Early infant feeding effect on growth and body composition during the first 6 years and neurodevelopment at age 72 months

Authors: SOBIK, SARAH - Arkansas Children'S Nutrition Research Center (ACNC); SIMS, CLARK - Arkansas Children'S Nutrition Research Center (ACNC); MCKORKLE, GINGER - Arkansas Children'S Nutrition Research Center (ACNC); BELLANDO, JJAYNE - University Arkansas For Medical Sciences (UAMS); SORENSEN, SETH - University Arkansas For Medical Sciences (UAMS); Badger, Thomas; CASEY, PATRICK - University Arkansas For Medical Sciences (UAMS); WILLIAMS, KEITH - University Arkansas For Medical Sciences (UAMS); ANDRES, ALINE - Arkansas Children'S Nutrition Research Center (ACNC)

Submitted to: Pediatric Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/1/2020
Publication Date: 9/22/2020
Citation: Sobik, S., Sims, C., Mckorkle, G., Bellando, J., Sorensen, S., Badger, T.M., Casey, P., Williams, K.D., Andres, A. 2020. Early infant feeding effect on growth and body composition during the first 6 years and neurodevelopment at age 72 months. Pediatric Research. https://doi.org/10.1038/s41390-020-01157-z.
DOI: https://doi.org/10.1038/s41390-020-01157-z

Interpretive Summary: Breastfeeding is considered the ideal source of nutrition for infant feeding during the first six months, which should be continued to 12 months of age with the introduction of complementary solid foods according to the American Academy of Pediatrics. However, by 2 months of age most infants have received some form of supplemental formula. In this study, we compared growth, body composition, dietary intake and developmental outcomes during the first 6 years of life of children fed breastmilk (BM), dairy milk formula (MF), or soy formula (SF) during infancy. Study visits were performed at 3, 6, 9, 12, 24, 36, 48 and 60 months. It was anticipated that infants fed MF and SF would have greater growth velocity, higher body mass, and higher fat mass (FM) during the first 6 years of childhood compared to BF children. We also predicted that SF infants would exhibit similar growth and developmental patterns to MF infants throughout the first 6 years of life. There was a significant difference in body composition between breastfed, soy-protein based formula, and cow's milk based formula fed infants during the first year of life (fat mass higher in BF) and into early childhood (fat mass lower in BF children compared to other groups between 24 to 72 months). Infants fed SF, MF, or BM all performed within normal limits in standardized neurodevelopmental testing. This study supports a growing body of evidence that there are no significant differences in growth or neurodevelopmental outcomes in infants and children who are formula fed versus breastfed.

Technical Abstract: This study longitudinally characterized the developmental status, growth, and body composition of children who were fed human milk (breastfed, BF), cow's milk-based (MF), or soy protein-based (SF) infant formula from 3 to 12 months. Standardized anthropometrics and dual-energy X-ray absorptiometry were used to characterize growth and body composition at 3, 6, 9, 12, 24, 36, 48, 60, and 72 months. Preschool Language Scale-3, Children's Memory Scale Index (CMS), and Wechsler Preschool and Primary Scale of Intelligence were administered at age 72 months. Mixed-effects models adjusting for gestational age, birth weight, child race and sex, parental education, and maternal IQ were performed. Body Mass index (BMI) was significantly lower between 24 and 72 months in BF children compared to SF children. At 3 and 6 months, BF infants had significantly higher fat mass (FM) than SF infants, whereas BF children had significantly lower FM at 36 and 48 months than SF children. Delayed Recognition Index of the CMS was higher for SF than for MF participants (p = 0.009). There was no other significant difference in developmental outcomes between groups. In conclusion, BF, MF, and SF support adequate growth and development up to age 6 years.