Excessive weight gain followed by catch-down in exclusively breastfed infants: An exploratory study

TY - JOUR

T1 - Excessive weight gain followed by catch-down in exclusively breastfed infants

T2 - An exploratory study

AU - Larsson, Melanie Wange

AU - Lind, Mads Vendelbo

AU - Larnkjær, Anni

AU - Due, Anette P

AU - Blom, Irina C

AU - Wells, Jonathan

AU - Lai, Ching T

AU - Mølgaard, Christian

AU - Geddes, Donna T

AU - Michaelsen, Kim F.

N1 - CURIS 2018 NEXS 321

PY - 2018/9/12

Y1 - 2018/9/12

N2 - Some infants experience excessive weight gain (EWG) during exclusive breastfeeding, but causes and consequences are unknown. The objective was to identify factors associated with early EWG. Infants with EWG (HW-group) were examined at 5, 9 and 18 mo and compared to a breastfed group with normal weight gain (NW-group). Anthropometry, body composition, milk and blood samples, and milk intake were measured. Mean body-mass-index-for-age z-scores (BAZ) increased 1.93 from birth to 5 mo in the HW-group (n = 13) while the NW-group (n = 17) was unchanged (-0.01). The HW-group had 70% more fat mass at 5 mo, and then showed marked catch-down in BAZ from 5 to 18 mo (-0.84). Milk intake at 5⁻6 mo did not differ between the groups. In the HW-group milk-leptin was lower at 5 mo and serum-leptin was considerably higher at 5 and 9 mo compared to the NW-group. Serum-leptin at 5 mo was positively associated with weight-for-age z-score (WAZ) and fat mass and negatively with WAZ change from 5 to 9 mo. In conclusion, breastfed infants with EWG had catch-down growth when other foods were introduced. Low milk-leptin in the HW-group may have stimulated appetite and milk intake when weight gain was high. High serum-leptin in the HW-group suggests early leptin resistance, which could impact cerebral regulation of energy intake. Larger studies are needed to confirm these results.

AB - Some infants experience excessive weight gain (EWG) during exclusive breastfeeding, but causes and consequences are unknown. The objective was to identify factors associated with early EWG. Infants with EWG (HW-group) were examined at 5, 9 and 18 mo and compared to a breastfed group with normal weight gain (NW-group). Anthropometry, body composition, milk and blood samples, and milk intake were measured. Mean body-mass-index-for-age z-scores (BAZ) increased 1.93 from birth to 5 mo in the HW-group (n = 13) while the NW-group (n = 17) was unchanged (-0.01). The HW-group had 70% more fat mass at 5 mo, and then showed marked catch-down in BAZ from 5 to 18 mo (-0.84). Milk intake at 5⁻6 mo did not differ between the groups. In the HW-group milk-leptin was lower at 5 mo and serum-leptin was considerably higher at 5 and 9 mo compared to the NW-group. Serum-leptin at 5 mo was positively associated with weight-for-age z-score (WAZ) and fat mass and negatively with WAZ change from 5 to 9 mo. In conclusion, breastfed infants with EWG had catch-down growth when other foods were introduced. Low milk-leptin in the HW-group may have stimulated appetite and milk intake when weight gain was high. High serum-leptin in the HW-group suggests early leptin resistance, which could impact cerebral regulation of energy intake. Larger studies are needed to confirm these results.

KW - Faculty of Science

KW - Exclusively breastfed infants

KW - Weight-gain

KW - Infant growth

KW - Body composition

KW - Human milk composition

KW - Leptin

KW - Human milk intake

KW - Pediatrics

KW - Breastfeeding

U2 - 10.3390/nu10091290

DO - 10.3390/nu10091290

M3 - Journal article

C2 - 30213080

SN - 2072-6643

VL - 10

JO - Nutrients

JF - Nutrients

IS - 9

M1 - 1290

ER -