of infant obesity in the US has been estimated at 8.1% [1]. This is higher among infants participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Early modifiable risk factors could have an impactful influence on the long-term health of infants. Multiple factors affect the growth trajectory in infant, but nutrition is considered a key determinant [9]. Breastfeeding has been long recognized to help reduce the risk of obesity compared to non-breastfeeding [10,11]. Formula feeding has been associated with a higher risk of obesity
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