Higher fat mass and fat mass accretion during the first six months of life in exclusively breastfed infants

Abstract

BACKGROUND: Early nutrition influences infant growth and body composition, which may play a role in the infant's metabolic programming. Breastfed infants appear to have higher fat mass than formula-fed infants, but most comparisons have been crosssectional, and evidence is scarce. The aim of this study was to describe fat mass and fat mass accretion during the first six months of life and evaluate differences by type of feeding (OMS). METHODS: Prospective cohort of healthy pregnant women and their infants (Mexico City, 2009-2014). At 1 (T1), 3 (T2) and 6 (T3) months of age, fat mass (FM) (PEAPOD) and type of feeding (feeding questionnaire) were evaluated. RESULTS: We included 109 healthy infants (mean ± SD age: 39 ± 1.1 weeks; birthweight: 2959 ± 294 g). Exclusive/predominant breastfed (EBF) infants had higher FM at T2 and T3 compared with non-EBF (%FM T3: 29.7 ± 5.9% vs 24.7 ± 5.6%, respectively) (p < 0.05). All infants increased their FM throughout time (p < 0.001). EBF infants showed a significant higher FM accretion (β: 3.61; 95% CI: 1.57-5.66, p < 0.01); the difference was maintained after controlling for confounding variables. CONCLUSIONS: Exclusive/predominant breastfeeding promotes higher accretion of FM during the first six months of life which could have an important effect in the programming of health outcomes later in life.

Development of Visceral and Subcutaneous-Abdominal Adipose Tissue in Breastfed Infants during First Year of Lactation

“…Reportedly, breastfed infants have higher fat accretion compared with formula-fed [ 10 , 42 ] and non-exclusively breastfed infants [ 43 ], speculating that substantial fat accrual during this period of active growth may be protective against obesity later in life. As specific location of fat accretion may determine higher metabolic risk [ 44 ], it is imperative to investigate if higher fat accretion in the abdominal area in breastfed infants means more metabolic risk, and if development of these fat depots is independently regulated in this population and affected by nutrition.…”

Breastfeeding Education and Support to Improve Early Initiation and Exclusive Breastfeeding Practices and Infant Growth: A Cluster Randomized Controlled Trial from a Rural Ethiopian Setting

“…In our study, except for a modest increase in MUAC, the differences for LAZ, WAZ, and WLZ were not statistically significant. These findings could be due to the effect of exclusive or predominant breastfeeding that promotes higher accretion of fat mass during the first six months of life [40]. Moreover, not only breastfeeding behaviour but also intrauterine growth retardation contributes considerably to infant growth faltering, and growth faltering is also more prominent after six months of age when infants start complementary feeding [41].…”

Overweight Increases the Risk of Right Ventricular Dysfunction in the non-Breastfed Infants

“…Another study including a total of 158 infants (72 exclusively breastfed and 86 exclusively formula-fed) reported that body composition was similar between the two groups at enrolment, but fat-free mass at 4 months and the fat-free mass changes between enrolment and 4 months were higher in formula-fed infants than breastfed ones (16) . In contradistinction, another study showed that EBF infants showed a significantly higher fat mass accretion (17) . Hence there is considerable controversy regarding fat mass accretion between breastfed and formula fed.…”