Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Maternal and pediatric nutrition

Relationship between age at giving fortified powdered cow’s milk and cessation of breastfeeding on the nutritional status of a Chilean child cohort followed from birth to 3 years of age

Abstract

Background/objectives

To examine how much of the variation in weight-for-height (WHZ) z-scores were associated with age at which breastfeeding ceased and provision of fortified cow’s milk (Leche Purita Fortificada, LPF) commenced in a cohort of children studied from birth to 3 years of age.

Subjects/methods

Longitudinal data were obtained from routine medical check-ups on 8373 children from nine Chilean counties through convenience sampling. WHZ z-scores were generated at six-monthly intervals using WHO 2006 standards from birth to 3 years old (seven measurements). Age of cessation of breastfeeding and age of commencement of LPF were the independent variables. Repeated-measures ANOVA were used to analyse the changes in WHZ over the seven measurements. Binomial generalised estimating equations (GEE) were used to analyse the effect of each independent variable on the change from normal to overweight, and normal to obese over the seven measurements.

Results

ANOVA indicated that children given LPF milk before 3 months of age had, on average, higher mean WHZ of about 0.11 SD from 18 months of age onwards (p < 0.001). GEE analyses showed that children given LPF before 3 months of age were significantly more likely to be overweight or obese (OR = 1) compared with children given LPF later (overweight OR: 0.809–0.970, p = 0.009, obese (OR: 0.666–0.901, p = 0.001).

Conclusions

Early intake of LPF increases WHZ and is a risk factor for overweight and obesity in young children, while prolonged breastfeeding acts as protective factor against obesity.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1

Similar content being viewed by others

References

  1. Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. J Fam Med Prim Care. 2015;4:187–92. https://doi.org/10.4103/2249-4863.154628.

    Article  Google Scholar 

  2. Report GN Chile Nutrition Profile. Global nutrition report. Chile Nutrition Profile; 2018. https://globalnutritionreport.org/.

  3. Ip S, Chung M, Raman G, Trikalinos TA, Lau J. A summary of the Agency for Healthcare Research and Quality’s evidence report on breastfeeding in developed countries. Breastfeed Med: Off J Acad Breastfeed Med. 2009;4(Suppl 1):S17–30. https://doi.org/10.1089/bfm.2009.0050. e-pub ahead of print 2009/10/16

    Article  Google Scholar 

  4. Rito AI, Buoncristiano M, Spinelli A, Salanave B, Kunesova M, Hejgaard T, et al. Association between characteristics at birth, breastfeeding and obesity in 22 countries: The WHO European Childhood Obesity Surveillance Initiative—COSI 2015/2017. Obes Facts. 2019;12:226–43. https://doi.org/10.1159/000500425. e-pub ahead of print 2019/04/29

    Article  PubMed  PubMed Central  Google Scholar 

  5. WHO. Report of the commission on ending childhood obesity. Geneva: World Health Organization; 2016.

    Google Scholar 

  6. Arenz S, Ruckerl R, Koletzko B, von Kries R. Breast-feeding and childhood obesity-a systematic review. Int J Obes Relat Metab Disord. 2004;28:1247–56. https://doi.org/10.1038/sj.ijo.0802758. e-pub ahead of print 2004/08/18

    Article  CAS  PubMed  Google Scholar 

  7. Dietz WH. Breastfeeding may help prevent childhood overweight. JAMA. 2001;285:2506–7. https://doi.org/10.1001/jama.285.19.2506. e-pub ahead of print 2001/05/23

    Article  CAS  PubMed  Google Scholar 

  8. Hediger ML, Overpeck MD, Kuczmarski RJ, Ruan WJ. Association between infant breastfeeding and overweight in young children. JAMA. 2001;285:2453–60. https://doi.org/10.1001/jama.285.19.2453. e-pub ahead of print 2001/05/23

    Article  CAS  PubMed  Google Scholar 

  9. von Kries R, Koletzko B, Sauerwald T, von Mutius E, Barnert D, Grunert V, et al. Breast feeding and obesity: cross sectional study. BMJ (Clin Res Ed). 1999;319:147–50. https://doi.org/10.1136/bmj.319.7203.147. e-pub ahead of print 1999/07/16

    Article  Google Scholar 

  10. Pearce J, Taylor MA, Langley-Evans SC. Timing of the introduction of complementary feeding and risk of childhood obesity: a systematic review. Int J Obes. 2013;37:1295–306. https://doi.org/10.1038/ijo.2013.99. e-pub ahead of print 2013/06/06

    Article  CAS  Google Scholar 

  11. Tulldahl J, Pettersson K, Andersson SW, Hulthen L. Mode of infant feeding and achieved growth in adolescence: early feeding patterns in relation to growth and body composition in adolescence. Obes Res. 1999;7:431–7. https://doi.org/10.1002/j.1550-8528.1999.tb00430.x. e-pub ahead of print 1999/10/06

    Article  CAS  PubMed  Google Scholar 

  12. Victora CG, Barros F, Lima RC, Horta BL, Wells J. Anthropometry and body composition of 18 year old men according to duration of breast feeding: birth cohort study from Brazil. BMJ (Clin Res Ed). 2003;327:901 https://doi.org/10.1136/bmj.327.7420.901. e-pub ahead of print 2003/10/18

    Article  Google Scholar 

  13. Owen CG, Martin RM, Whincup PH, Smith GD, Cook DG. Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics. 2005;115:1367–77. https://doi.org/10.1542/peds.2004-1176. e-pub ahead of print 2005/05/04

    Article  PubMed  Google Scholar 

  14. Prell C, Koletzko B. Breastfeeding and complementary feeding. Dtsch Arzteblatt Int. 2016;113:435–44. https://doi.org/10.3238/arztebl.2016.0435. e-pub ahead of print 2016/07/12

    Article  Google Scholar 

  15. Cu FL, Villarreal RE, Rangel PB, Galicia RL, Vargas DE, Martinez GL. Factores de riesgo para sobrepeso y obesidad en lactantes. Rev Chil de Nutrición. 2015;42:139–44.

    Article  Google Scholar 

  16. Singhal A, Kennedy K, Lanigan J, Fewtrell M, Cole TJ, Stephenson T, et al. Nutrition in infancy and long-term risk of obesity: evidence from 2 randomized controlled trials. Am J Clin Nutr. 2010;92:1133–44. https://doi.org/10.3945/ajcn.2010.29302. e-pub ahead of print 2010/10/01

    Article  CAS  PubMed  Google Scholar 

  17. Lucas A. Growth and later health: a general perspective. Nestle Nutr Workshop Ser Pediatr Program. 2010;65:1–11. https://doi.org/10.1159/000281107.

    Article  PubMed  Google Scholar 

  18. Baird J, Fisher D, Lucas P, Kleijnen J, Roberts H, Law C. Being big or growing fast: systematic review of size and growth in infancy and later obesity. BMJ (Clin Res Ed). 2005;331:929 https://doi.org/10.1136/bmj.38586.411273.E0. e-pub ahead of print 2005/10/18

    Article  Google Scholar 

  19. Monteiro PO, Victora CG. Rapid growth in infancy and childhood and obesity in later life-a systematic review. Obes Rev. 2005;6:143–54. https://doi.org/10.1111/j.1467-789X.2005.00183.x. e-pub ahead of print 2005/04/20

    Article  CAS  PubMed  Google Scholar 

  20. Ong KK, Loos RJ. Rapid infancy weight gain and subsequent obesity: systematic reviews and hopeful suggestions. Acta Paediatr. 2006;95:904–8. https://doi.org/10.1080/08035250600719754. e-pub ahead of print 2006/08/03

    Article  PubMed  Google Scholar 

  21. Retamal R, Mascie-Taylor CGN. Trends of weight gain and prevalence of overweight and obesity from birth to three years of age. Obes Res Clin Pract. 2019;13:6–11. https://doi.org/10.1016/j.orcp.2018.10.005. e-pub ahead of print 2018/11/15

    Article  PubMed  Google Scholar 

  22. Rodríguez L, Herrera Y, Leyton C, Pinheiro AC. Patrones de crecimiento para la evaluación nutricional de niños, niñas y adolescentes, desde el nacimiento hasta los 19 años de edad. Santiago: Departamento de Nutrición y Alimentos, Ministerio de Salud; 2018. p. 92.

  23. Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Earlbaum Associates; 1988.

    Google Scholar 

  24. Dewey KG, Peerson JM, Brown KH, Krebs NF, Michaelsen KF, Persson LA, et al. Growth of breast-fed infants deviates from current reference data: a pooled analysis of US, Canadian, and European data sets. World Health Organization Working Group on Infant Growth. Pediatrics. 1995;96:495–503. e-pub ahead of print 1995/09/01

    CAS  PubMed  Google Scholar 

  25. Freeman V, van’t Hof M, Haschke F. Patterns of milk and food intake in infants from birth to age 36 months: the Euro-growth study. J Pediatr Gastroenterol Nutr. 2000;31(Suppl 1):S76–85. https://doi.org/10.1097/00005176-200007001-00008. e-pub ahead of print 2000/07/15

    Article  PubMed  Google Scholar 

  26. van Buuren S. Effects of selective dropout on infant growth standards. Nestle Nutrition Workshop Series. Nestle Nutr Workshop Ser Paediatr Program. 2010;65:167–75. https://doi.org/10.1159/000281161. discussion 175-169. e-pub ahead of print 2010/02/09

    Article  Google Scholar 

  27. Kramer MS, Guo T, Platt RW, Vanilovich I, Sevkovskaya Z, Dzikovich I, et al. Feeding effects on growth during infancy. J Pediatr. 2004;145:600–5. https://doi.org/10.1016/j.jpeds.2004.06.069. e-pub ahead of print 2004/11/03

    Article  PubMed  Google Scholar 

  28. Singhal A, Cole TJ, Fewtrell M, Lucas A. Breastmilk feeding and lipoprotein profile in adolescents born preterm: follow-up of a prospective randomised study. Lancet. 2004;363:1571–8. https://doi.org/10.1016/s0140-6736(04)16198-9. e-pub ahead of print 2004/05/18

    Article  CAS  PubMed  Google Scholar 

  29. Gillman MW. Early infancy as a critical period for development of obesity and related conditions. Nestle Nutr Workshop Ser Paediatr Program. 2010;65:13–24.

    Article  Google Scholar 

  30. Luque V, Closa-Monasterolo R, Escribano J, Ferré N. Early programming by protein intake: the effect of protein on adiposity development and the growth and functionality of vital organs. Insights Nutr Metab. 2016;8(Suppl 1):49–56. https://doi.org/10.4137/NMI.S29525.

    Article  Google Scholar 

  31. Melnik BC. Excessive leucine-mTORC1-signalling of cow milk-based infant formula: the missing link to understand early childhood obesity. J Obes. 2012;2012:197653–197653. https://doi.org/10.1155/2012/197653. e-pub ahead of print 03/19

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Jackson AA. Protein requirements for catch-up growth. Proc Nutr Soc. 1990;49:507–16. https://doi.org/10.1079/pns19900059. e-pub ahead of print 1990/10/01

    Article  CAS  PubMed  Google Scholar 

  33. Lucas A, Sarson DL, Blackburn AM, Adrian TE, Aynsley-Green A, Bloom SR. Breast vs bottle: endocrine responses are different with formula feeding. Lancet. 1980;1:1267–9. https://doi.org/10.1016/s0140-6736(80)91731-6. e-pub ahead of print 1980/06/14

    Article  CAS  PubMed  Google Scholar 

  34. Rosso F, Skarmeta N, Sade A. Informe Técnico Encuesta Nacional de Lactancia Materna en la Atención Primaria (ENALMA). Santiago: Ministerio de Salud, Subsecretaría de Salud Pública; 2013.

  35. Lucas A. Programming by early nutrition: an experimental approach. J Nutr. 1998;128(2 Suppl):401s–406s. https://doi.org/10.1093/jn/128.2.401S. e-pub ahead of print 1998/03/21.

    Article  CAS  PubMed  Google Scholar 

  36. Plagemann A, Harder T. Breast feeding and the risk of obesity and related metabolic diseases in the child. Metab Syndr Relat Disord. 2005;3:222–32. https://doi.org/10.1089/met.2005.3.222. e-pub ahead of print 2008/03/29

    Article  PubMed  Google Scholar 

  37. Rolland-Cachera MF, Deheeger M, Akrout M, Bellisle F. Influence of macronutrients on adiposity development: a follow up study of nutrition and growth from 10 months to 8 years of age. Int J Obes Relat Metab Disord. 1995;19:573–8. e-pub ahead of print 1995/08/01.

    CAS  PubMed  Google Scholar 

  38. Singhal A, Lucas A. Early origins of cardiovascular disease: is there a unifying hypothesis? Lancet. 2004;363:1642–5. https://doi.org/10.1016/s0140-6736(04)16210-7. e-pub ahead of print 2004/05/18

    Article  PubMed  Google Scholar 

  39. Singhal A, Lanigan J. Breastfeeding, early growth and later obesity. Obes Rev. 2007;8(Suppl 1):51–54. https://doi.org/10.1111/j.1467-789X.2007.00318.x.

    Article  PubMed  Google Scholar 

  40. Castillo C, Balboa P, Raimann X. Modificaciones a la Leche del Programa Nacional de Alimentación Complementaria (PNAC) en Chile. 2009. Rev Chil de Pediatría. 2009;80:508–12.

    Google Scholar 

  41. Totzauer M, Luque V, Escribano J, Closa-Monasterolo R, Verduci E, ReDionigi A, et al. Effect of lower versus higher protein content in infant formula through the first year on body composition from 1 to 6 years: follow-up of a randomized clinical trial. Obesity. 2018;26:1203–10. https://doi.org/10.1002/oby.22203.

    Article  CAS  PubMed  Google Scholar 

  42. Patro-Golab B, Zalewski BM, Kouwenhoven SM, Karas J, Koletzko B, Bernard van Goudoever J, et al. Protein concentration in milk formula, growth, and later risk of obesity: a systematic review. J Nutr. 2016;146:551–64. https://doi.org/10.3945/jn.115.223651. e-pub ahead of print 2016/02/13

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

Grant sponsorship: Becas Chile Scholarship Program, CONICYT, Chile.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rodrigo Retamal.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Retamal, R., Mascie-Taylor, C.G.N., Villegas, R. et al. Relationship between age at giving fortified powdered cow’s milk and cessation of breastfeeding on the nutritional status of a Chilean child cohort followed from birth to 3 years of age. Eur J Clin Nutr 74, 1022–1028 (2020). https://doi.org/10.1038/s41430-020-0665-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41430-020-0665-9

Search

Quick links