Abstract
Rapid infant growth is positively, and breastfeeding inversely, associated with childhood overweight. However, the interplay has only been sparsely investigated. We aimed to investigate how exclusive breastfeeding duration modify the effect of infant growth on childhood overweight. We included routinely collected data on duration of exclusive breastfeeding and child growth from Aarhus Municipality, Denmark, and on maternal health from the patient records at Aarhus University Hospital, 2008-2013. Infant growth was estimated using latent class analysis. Duration of exclusive breastfeeding was grouped in never, ≤4 months, and >4 months. Childhood overweight was defined as a BMI Z-score of >1 at age 5-9 years. We investigated the risk of overweight dependent on infant growth and breastfeeding duration both independently and combined using logistic regression and adjusting for potential confounders. In 7,074 infants we identified three growth patterns: average, accelerated, and decelerated. Never or ≤4 months of breastfeeding was associated with being overweight at 5-9 years (adjusted odds ratio (aOR): 1.61 [95% CI: 1.27 -2.03] and aOR: 1.54 [95% CI: 1.28 - 1.85], respectively) compared to >4 months of breastfeeding. Accelerated, as compared to average, infant growth was associated with childhood overweight (aOR: 1.35 [95% CI: 1.01 - 1.79]). In the combined analysis, accelerated infant growth showed no evidence of being associated with overweight if infants were exclusively breastfed >4 months (aOR: 1.20 [0.68-2.10]). Decelerated growth was not associated with overweight regardless of exclusive breastfeeding duration, compared to infants with average growth who were exclusively breastfed >4 months. Longer duration of exclusive breastfeeding was associated with decreased risk of being overweight, while accelerated infant growth was associated with increased risk. Children with accelerated infant growth who were never breastfed had the highest risk of overweight at 5-9 years of age, while there was no association if the infants were exclusively breastfed >4 months.
Published Version
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