Abstract
High infant weight increases the risk of childhood overweight, while breastfeeding may reduce the risk. However, some infants have a very high weight gain even though they are exclusively breastfed. We examined the risk of a high body mass index (BMI) and overweight in childhood for infants ≥2.5 SD above the median weight‐for‐age (WAZ) at age 5 months according to duration of exclusive breastfeeding (≤2, >2 to <4 or ≥4 months). The study is based on 13,401 7‐year‐old and 9,819 11‐year‐old children enrolled into the Danish National Birth Cohort (born 1997–2003). Linear and logistic regression analyses were used to examine the associations while adjusting for presumed confounders including birth weight. The results showed that infants ≥2.5 SD at 5 months, breastfed exclusively ≤2, >2 to <4 or ≥4 months had adjusted odds ratios (ORs) for overweight at age 7 at 3.67 (95% confidence interval [CI] [2.10, 6.43]), 3.42 (95% CI [2.32, 5.04]) and 3.19 (95% CI [1.90, 5.36]) respectively, when compared with infants <2.5 SD WAZ exclusively breastfed ≥4 months. The corresponding results for BMI z‐scores were 0.82 (95% CI [0.60, 1.04]), 0.63 (95% CI [0.48, 0.78]) and 0.57 (95% CI [0.38, 0.77]). For the ≥2.5 SD infants, the differences in risk of overweight and BMI according to duration of exclusive breastfeeding were neither significantly different among the 7‐year nor among the 11‐year‐old children. A high infant weight increases the odds of overweight and is associated with a higher BMI in childhood. Whereas the odds and BMI z‐scores tended to be lower for those exclusively breastfed longer, the differences were not statistically significant.
Highlights
Infancy and childhood is a sensitive period in relation to development of overweight and obesity later in life (Woo Baidal et al, 2016)
We examined the risk of a high body mass index (BMI) and overweight in childhood for infants ≥2.5 SD above the median weight-for-age (WAZ) at age 5 months according to duration of exclusive breastfeeding (≤2, >2 to
Information on gestational weight gain was obtained from the interview 6 months postpartum and was converted into kg per week of the actual gestational length and was included as a continuous measure; because high birth weight is associated with breast feeding, infant weight gain and with later risk of overweight and obesity (Rugholm et al, 2005; Woo Baidal et al, 2016), we included information on birth weight, which was collected from The Medical Birth Registry (Knudsen et al, 1998)
Summary
Infancy and childhood is a sensitive period in relation to development of overweight and obesity later in life (Woo Baidal et al, 2016). The ‘growth acceleration hypothesis’ suggests that the early rapid growth influences the infant's metabolic profile leading to increased susceptibility to later obesity (Singhal et al, 2007) This hypothesis has shown to be relevant for the first 6 months of life (Bjerregaard et al, 2014; Singhal et al, 2007; Young, Johnson, & Krebs, 2012). In the explorative cohort study by Larsson, Lind et al, it is suggested that low milk leptin content could increase appetite and have a role in the excessive weight gain during breastfeeding (Larsson, Lind et al, 2018) These studies did not address the long-term risk of overweight and obesity in these infants. We tested this hypothesis in the DNBC by estimating the associations of combined high weight at age 5 months and different durations of exclusive breastfeeding with overweight and BMI in childhood
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