Feeding patterns and BMI trajectories during infancy: a multi-ethnic, prospective birth cohort

Outi Sirkka*, Michel H. Hof, Tanja Vrijkotte, Marieke Abrahamse-Berkeveld, Jutka Halberstadt, Jacob C. Seidell, Margreet R. Olthof

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Milk feeding type (exclusive breastfeeding [EBF], formula feeding or mixed feeding) and timing of complementary feeding (CF) have been associated with infant growth. However, studies evaluating their combined role, and the role of ethnicity, are scarce. We examined associations of feeding patterns (milk feeding type combined with timing of CF) with infant body mass index (BMI) trajectories and potential ethnic-specific associations.

Infant feeding and BMI data during the 1st year of life from 3524 children (Dutch n = 2880, Moroccan n = 404 and Turkish n = 240) from the Amsterdam Born Children and their Development (ABCD) cohort were used. Six feeding patterns were defined: EBF/earlyCF, EBF/lateCF (reference), formula/earlyCF, formula/lateCF, mixed/earlyCF and mixed/lateCF. A covariate adjusted latent class mixed model was applied to simultaneously model BMI trajectories and associations with feeding patterns. Potential ethnic differences in the associations were studied in a separate model where interactions between ethnicity and feeding patterns were included.

Four distinct BMI trajectories (low, mid-low, mid-high and high) were identified. Feeding pattern of formula/earlyCF was associated with lower odds for low (OR: 0.43; 95% CI: 0.25, 0.76) or mid-high (0.28; 0.16, 0.51) (ref: high) trajectory compared with EBF/lateCF pattern (ref). An ethnic-specific model revealed that among Dutch infants, formula/earlyCF pattern was associated with lower odds for low trajectory (0.46; 0.24, 0.87), whereas among Turkish/Moroccan infants almost all feeding patterns were associated with lower odds for the low trajectory (ref: high).

Infant feeding patterns are associated with early BMI trajectories with specific ethnic differences. Future studies should take the role of ethnicity into account in the associations between infant feeding and growth.
Original languageEnglish
Article number34
Pages (from-to)1-11
Number of pages11
JournalBMC Pediatrics
Early online date13 Jan 2021
Publication statusPublished - Dec 2021

Bibliographical note

Funding Information:
The ABCD study was supported by the following grants from the Netherlands Organization for Health Research and Development (ZonMw) TOP, 40–00812–98-11010, 40–00812–98–11010, 40–00703–98-11627, 92003489, 2100.0076, 85600004, 85800001 and the Netherlands Heart Foundation (Hartstichting) DHF-2007B103. PhD position of OS is partly funded by the Amsterdam Public Health institute (former EMGO+ Institute).

Publisher Copyright:
© 2021, The Author(s).

Copyright 2021 Elsevier B.V., All rights reserved.


  • BMI trajectories
  • Breastfeeding
  • Complementary feeding
  • Infant feeding
  • Overweight


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