Objective: The influence of infant feeding practices on weight gain during childhood remains unresolved, with few studies adjusting appropriately for confounding factors. This study examined the effect of breastfeeding initiation, breastfeeding duration and age at introduction of solid foods on weight gain from birth to 3 years.
Design: Nationally representative prospective study.
Setting: England, Wales, Scotland and Northern Ireland.
Participants: 10 533 3-year-old children from the UK Millennium Cohort Study.
Main outcome measure: Conditional weight gain z-scores from birth to 3 years (adjusted for birthweight); multiple linear regression analyses were conducted to examine the impact of infant feeding practices on this measure after adjustment for confounding factors.
Results: Breastfeeding initiation and breastfeeding duration were significantly associated with weight gain from birth to 3 years. Infants receiving no breast milk grew faster than those whose mothers initiated breastfeeding (adjusted regression coefficient (difference in z-scores) 0.06, 95% CI 0.02 to 0.09), as did those breastfed for less than 4 months (0.05, 95% CI 0.01 to 0.09) versus those breastfed 4 months or longer. Early introduction of solids was not associated with faster weight gain after adjustment for height z-score at 3 years (−0.01, 95% CI −0.04 to 0.03).
Conclusions: Initiating and prolonging breastfeeding may reduce excess weight gain by preschool age. Association of the early introduction of solids with rapid weight gain during early childhood is mediated through childhood stature. Although effects sizes are small, at a population level they are of public health importance as these risk factors are potentially modifiable. Strategies to support mothers to follow internationally recommended infant feeding practices are required.
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Competing interests: None.
Funding: The Millennium Cohort Study is funded by grants to Professor Heather Joshi, director of the study, from the ESRC and a consortium of government funders. LJG is supported by a MRC Special Training Fellowship in Health Services and Health of the Public Research (grant G1061221); LS is supported by a Wellcome Trust Senior Research Fellowship in Clinical Science; SSH is supported by a Department of Health (England) Researcher Development Award; TJC is supported by MRC programme grant G9827821; CD is supported by HEFCE. This work was undertaken at GOSH/UCL Institute of Child Health, which received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme.
Other members of the Millennium Cohort Study Child Health Group include: Suzanne Bartington, Helen Bedford, Phillippa Cumberland, Catherine Law, Anna Pearce, Catherine Peckham and Jugnoo Rahi.
Ethics approval: The MCS was given ethics approval from the South West and London Multi-Centre Research Ethics Committees for the first and second contacts, respectively.
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