Mode of infant feeding, eating behaviour and anthropometry in infants at 6-months of age born to obese women - A secondary analysis of the UPBEAT Trial

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Background: Maternal 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 aim of this study was to investigate associations between mode of early life feeding, eating behaviours and measures of body composition in 6-month old infants of obese women who participated in the UPBEAT trial; a multi-centre randomised controlled trial comparing a lifestyle intervention of diet and physical activity to standard care during pregnancy.

Methods: Three 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 and measures of infant body composition were undertaken. As there was no effect of the antenatal intervention on any of these variables, 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.

Results: Formula 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).

Conclusions: In obese women, exclusive breastfeeding was protective against
increasing weight z-scores and velocity of weight gain in their 6-month old infants. Ongoing follow-up and analyses of the UPBEAT cohort will provide further understanding of the long-term influence of breastfeeding
Original languageEnglish
JournalBMC Pregnancy and Childbirth
Publication statusPublished - 3 Sept 2018


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