Abstract
BackgroundMaternal obesity and rapid infant weight gain have been associated with increased risk of obesity in childhood. Breastfeeding is suggested to be protective against childhood obesity, but no previous study has addressed the potential benefit of breastfeeding as a preventive method of childhood obesity amongst obese women. The primary aim of this study was to assess the relationship between mode of feeding and body composition, growth and eating behaviours in 6-month-old infants of obese women who participated in UPBEAT; a multi-centre randomised controlled trial comparing a lifestyle intervention of diet and physical activity to standard care during pregnancy.MethodsThree hundred and fifty-three mother and infant pairs attended a 6-months postpartum follow-up visit, during which they completed the Baby-Eating Behaviour Questionnaire, a parent-reported psychometric measure of appetite traits. Measures of infant body composition were also undertaken. As there was no effect of the antenatal intervention on infant feeding and appetite the study was treated as a cohort. Using regression analyses, we examined relationships between: 1) mode of feeding and body composition and growth; 2) mode of feeding and eating behaviour and 3) eating behaviour and body composition.ResultsFormula fed infants of obese women in comparison to those exclusively breastfed, demonstrated higher weight z-scores (mean difference 0.26; 95% confidence interval 0.01 to 0.52), higher rate of weight gain (0.04; 0.00 to 0.07) and greater catch-up growth (2.48; 1.31 to 4.71). There was also a lower enjoyment of food (p = 0.002) amongst formula fed infants, following adjustment for confounders. Independent of the mode of feeding, a measure of infant appetite was associated with sum of skinfold thicknesses (β 0.66; 95% CI 0.12 to 1.21), calculated body fat percentage (0.83; 0.15 to 1.52), weight z-scores (0.21; 0.06 to 0.36) and catch-up growth (odds ratio 1.98; 1.21 to 3.21).ConclusionsIn obese women, exclusive breastfeeding was protective against increasing weight z-scores and trajectories of weight gain in their 6-month old infants. Measures of general appetite in early infancy were associated with measures of adiposity, weight and catch up growth independent of cord blood leptin concentrations and mode of early feeding.
Highlights
Maternal obesity and rapid infant weight gain have been associated with increased risk of obesity in childhood
The trajectory of growth associated with the development of obesity in childhood may be established as early as 5 years of age in offspring born to mothers of heterogeneous body mass index (BMI) [9]
There was no difference in distribution of infant anthropometry by offspring sex, and data was not stratified by infant sex (Additional file 4: Figure S1)
Summary
Maternal obesity and rapid infant weight gain have been associated with increased risk of obesity in childhood. The early infant growth trajectory has been linked to long term health [5, 6] as evidenced by the association between rapid early weight gain in the first few years of life and increased blood pressure [7], greater risk of obesity and the development of diabetes [8]. Recent observational studies have demonstrated a role for early postnatal nutritional status and growth in the development of childhood obesity. These studies provide supporting evidence that early life mode and/or duration of feeding method may be a modifiable factor for optimising early growth trajectories [10, 11]
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