Mediating effect of infant rapid weight gain on the association between exclusive breastfeeding and the risk of obesity later in life

Nagore González, Carlos ; Iglesia Altaba, Iris ; Guillén Sebastián, Cristina ; Álvarez Sauras, Maria Luisa ; García Enguita, Sheila ; Moreno, Luis A. (Universidad de Zaragoza) ; Rodríguez, Gerardo (Universidad de Zaragoza)

Resumen: Introduction
Obesity is a global health problem, with an impact on future health. Early factors such as infant feeding and rapid weight gain (RWG) may play a role in its development. However, their contribution is not fully understood.

Objective
To analyse associations and potential interactions between the type of infant feeding during the first 4 months of age, RWG and later development of obesity in children at 6 years of age.

Materials and Methods
This observational longitudinal study examines growth in 834 children born at term with adequate weight for their gestational age. Data were collected from birth to 6 years, focusing on weight, height and body mass index (BMI) z-scores. The relationships between infant feeding, RWG, and BMI at 6 years were explored using mediation models.

Results
Formula-fed infants showed higher BMI z-scores and obesity prevalence at 6 years compared to exclusively breastfed infants (p = 0.012 and p = 0.003 respectively). RWG also was associated with higher BMI z-scores and obesity (p < 0.001 in both cases), with formula-fed infants more likely to experience RWG (39.7% vs. 32.2%; p = 0.036). Mediation analysis revealed that the association between feeding type and BMI at 6 years is partly positively mediated by infant RWG up to 6 months.

Conclusions
Infant feeding practices, particularly exclusive breastfeeding in the first 4 months, are associated with weight and BMI trajectories up to 6 years. Rapid weight gain mediates this relationship in the first 6 months, but from 6 to 12 months.

Idioma: Inglés

DOI: 10.1111/ijpo.70039

Año: 2025

Publicado en: Pediatric obesity (2025), e70039 [13 pp.]
ISSN: 2047-6302

Financiación: info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI13-02359

Tipo y forma: Article (Published version)

Área (Departamento): Área Enfermería (Dpto. Fisiatría y Enfermería)
Área (Departamento): Área Pediatría (Dpto. Microb.Ped.Radio.Sal.Pú.)