Breastfeeding on childhood obesity in children were large-for-gestational age: retrospective study from birth to 4 years

Abstract

Our aim was to assess effects of breast-feeding (BF) in the association between large-for-gestational age (LGA) and body mass index (BMI) trajectories on childhood overweight from 1 to 4 years old. A total of 1649 healthcare records of mother-child pairs had detailed records of feeding practices and were included in this retrospective cohort study. Data were available in Medical Birth Registry of Xiamen between January 2011 and March 2018. Linear and logistic regression models were used to access the difference between BF and no-BF group. For offspring were LGA and BF was significantly associated with a lower BMI Z-score from 1 to 4 years old after adjustment confounders in Model 1 to 3 [difference in BMI Z-score in Model 1: estimated β: -0.07 [95%CI: -0.13 to -0.01]; Model 2: estimated β: -0.07 (-0.13 to -0.004); Model 3: estimated β: -0.06 (-0.12 to -0.001); P = 0.0221, 0.0371, 0.0471]. A significantly lower risk of childhood overweight was observed in Model 1 [odd ratio (OR): 0.85 (95%CI, 0.73 to 1.00)], P = 0.0475) with adjustment for maternal pre-pregnancy BMI. Furthermore, Model 2 and Model 3 showed LGA-BF infants had a lower risk for childhood overweight then LGA-no-BF infants [OR: 0.87 and 0.87 (95%CI, 0.73 to 1.03; 0.74 to 1.03)], however, there was no statistical significance (P = 0.1099, and 0.1125)]. BF is inversely related to BMI Z-score and risk for overweight in children were LGA from 1 to 4 years old. Adjustment for maternal pre-pregnancy BMI, the protective association between BF and childhood overweight was more significant.

Figure 1

BMI Z-score trajectories of children were LGA-BF and LGA-no-BF from 1 to 4 years in different models. LGA large-for-gestation age, BMI body mass index, BF breast-feeding. Model 1, adjusted for maternal pre-pregnancy BMI; Model 2, adjusted for covariates in Model 1 + maternal age, education, and child sex; Model 3, adjusted for covariates in Model 2 + gestational diabetes melitus.