Effects of Breastfeeding, Formula Feeding, and Complementary Feeding on Rapid Weight Gain in the First Year of Life

Charles T. Wood, Whitney P. Witt, Asheley C. Skinner, Hsiang S. Yin, Russell L. Rothman, Lee M. Sanders, Alan M. Delamater, Kori B. Flower, Melissa C. Kay, Eliana M. Perrin, Effects of Breastfeeding, Formula Feeding, and Complementary Feeding on Rapid Weight Gain in the First Year of Life, Academic Pediatrics, 2020, ISSN 1876-2859, https://doi.org/10.1016/j.acap.2020.09.009. (https://www.sciencedirect.com/science/article/pii/S1876285920305076)

I chose to present this article together with my case presentation of an infant in the pediatric emergency room complaining of chronic vomiting after switching from breastfeeding to formula feeding. This article compared breastfeeding, formula feeding and complementary feeding to see which has a greater effect on  rapid infant weight gain. Risk factors for obesity are being recognized from conception to age 2. As a way to combat obesity, the researchers here looked at weight-for-age-z-score (WAZ) and weight-for-length-z-score (WLZ) in a diverse population based on milk feeding (breast, formula or mixed) and introduction of complementary food before 4 months. 

The researchers used data from the Greenlight Intervention study, of the 865 infants enrolled in that study 469 had the data the researchers here were looking for. They found that the odds of a rapid increase in WAZ was the lowest for infants who were breastfed between 2-6 months when compared to those who were formula fed. They also found that when complementary food was introduced after 4 months there was a decreased odds of a rapid increase in WLZ. From this they concluded that delaying complementary food and breastfeeding are associated with a lower risk of rapid infant weight gain in the first year of life. 

There were some limitations to this study as acknowledged by the authors, including they only analyzed growth changes between 2 months and 12 months of age and feeding in the first week and month of life also influence weight gain and obesity risk. The researchers chose to measure risk of obesity by WAZ and WLZ, but using a BMI or peak weight velocity might be better predictors for cardiometabolic disease risks that occur from obesity.

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