ESPE Abstracts

Background: Early gain in fat mass (FM) might be influenced by type of feeding. Excessive gain in FM during the first three months of life is associated with an increased risk for adiposity and cardiovascular diseases. This three-month period is also known as the critical window for adiposity programming.

Aims: To investigate differences in body composition between exclusively breastfed (BF) and formula fed (FF) infants from birth to 24 months.

Methods: 106 exclusively BF (i.e. BF for at least 3 months) infants (57 boys) and 67 exclusively FF (i.e. start FF before 1 month) infants (44 boys) were included from the Sophia Pluto Cohort in Rotterdam, The Netherlands. We measured body composition at 1 and 3 months by PEAPOD (COSMED, Italy) and 24 months by DXA (Lunar Prodigy, GE Healthcare, UK). Abdominal FM was measured by ultrasound at 3 and 24 months.

Results: Median (IQR) FM% at 24 months was 14.7 (13.2–18.0) in breastfed infants and 15.0 (12.9–17.5) in formula fed infants (P=0.968). Changes in weight-for-height_1-24mo (P=0.026) and weight-for-age_1-24mo (P=0.001) were higher in FF infants compared to BF infants. Overall, no significant differences in change in FM%_1-24mo between both groups were found (P=0.159). However, in boys, change in FM%_3-24mo was significantly higher in FF infants (P=0.017). Change in FM%_1-3mo correlated positively with FM% at 24 months in the total group (r=0.144, P=0.036) and with subcutaneous FM at 24 months (r=0.167, P=0.007), not with visceral FM (r=0.014, P=0.816).

Conclusions: Infants receiving FF have a significantly higher change in weight-for-height and weight-for-age during the first two years of life compared to BF infants. Change in FM%_1-3mo correlates with FM% at 24 months, which supports the theory of a critical window for FM development after birth.