Breastfeeding Status at Age 3 Months Is Associated with Adiposity and Cardiometabolic Markers at Age 4 Years in Mexican Children1–3

Background: The effect of breastfeeding (BF) on cardiometabolic risk factors is not well characterized. Objective: The objective was to assess the association of BF status at 3 mo and duration with adiposity and cardiometabolic markers at 4 y. Methods:We studied 727 children with prospectively collected BF information and anthropometric measurements at 4 y, of whom 524 provided a nonfasting blood sample. BF status at 3 mo was classified as exclusive or predominant (EBF-PreBF), partial (PaBF), or nonbreastfeeding (NBF). Total duration of any BF was classified as <3 mo, 3 – 6 mo,>6 to 12 mo, and>12 mo. We modeled associations of BF with body mass index (BMI; in kg/m2), serum total cholesterol and low-density lipoprotein (LDL) cholesterol, triglycerides (TGs), and insulin at 4 y. Results: Children whowere NBF or PaBF at 3 mo had higher BMI [0.46 (95%CI: 0.16, 0.76) and 0.31 (95%CI: 0.07, 0.54), respectively] than the EBF-PreBF group (P < 0.01). NBF children had higher total cholesterol (8.02 mg/dL; 95 % CI: 1.39, 14.64; P = 0.02) than children who were EBF-PreBF. LDL cholesterol (5.04 mg/dL; 95 % CI: 20.72, 10.81) and TGs (12% change; 95 % CI:20.01, 0.24) showed similar patterns. An inverse association between EBF-PreBF and insulin, mediated through abdominal circumference, was documented (P < 0.05). Children breastfed <3 mo had higher BMI (0.44; 95 % CI: 0.11, 0.77) at 4 y than children breastfed for>12 mo