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J Pediatr. 2016 Dec;179:104-110.e1. doi: 10.1016/j.jpeds.2016.08.064. Epub 2016 Sep 20.

The Impact of Timing of Introduction of Solids on Infant Body Mass Index.

Author information

1
Environmental and Genetic Epidemiology Research Group, Murdoch Childrens Research Institute (MCRI), Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia.
2
Monash University, Melbourne, Victoria, Australia.
3
Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Centre for Food and Allergy Research, MCRI, Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia; Institute of Inflammation and Repair, University of Manchester, Manchester, UK. Electronic address: katie.allen@rch.org.au.
4
Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
5
Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Centre for Food and Allergy Research, MCRI, Royal Children's Hospital, Melbourne, Victoria, Australia.
6
Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia; Allergy and Immune Disorders, MCRI, Royal Children's Hospital, Melbourne, Victoria, Australia.
7
Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Centre for Community Child Health, MCRI, Royal Children's Hospital, Melbourne, Victoria, Australia.
8
Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Centre for Hormone Research, MCRI, Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Victoria, Australia.

Abstract

OBJECTIVES:

To evaluate the associations between breastfeeding duration, age at solids introduction, and their interaction in relation to infant (age 9-15 months) above normal body mass index (BMI).

STUDY DESIGN:

Cross-sectional, population-based study with 3153 infants from Melbourne (2007-2011). Above normal BMI (z score > 2, equivalent to >97.7th percentile) defined using the World Health Organization standard.

RESULTS:

Both longer duration of full and any (full or partial) breastfeeding were associated with lower odds of above normal BMI (eg, aOR, 0.37 [95% CI, 0.22-0.60] for full breastfeeding 4-5 months versus 0-1 months). Compared with introduction of solids at 5-6 months, both early and delayed introduction were associated with increased odds of above normal BMI (aOR for 4 months, 1.75 [95% CI, 1.10-2.80] and for ≥7 months, 2.64 [95% CI, 1.26-5.54] versus 6 months). Such associations differ by breastfeeding status at 4 months (interaction P = .08). Early introduction of solids was associated with increased odds of above normal BMI in both infants fully or partially breastfed for ≥4 months (aOR, 3.66; 95% CI, 1.41-9.51) and those breastfed for <4 months (aOR, 3.11; 95% CI, 1.39-6.97). Introduction of solids at ≥7 months was associated with increased odds of above normal BMI (aOR, 5.79; 95% CI, 1.91-17.49) among infants breastfed for <4 months only.

CONCLUSION:

Introduction of solids at 5-6 months, compared with either early or delayed introduction, is associated with decreased odds of above normal BMI at 1 year of age, regardless of infants' breastfeeding status at 4 months. These results may have implications for public health guidelines with regard to recommendations about the optimal timing of the introduction of solid foods in infancy.

KEYWORDS:

childhood obesity; childhood overweight; early life nutrition; infant; population-based studies

PMID:
27663213
DOI:
10.1016/j.jpeds.2016.08.064
[Indexed for MEDLINE]
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