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Does maternal smoking in pregnancy explain the differences in the body composition trajectory between breastfed and formula-fed infants?

Published online by Cambridge University Press:  08 November 2019

Shao J. Zhou*
Affiliation:
School of Agriculture, Food and Wine, The University of Adelaide, Waite Campus, Urrbrae, SA 5064, Australia
Karen Hawke
Affiliation:
South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
Carmel T. Collins
Affiliation:
South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia Discipline of Paediatrics, Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia
Robert A. Gibson
Affiliation:
School of Agriculture, Food and Wine, The University of Adelaide, Waite Campus, Urrbrae, SA 5064, Australia South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
Maria Makrides
Affiliation:
South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia Discipline of Paediatrics, Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia
*
*Corresponding author: Shao J. Zhou, fax +61 8 8 8313 7135, email jo.zhou@adelaide.edu.au
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Abstract

Growth patterns are known to differ between breastfed and formula-fed infants, but little is known about the relative impact of maternal smoking in pregnancy v. feeding mode on growth trajectory in infancy. We conducted a secondary analysis of a trial, the Tolerance of Infant Goat Milk Formula and Growth Assessment trial involving 290 healthy infants, to examine whether smoking in pregnancy modified the association between feeding mode and body composition of infants. Fat mass (FM) and fat-free mass (FFM) were estimated at 1, 2, 3, 4, 6 and 12 months of age using bioimpedance spectroscopy. Formula-fed infants (n 190) had a higher mean FFM at 4 months (mean difference (MD) 160 g, 95 % CI 50·4, 269·5 g, P < 0·05)) and 6 months (MD 179 g, 95 % CI 41·5, 316·9 g, P < 0·05) compared with the breastfed infants (n 100). Sub-group analysis of breastfed v. formula-fed infants by maternal smoking status in pregnancy showed that there were no differences in the FM and FFM between the breastfed and formula-fed infants whose mothers did not smoke in pregnancy. Formula-fed infants whose mothers smoked in pregnancy were smaller at birth and had a lower FM% and higher FFM% at 1 month compared with infants of non-smoking mothers regardless of feeding mode, but the differences were not significant at other time points. Adequately powered prospective studies with an appropriate design are warranted to better understand the relative impact of maternal smoking, feeding practice and the growth trajectory of infants.

Information

Type
Full Papers
Copyright
© The Authors 2019 
Figure 0

Table 1. Demographic characteristics of participants by feeding mode and maternal smoking status (Mean values and standard deviations; numbers and percentages)

Figure 1

Fig. 1. Fat mass (a), fat mass percentage (b), fat-free mass (c) and fat-free mass percentage (d) of formula-fed v. breastfed infants in the first 12 months of age. Values are mean values with their standard errors. Error bars indicate 95 % confidence intervals. A generalised estimating equation with robust variance estimation was used for statistical analysis. , Formula-fed (n 190); , breastfed (n 100).

Figure 2

Fig. 2. Fat mass (a), fat mass percentage (b), fat-free mass (c) and fat-free mass percentage (d) of infant by feeding mode and maternal smoking status. Values are mean values with their standard errors. Error bars indicate 95 % confidence intervals. A generalised estimating equation with robust variance estimation was used for statistical analysis. BF/non-smoking, breastfed infants whose mothers did not smoke in pregnancy; FF/non-smoking, formula-fed infants whose mothers did not smoke in pregnancy; FF/smoking, formula-fed infants whose mothers smoked in pregnancy. , BF/non-smoking (n 90); , FF/non-smoking (n 114); , FF/smoking (n 76).

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Zhou et al. supplementary material

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Zhou et al. supplementary material

Tables S1-S3

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