No abstract

Opportunities exist for improving OPAT monitoring and patient safety. Formal OPAT programs provide the framework for safe and effective care and are to be encouraged.

This study examines associations of timing of CF introduction with adiposity throughout childhood and adolescence in the US Project Viva prospective cohort study. OBJECTIVES: To examine associations of the timing of complementary feeding (CF) introduction with adiposity throughout childhood. METHODS: We studied 1013 children from Project Viva. Our exposure was CF introduction, categorized as ,4 months (19%), 4 to ,6 months (68%; reference group), and $6 months of age (14%). Our outcomes included adiposity measures in midchildhood (mean: 7.9 years; SD 0.8; n = 896) and early adolescence (mean: 13.2 years; SD 0.9; n = 850). We used linear regression models adjusted for potential confounders and ran separate models for infants who were breastfed at least partly for $4 months (categorized as breastfed; 69%) and infants who were never breastfed or stopped breastfeeding at ,4 months (categorized as formula fed; 31%). RESULTS: CF initiated at ,4 months was associated with higher adiposity in midchildhood in breastfed children; associations persisted into adolescence for waist circumference, truncal fat mass, and the sum of subscapular and triceps skinfolds (eg, waist circumference: confounderadjusted b 2.97 [95% confidence interval (CI) 0.47 to 5.47] cm). The effect estimates were larger in formula-fed children, with more associations persisting into adolescence (eg, waist circumference: adjusted b 3.42 [95% CI 0.12 to 6.71] cm). CF initiated at $6 months was associated with a higher subscapular/triceps skinfold ratio in midchildhood and adolescence (adjusted b 0.13 [95% CI 0.02 to 0.25]) in formula-fed children. CONCLUSIONS: We found associations of early CF introduction with higher adiposity measurements in breastfed and formula-fed children and associations of late introduction of CF with higher adiposity in formula-fed children. WHAT'S KNOWN ON THIS SUBJECT: The timing of complementary feeding (CF) introduction could possibly contribute to childhood obesity, although the evidence is inconsistent. Previous findings suggest that early introduction of complementary foods might be associated with an increased risk of obesity in early childhood.

In a population with relatively high protein intake during pregnancy, higher protein intake was associated with shorter offspring birth length and slower linear growth into midchildhood. Results suggest that higher protein intake during pregnancy does not increase fetal and child growth and may even reduce early length growth. Project Viva was registered at clinicaltrials.gov as NCT02820402.