Breastfeeding duration and weight gain trajectory in infancy

Abstract

Background and objectives: Short breastfeeding duration may exacerbate accelerated early growth, which is linked to higher obesity risk in later life. This study tested the hypothesis that infants at higher risk for obesity were more likely to be members of a rising weight-for-length (WFL) z score trajectory if breastfed for shorter durations.

Methods: This prospective, observational study recruited women from an obstetric patient population in rural central New York. Medical records of children born to women in the cohort were audited for weight and length measurements (n = 595). We identified weight gain trajectories for infants' WFL z scores from 0 to 24 months by using maximum likelihood latent class models. Individual risk factors associated with weight gain trajectories (P ≤ .05) were included in an obesity risk index. Logistic regression analysis was performed to investigate whether the association between breastfeeding duration (<2 months, 2-4 months, >4 months) and weight gain trajectory varied across obesity risk groups.

Results: Rising and stable weight gain trajectories emerged. The obesity risk index included maternal BMI, education, and smoking during pregnancy. High-risk infants breastfed for <2 months were more likely to belong to a rising rather than stable weight gain trajectory (odds ratio, 2.55; 95% confidence interval, 1.14-5.72; P = .02).

Conclusions: Infants at the highest risk for rising weight patterns appear to benefit the most from longer breastfeeding duration. Targeting mothers of high-risk infants for breastfeeding promotion and support may be protective against overweight and obesity during a critical window of development.

Keywords: breastfeeding; infants; obesity; weight-for-length z score trajectory.

FIGURE 1

WFL z score trajectories with 95% confidence intervals (dotted lines) that emerged from latent class modeling. A, High–rising trajectory containing 19.8% of analysis sample. B, Low–rising trajectory containing 27.9% of analysis sample. C, Mid–stable trajectory containing 23.4% of analysis sample. D, Low–stable trajectory containing 28.9% of analysis sample. The red solid line is added for reference to WFL z score equal to 0.