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Am J Clin Nutr. 2014 Jun;99(6):1351-8. doi: 10.3945/ajcn.113.075937. Epub 2014 Mar 12.

General and abdominal fat outcomes in school-age children associated with infant breastfeeding patterns.

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  • 1From the Generation R Study Group (BD, DHMH, OG, RG, and VWVJ) and the Departments of Pediatrics (DHMH, OG, LD, RG, and VWVJ) and Epidemiology (BD, DHMH, OG, AH, LD, RG, and VWVJ), Erasmus University Medical Center, Rotterdam, Netherlands; the Department of Radiology, Radboud University, Nijmegen, Netherlands (RM); and Nutricia Research, Utrecht, Netherlands (MA-B and EMvdB).



Breastfeeding may have a protective effect on the development of obesity in later life. Not much is known about the effects of infant feeding on more-specific fat measures.


We examined associations of breastfeeding duration and exclusiveness and age at the introduction of solid foods with general and abdominal fat outcomes in children.


We performed a population-based, prospective cohort study in 5063 children. Information about infant feeding was obtained by using questionnaires. At the median age of 6.0 y (95% range: 5.7 y, 6.8 y), we measured childhood anthropometric measures, total fat mass and the android:gynoid fat ratio by using dual-energy X-ray absorptiometry, and preperitoneal abdominal fat by using ultrasound.


We observed that, in the models adjusted for child age, sex, and height only, a shorter breastfeeding duration, nonexclusive breastfeeding, and younger age at the introduction of solid foods were associated with higher childhood general and abdominal fat measures (P-trend < 0.05) but not with higher childhood body mass index. The introduction of solid foods at a younger age but not breastfeeding duration or exclusivity was associated with higher risk of overweight or obesity (OR: 2.05; 95% CI: 1.41, 2.90). After adjustment for family-based sociodemographic, maternal lifestyle, and childhood factors, the introduction of solid food between 4 and 4.9 mo of age was associated with higher risks of overweight or obesity, but the overall trend was not significant.


Associations of infant breastfeeding and age at the introduction of solid foods with general and abdominal fat outcomes are explained by sociodemographic and lifestyle-related factors. Whether infant dietary composition affects specific fat outcomes at older ages should be further studied.

© 2014 American Society for Nutrition.

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