(P10-023-24) The Impact of Prolonged Breastfeeding on Growth, Development, and Diet Quality Until Age 24 months

Objectives: The current recommendation by the World Health Organization and the American Academy of Pediatrics is to continue breastfeeding through 2 years of age. The objective of this study was to examine the effects of breastfeeding beyond infancy ( >1 year) (BBI) on toddler growth, development and dietary intake.

Methods: Participants (n= 195) of a prospective longitudinal study were categorized into 3 groups based on early infant feeding: exclusively formula fed (FF, N= 32), breastfed between 1 and 12 months (BF12, N= 110), breastfeed after 12 months until up to 24 months (BF24, N= 53). Data collected included demographics, anthropometrics, Toddler Healthy Eating Index (HEI, ages 12-23 months), and Bayley Scales of Infant and Toddler Development (BSID). Statistical methods used include Pearson’s Chi-squared test, ANOVAs, linear models, linear mixed effects modeling, and estimated marginal means. Maternal BMI, race, education and infant age of complementary food introduction were included as covariates.

Results: At age 1 year, BF12 and FF males had higher weight (β= 0.47 kg, p= 0.034; and β= 0.69, p= 0.017, respectively) and fat free mass (β= 0.43 kg, p= 0.054; and β= 0.53, p= 0.002, respectively) compared to BF24 males. The motor and gross motor scores (Δ= -3.89, p= 0.051 and Δ= -1.25, p= 0.0053) of BF24 children were significantly lower compared to BF12 children. HEI score was higher in BF12 children compared to BF24 children (Δ= 2.91, p= 0.029). At age 2 years, BF24 children has lower weight-for-length z-scores compared to FF children and BF12 children (β= 0.43, p= 0.03 and β= 0.28, p= 0.07, respectively). Cognitive and adaptive behavior scores were higher in BF24 children (Δ= 2.87, p= 0.03 and Δ= 5.36, p= 0.025, respectively) compared to BF12 children. Introduction complementary foods happened on average 2.6 weeks earlier for the BF12 compared to BF24 children (p= 0.0079). There were no differences in HEI scores.

Conclusions: To our knowledge, this report is one of the first using data from a prospective longitudinal study on this topic. The results of this study support the current recommendations that breastfeeding beyond infancy is beneficial by highlighting differences in childhood growth, nutritional status, and overall development. Further studies are needed to continue to evaluate the effect of BBI throughout childhood and beyond.

Funding Sources: USDA-ARS