title: Early infant feeding and adiposity risk: from infancy to adulthood.
abstract: BACKGROUND
  Systematic reviews suggest that a longer duration of breast-feeding is associated with a reduction in the risk of later overweight and obesity. Most studies examining breast-feeding in relation to adiposity have not used longitudinal analysis. In our study, we aimed to examine early infant feeding and adiposity risk in a longitudinal cohort from birth to young adulthood using new as well as published data.
  
  
  METHODS
  Data from the Western Australian Pregnancy Cohort (Raine) Study in Perth, W.A., Australia, were used to examine associations between breast-feeding and measures of adiposity at 1, 2, 3, 6, 8, 10, 14, 17, and 20 years.
  
  
  RESULTS
  Breast-feeding was measured in a number of ways. Longer breast-feeding (in months) was associated with reductions in weight z-scores between birth and 1 year (β = -0.027; p < 0.001) in the adjusted analysis. At 3 years, breast-feeding for <4 months increased the odds of infants experiencing early rapid growth (OR 2.05; 95% CI 1.43-2.94; p < 0.001). From 1 to 8 years, children breast-fed for ≤4 months compared to ≥12 months had a significantly greater probability of exceeding the 95th percentile of weight. The age at which breast-feeding was stopped and a milk other than breast milk was introduced (introduction of formula milk) played a significant role in the trajectory of the BMI from birth to 14 years; the 4-month cutoff point was consistently associated with a higher BMI trajectory. Introduction of a milk other than breast milk before 6 months compared to at 6 months or later was a risk factor for being overweight or obese at 20 years of age (OR 1.47; 95% CI 1.12-1.93; p = 0.005).
  
  
  CONCLUSIONS
  Breast-feeding until 6 months of age and beyond should be encouraged and is recommended for protection against increased adiposity in childhood, adolescence, and young adulthood. Adverse long-term effects of early growth acceleration are fundamental in later overweight and obesity. Formula feeding stimulates a higher postnatal growth velocity, whereas breast-feeding promotes slower growth and a reduced likelihood of overweight and obesity. Biological mechanisms underlying the protective effect of breast-feeding against obesity are based on the unique composition and metabolic and physiological responses to human milk.
authors.affiliation: Telethon Kids Institute, Perth, W.A., Australia.
authors.forename: Wendy H
authors.initials: WH
authors.lastname: Oddy
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Mori
authors.forename: Rae-Chi
authors.initials: RC
authors.lastname: Huang
authors.forename: Julie A
authors.initials: JA
authors.lastname: Marsh
authors.forename: Craig E
authors.initials: CE
authors.lastname: Pennell
authors.forename: Paola T
authors.initials: PT
authors.lastname: Chivers
authors.forename: Beth P
authors.initials: BP
authors.lastname: Hands
authors.forename: Peter
authors.initials: P
authors.lastname: Jacoby
authors.forename: Peter
authors.initials: P
authors.lastname: Rzehak
authors.forename: Berthold V
authors.initials: BV
authors.lastname: Koletzko
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Beilin
mesh_terms: D050154:Adiposity / Q000187:drug effects*; D000293:Adolescent; D041923:Adolescent Development; D017195:Adolescent Nutritional Physiological Phenomena; D015992:Body Mass Index; D001942:Breast Feeding; D002648:Child; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D050177:Overweight / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012306:Risk; D014886:Weaning; D015430:Weight Gain; D014904:Western Australia / Q000453:epidemiology