Breast-feeding and adherence to infant feeding guidelines do not influence bone mass at age 4 years

Abstract

The impact of variations in current infant feeding practice on bone mineral accrual is not known. We examined the associations between duration of breast-feeding and compliance with infant dietary guidelines and later bone size and density at age 4 years. At total of 599 (318 boys) mother -child pairs were recruited from the Southampton Women's Survey. Duration of breast-feeding was recorded and infant diet was assessed at 6 and 12 months using FFQ. At 6 and 12 months the most important dietary pattern, defined by principal component analysis, was characterised by high consumption of vegetables, fruits and home-prepared foods. As this was consistent with infant feeding recommendations, it was denoted the 'infant guidelines' pattern. At age 4 years, children underwent assessment of whole-body bone size and density using a Hologic Discovery dual-energy X-ray absorptiometry instrument. Correlation methods were used to explore the relationships between infant dietary variables and bone mineral. There was no association between duration of breast-feeding in the first year of life and 4-year bone size or density. 'Infant guidelines' pattern scores at 6 and 12 months were also unrelated to bone mass at age 4 years. We observed wide variations in current infant feeding practice, but these variations were not associated with differences in childhood bone mass at age 4 years. Osteoporosis epidemiology: Growth: Infant diet: Guidelines: Peak bone massLittle is known about the impact of early nutrition on later childhood bone health. Previous studies have focused on variations in milk-feeding, as formula milk and breast milk differ in composition, most notably in protein and vitamin D content. However, the findings of these studies are not consistent and bone mineral in breast-fed children has been shown to be both lower and higher than in those who were formula-fed. A study of forty infants found reduced whole-body bone mineral content (BMC) in the breast-fed v. formula-fed babies at 12 months (1) . In contrast, amongst 330 eight-year-old children, those who had been breast-fed in infancy had higher bone mineral density (BMD) compared with those who had been formula-fed (2) . Previous work has also revealed uncertainty regarding the long-term impact of breast-v. formula-feeding, although the few studies with greater duration of follow-up suggest that any short-term differences are ameliorated by later childhood (3,4) .There are large variations in infant feeding practice in the UK (5,6) but little is known about the role of the weaning diet in relation to later bone health. These variations need to be considered. First, there may be confounding effects on the associations between bone health and variations in milk-feeding, as the duration of breast-feeding is related both to the age when solid foods are introduced (6) and the types of solid foods fed during weaning (5 -7) . Second, in a recent study we have shown that variations in bone health in children are associated with the dietary patterns of their mothers in pregnan...

Early Life Nutrition and Bone Development in Children

“…There are less data in healthy children. Harvey et al [23] reported no association at age 4 years, and we have previously reported a beneficial association of breastfeeding for both bone mass [24] and fractures [25] up to age 8 years in children, especially in those born at term. Other observational studies with bone measures at younger ages did not demonstrate associations between breastfeeding and bone density [19].…”

Cow's Milk Allergy and Bone Mineral Density in Prepubertal Children

“…First, both exclusive and total breastfeeding duration did not differ between groups. Second, previous studies have shown that breastfeeding has instead a positive 34 or neutral [35][36][37] effect on prepubertal bone mass. Finally, comparison of BMD between breastfed and formulafed children for each group revealed no differences (data not shown).…”

Calcium and Other Nutrients During Growth

“…In one observational study, breastfeeding for more than 7 months resulted in lower TB BMD, LS bone area, and LS BMC at age 32 years in males, but not females [56] . However, breastfeeding duration was not associated with bone density outcomes at age 4 in a different cohort [57] .…”