Association of Breastfeeding With Maternal Control of Infant Feeding at Age 1 Year

Abstract

ABSTRACT.Objective. Previous studies have found that breastfeeding may protect infants against future overweight. One proposed mechanism is that breastfeeding, compared with bottle-feeding, may promote maternal feeding styles that are less controlling and more responsive to infant cues of hunger and satiety, thereby allowing infants greater self-regulation of energy intake. The objective of this study was to examine whether preponderance of breastfeeding in the first 6 months of life and breastfeeding duration are associated with less maternal restrictive behavior and less pressure to eat.Methods. We studied 1160 mother-infant pairs in Project Viva, an ongoing prospective cohort study of pregnant mothers and their children. The main outcome measures were mothers' reports of restricting their children's food intake and of pressuring their children to eat more food, as measured by a modified Child Feeding Questionnaire (CFQ) at 1 year postpartum. Restriction was defined by strongly agreeing or agreeing with the following question from the modified CFQ: "I have to be careful not to feed my child too much." We derived a continuous pressure to eat score from 5 questions of the modified CFQ. We used multiple logistic regression to examine the association between preponderance of breastfeeding in the first 6 months of life, breastfeeding duration, and mothers' restriction of children's access to food. We used multiple linear regression, both before and after adjusting for several groups of confounders, to predict the effects of breastfeeding on the mothers' scores for pressuring their children to eat.Results. The mean (SD) age of the women was 32.4 (4.8) years; 24% of the women were nonwhite, and 32% were primigravidas. At 6 months postpartum, 24% of the mothers were exclusively breastfeeding, 25% were mixed feeding, 41% had weaned, and 10% had fed their infants formula only. The mean (SD) duration of breastfeeding was 6.3 (4.5) months. Thirteen percent of the mothers strongly agreed or agreed with the restriction question. The mean (SD) score on the pressure to eat scale was 5.3 (3.7), and the range was 0 to 20. After adjusting for mothers' preexisting concerns about their children's future eating and weight status, as well as sociodemographic, economic, and anthropometric predictors of breastfeeding duration, we found that the longer the mothers breastfed, the less likely they were to restrict their children's food intake at age 1 year. The adjusted odds ratio was 0.89 (95% confidence interval [CI]: 0.84 -0.95) for each 1-month increment in breastfeeding duration. In addition, we found that compared with mothers who were exclusively formula feeding, mothers who were exclusively breastfeeding at 6 months of age had much lower odds of restricting their children's food intake at 1 year (odds ratio: 0.27; 95% CI: 0.10 -0.72 S everal recent studies suggest a protective effect of breastfeeding versus bottle-feeding of infants on future overweight. 1-7 Despite differences in methods, the studies are consistent in demonstrat...

Developmental and epigenetic pathways to obesity: an evolutionary-developmental perspective

“…106 Formula-fed children drink higher volumes, which may entrain satiety differently. 107 Breastfed infants may have a different gut biota, and thus their biotic conversion of intestinal nutrients may be different, leading to different absorption. 108 It may be that unrestricted bottle feeding after a period of relative constraint in fetal life merely exaggerates a mismatch.…”

To what extent do weight gain and eating avidity during infancy predict later adiposity?

“…Thus while on average rapid weight gain may predict later adiposity, what is not clear is how well it would prospectively identify individual children at risk. There is also recent research that suggests there are distinctive childhood eating behaviours related to overweight which may reflect an inherent tendency to overeat (7) , so eating behaviour in infancy could predispose to, or protect against, later obesity (7,8) .…”

“…Thus while on average rapid weight gain may predict later adiposity, what is not clear is how well it would prospectively identify individual children at risk. There is also recent research that suggests there are distinctive childhood eating behaviours related to overweight which may reflect an inherent tendency to overeat (7) , so eating behaviour in infancy could predispose to, or protect against, later obesity (7,8) . Apart from studies examining how the type and style of milk feeding relates to later obesity (9)(10)(11) , we currently know little about eating behaviour in infancy and even less about how it tracks on to later adiposity or eating style.…”

Dietary Recommendations for Children and Adolescents: A Guide for Practitioners

“…[107][108][109][110] The first potential benefit may be better self-regulation of intake. Compared with parents who bottle-feed, mothers who breastfeed appear to allow the infant to take an active role in controlling intake, possibly promoting maternal feeding practices that can foster better self-regulation of Choose breastfeeding for first nutrition; try to maintain for 12 mo Control when food is available and when it can be eaten (nutrient quality, portion size, snacking, regular meals) Provide social context for eating behavior (family meals, role of food in social intercourse) Teach about food and nutrition at the grocery store, when cooking meals Counteract inaccurate information from the media and other influences Teach other care providers (eg, daycare, babysitters) about what you want your children to eat Serve as role models and lead by example; "do as I do" rather than "do as I say" Promote and participate in regular daily physical activity energy intake as the child grows up.…”