[Association between feeding patterns within 4 months of age and physical growth, overweight and obesity in children aged 0-3 years old].

Objective: To investigate the association between feeding patterns within 4 months of age and both physical growth and the risk of overweight and obesity in young children aged 0-3 years.

Methods: Based on the TAWS prospective cohort study in China, children aged 0-3 years were followed up in Taicang cohort from 2013 to 2019. A structured questionnaire was used to collect and evaluate the feeding patterns of children within the first 4 months, weight and height/length were measured at birth and at 1, 3, 6, 8, 12, 18, 24, 30 and 36 months of age, weight for age Z-score(WAZ), length for age Z-score(LAZ) and weight for length Z-score(WLZ) were calculated for each measurement. The χ~2 test was used to compare the malnutrition rates, and applied ANOVA to analyze the differences in physical Z-scores among different feeding patterns at each measurement. Multivariate logistic regression was employed to analyze the correlation between feeding patterns and the risk of overweight and obesity.

Results: Among 1458 children, 18.11%(n=264), 19.41%(n=283), 44.58%(n=650), 15.16%(n=221) and 1.65%(n=24) of them were exclusively breastfed, predominantly breastfed, mixed fed mainly on breast-milk, mixed fed mainly on formula, and formula fed. There were no differences in LAZ、WLZ and WAZ(except 3 months) among the different feeding pattern groups at each time point(P>0.05). After adjusting for the season of physical examination, birth weight, delivery mode, age at weaning, age at introduction of formula and complementary food, feeding patterns within the first 4 months were not associated with the risk of overweight and obesity. The risk of overweight and obesity in children under the age of 3 years was mainly associated with birth weight and delivery mode. Among them, at 12 months of age, the risk of overweight and obesity was higher in children with high birth weight(large-for-gestational-age) than children with normal birth weight(appropriate-for-gestational-age)(OR=4.14, 95% CI 2.06-8.32), and the risk of overweight and obesity was higher in children born by caesarean section than those born naturally(OR=2.47, 95% CI 1.06-8.32).

Conclusion: Children's feeding patterns withinh 4 months are not associated with their physical growth in their first 3 years. Overweight and obesity are mainly influenced by birth weight and delivery mode.