Later introduction to infant formula lowers risk for pediatric overweight
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Infants who begin drinking infant formula at age 4 to 6 months have lower risk for overweight at ages 1 and 3 years compared with those who begin drinking formula within the first 3 months of life, according to a speaker.
“Mounting evidence suggests that the first few months of life are critical for the development of obesity,” Xiu Qiu, MD, PhD, director of the women health department at Guangzhou Women and Children’s Medical Center in China, told Healio. “The relationships between the timing of solid food introduction and the risk of childhood obesity have been examined previously; however, evidence for the association of timing of infant formula introduction remains scarce. Our findings showed that even fed with breast milk, infants with different timing of infant formula introduction had a different risk of excess weight gain.”
Researchers analyzed data from the Born in Guangzhou Cohort Study, a prospective study of 5,733 full-term children born in Guangzhou, China, with a normal birth weight between 2,500 g and 4,000 g. Mothers self-reported socioeconomic, parental and feeding data. Height, weight, abdomen circumference and upper-arm circumference were measured at age 6 weeks, 1 year and 3 years. Growth z scores were calculated based on the WHO Growth Standard.
The findings were presented at ObesityWeek 2021.
Compared with infants introduced to formula at age 3 months or younger, those who begin drinking formula at age 4 to 6 months had a lower upper-arm circumference (beta = –0.17; 95% CI, –0.27 to –0.06; P = .002) and BMI z score (beta = –0.19; 95% CI, –0.28 to –0.1; P < .001) at 1 year. At 3 years, those introduced to formula at 4 to 6 months had a significantly lower BMI z score compared with those introduced to formula at 3 months or younger (beta = –0.15; 95% CI, –0.26 to –0.04; P = .006).
After adjusting for multiple covariates, infants introduced to formula at age 4 to 6 months had lower odds for being at risk for overweight at age 1 year (OR = 0.72; 95% CI, 0.55-0.94; P = .015) and 3 years (OR = 0.5; 95% CI, 0.3-0.85; P = .01) compared with those who began drinking formula at age 3 months or younger. Being introduced to infant formula at age 4 to 6 months was also associated with a lower likelihood for overweight at age 1 year compared with introduction to formula at age 3 months or younger (OR = 0.42; 95% CI, 0.21-0.84; P = .014).
Qiu said the findings are important because the prevalence of parents introducing infants to formula at a younger age is increasing, especially in China.
“In our cohort, a large proportion of infants, over 70%, were given infant formula as a supplement to breast milk — mix feeding — during the early months of life,” Qiu said. “The protective effects of delaying formula introduction at 4 to 6 months remained significant in children with longer breastfeeding duration, over 6 months. Although the results need to be replicated in other studies, avoiding the early introduction of infant formula, particularly in the first 3 months, should be considered to reduce the possibility of excess or rapid weight gain in early childhood.”
Qiu said future studies should examine how the timing and quantity of infant formula impact the risk for future obesity. Qualitative studies are also needed to assess why more parents are introducing infants to formula at an earlier age.
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Yuan M, et al. Timing of infant formula introduction and risk of overweight in early childhood: The BIGCS study. Presented at: ObesityWeek 2021; Nov. 1-5, 2021 (virtual meeting).
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