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Breastfeeding, introduction of complementary foods, and adiposity at 5 y of age^1,2,3

¹ From the Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA (HLB and WCH); the Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA (HLB); Mathematica Policy Research, Inc, Princeton, NJ (RCW); the Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH (SRD); and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH (SRD)

Background: Although dual-energy X-ray absorptiometry (DXA) is considered the most accurate measure of adiposity in children, it has rarely been used to examine the relation between infant feeding and adiposity during childhood.

Objective: The objective was to ascertain whether adiposity at age 5 y was related to breastfeeding, to the timing of the introduction of complementary foods during infancy, or to both.

Design: Body composition was measured in 313 children at age 5 y by using DXA. Data on breastfeeding, formula feeding, and the timing of the introduction of complementary foods were obtained from the mothers when the children were 3 y old. Regression analysis was used to examine the relation between infant feeding and fat mass after adjustment for lean body mass, sex, birth weight, maternal obesity, race, and other sociodemographic variables.

Results: Fifty-three percent of the children were boys, 80% were white, and 20% were black. There was no significant difference in adjusted fat mass between those ever breastfed and those never breastfed ( ± SE: 4.48 ± 0.09 and 4.76 ± 0.17 kg, respectively; P = 0.17). Children who were breastfed for a longer duration and those who were breastfed without concurrent formula feeding did not have significantly lower fat mass than did those children who were never breastfed. Children did not differ significantly in fat mass if they were introduced to complementary foods before or after 4 mo of age (4.49 ± 0.12 and 4.63 ± 0.12 kg, respectively; P = 0.42).

Conclusion: Neither breastfeeding nor the timing of the introduction of complementary foods was associated with adiposity at age 5 y.

Key Words: Breastfeeding • complementary feeding • children • preschool-age children • obesity • dual-energy X-ray absorptiometry

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