Infants with Excessive Weight Gain while Exclusively Breastfeeding: Follow-Up at 36 Months.

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Breastfeeding Medicine Pub Date : 2025-01-20 DOI:10.1089/bfm.2024.0387
Anni Larnkjær, Melanie W Larsson, Jonathan Wells, Sophie H Christensen, Jack I Lewis, Christian Mølgaard, Kim F Michaelsen
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Abstract

Objectives: Rapid weight gain in infancy is associated with an increased risk of later adiposity. Very rarely, however, exclusively breastfed infants experience excessive weight gain (EWG) during the period of exclusive breastfeeding (EBF) when breast milk is the only source of nutrition. We investigated growth and body composition at 36 months in children experiencing EWG during EBF. Methods: Ten infants with EWG during the first 6 months of EBF were followed up at 36 months. The infants had been followed from age 5 months. Examinations included anthropometry, body composition by bioimpedance, and blood samples. Body composition and plasma leptin concentrations were available for eight and five children, respectively. Results: From 5 to 36 months, body mass index-for-age z-scores (BAZ) decreased from (mean ± standard deviation) 2.33 ± 0.94 to 1.48 ± 0.57, and only one child still being overweight (BAZ >2). Fat mass and fat mass index (FMI) decreased from 18 to 36 months (4.71 ± 0.56 to 3.57 ± 0.67 kg and 6.50 ± 0.34 to 3.66 ± 0.72 kg/m2, respectively) with a concurrent 45% decrease in leptin. The increase in lean mass was higher than the increase in weight (5.27 versus 3.65 kg, respectively) due to fat loss. There was substantial conformity within the sample in the patterns of body composition change. Conclusion: This unusual group of children continued to decrease in BAZ and FMI with a concomitant increase in fat-free mass, indicating an ongoing normalization of body weight and composition.

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纯母乳喂养时体重过度增加的婴儿:36个月的随访。
目的:婴儿期体重迅速增加与后期肥胖风险增加有关。然而,在纯母乳喂养(EBF)期间,当母乳是唯一的营养来源时,纯母乳喂养的婴儿很少会出现体重过度增加(EWG)。我们调查了在EBF期间经历EWG的儿童在36个月时的生长和身体组成。方法:对10例在EBF前6个月出现EWG的婴儿进行随访,随访时间为36个月。这些婴儿从5个月大开始被跟踪。检查包括人体测量、生物阻抗身体成分和血液样本。分别有8名和5名儿童的身体成分和血浆瘦素浓度。结果:5 ~ 36月龄儿童体重指数z-score (BAZ)由(均值±标准差)2.33±0.94降至1.48±0.57,仅有1名儿童仍超重(BAZ bbb2)。脂肪质量和脂肪质量指数(FMI)从18个月到36个月下降(分别为4.71±0.56至3.57±0.67 kg和6.50±0.34至3.66±0.72 kg/m2),同时瘦素下降45%。由于脂肪减少,瘦质量的增加高于体重的增加(分别为5.27 kg和3.65 kg)。在样本内,身体成分变化的模式有很大的一致性。结论:这组不寻常的儿童BAZ和FMI持续下降,同时无脂质量增加,表明体重和组成正在正常化。
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来源期刊
Breastfeeding Medicine
Breastfeeding Medicine OBSTETRICS & GYNECOLOGY-PEDIATRICS
CiteScore
4.20
自引率
11.10%
发文量
130
审稿时长
6-12 weeks
期刊介绍: Breastfeeding Medicine provides unparalleled peer-reviewed research, protocols, and clinical applications to ensure optimal care for mother and infant. The Journal answers the growing demand for evidence-based research and explores the immediate and long-term outcomes of breastfeeding, including its epidemiologic, physiologic, and psychological benefits. It is the exclusive source of the Academy of Breastfeeding Medicine protocols. Breastfeeding Medicine coverage includes: Breastfeeding recommendations and protocols Health consequences of artificial feeding Physiology of lactation and biochemistry of breast milk Optimal nutrition for the breastfeeding mother Breastfeeding indications and contraindications Managing breastfeeding discomfort, pain, and other complications Breastfeeding the premature or sick infant Breastfeeding in the chronically ill mother Management of the breastfeeding mother on medication Infectious disease transmission through breast milk and breastfeeding The collection and storage of human milk and human milk banking Measuring the impact of being a “baby-friendly” hospital Cultural competence and cultural sensitivity International public health issues including social and economic issues.
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