Infant Feeding Practices and Subsequent Dietary Patterns of School-Aged Children in a US Birth Cohort

Background Infant feeding practices are thought to shape food acceptance and preferences. However, few studies have evaluated whether these affect child diet later in life. Objective The study objective was to examine the association between infant feeding practices and dietary patterns (DPs) in school-aged children. Design A secondary analysis of data from a diverse prospective birth cohort with 10 years of follow-up (WHEALS [Wayne County Health Environment Allergy and Asthma Longitudinal Study]) was conducted. Participants/setting Children from the WHEALS (Detroit, MI, born 2003 through 2007) who completed a food screener at age 10 years were included (471 of 1,258 original participants). Main outcome measures The main outcome was DPs at age 10 years, identified using the Block Kids Food Screener. Statistical analysis performed Latent class analysis was applied for DP identification. Breastfeeding and age at solid food introduction were associated with DPs using a 3 step approach for latent class modeling based on multinomial logistic regression models. Results The following childhood DPs were identified: processed/energy-dense food (35%), variety plus high intake (41%), and healthy (24%). After weighting for loss to follow-up and covariate adjustment, compared with formula-fed children at 1 month, breastfed children had 0.41 times lower odds of the processed/energy-dense food DP vs the healthy DP (95% CI 0.14 to 1.25) and 0.53 times lower odds of the variety plus high intake DP (95% CI 0.17 to 1.61), neither of which were statistically significant. Results were similar, but more imprecise, for breastfeeding at 6 months. In addition, the association between age at solid food introduction and DP was nonsignificant, with each 1-month increase in age at solid food introduction associated with 0.81 times lower odds of the processed/energy-dense food DP relative to the healthy DP (95% CI 0.64 to 1.02). Conclusions A significant association between early life feeding practices and dietary patterns at school age was not detected. Large studies with follow-up beyond early childhood that can also adjust for the multitude of potential confounders associated with breastfeeding are needed. J Acad Nutr Diet. 2021;121(6):1064-1079.

Automated summary

Infant feeding practices are thought to influence food acceptance and preferences, but their impact on children's dietary patterns in school age is not significant. Larger studies adjusting for potential confounders associated with breastfeeding are needed.