Abstract

Complementary feeding (CF) should start between 4–6 months of age to ensure infants’ growth but is also linked to childhood obesity. This study aimed to investigate the association of the timing of CF, breastfeeding and overweight in preschool children. Infant-feeding practices were self-reported in 2012 via a validated questionnaire by >7500 parents from six European countries participating in the ToyBox-study. The proportion of children who received breast milk and CF at 4–6 months was 51.2%. There was a positive association between timing of solid food (SF) introduction and duration of breastfeeding, as well as socioeconomic status and a negative association with smoking throughout pregnancy (p < 0.005). No significant risk to become overweight was observed among preschoolers who were introduced to SF at 1–3 months of age compared to those introduced at 4–6 months regardless of the type of milk feeding. Similarly, no significant association was observed between the early introduction of SF and risk for overweight in preschoolers who were breastfed for ≥4 months or were formula-fed. The study did not identify any significant association between the timing of introducing SF and obesity in childhood. It is likely that other factors than timing of SF introduction may have impact on childhood obesity.

Highlights

  • Obesity is an increasing worldwide problem with an estimate of 340 million overweight or obese children and adolescents aged 5–19 in 2016 and 38.2 million children under the age of 5 years being overweight or obese worldwide in 2019

  • Our study investigated the association between the timing of Complementary feeding (CF), breastfeeding status and overweight among European preschool children

  • Maternal educational level did not modify the association of CF < 4 months of age and overweight in the PIAMA cohort as well [19]

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Summary

Introduction

Obesity is an increasing worldwide problem with an estimate of 340 million overweight or obese children and adolescents aged 5–19 in 2016 and 38.2 million children under the age of 5 years being overweight or obese worldwide in 2019. Health expenditures for the adult population are constantly increasing, €70 billion per year in Europe (2017) and $342.2 billion in the US (2013). One of the risk factors for childhood obesity is inappropriate nutrition during infancy. The advantages of exclusive breastfeeding (EBF) compared to partial breastfeeding in the first months of life have been recognized. The World Health Organization’s global public health recommendations promote “exclusive breastfeeding for 6 months” with continued breastfeeding up to the age of two years or beyond. The recommended period for starting CF as stated by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition is at week 17–26 (between the beginning of the fifth month and the beginning of the seventh month of life) [8]. Smoking habits throughout pregnancy 1 1 (reference) 1.50 (0.75–3.01).

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