Skip to main content Accessibility help
×
Home

Associations of breast-feeding patterns and introduction of solid foods with childhood bone mass: The Generation R Study

  • Edith H. van den Hooven (a1), Mounira Gharsalli (a1) (a2) (a3), Denise H. M. Heppe (a1) (a2) (a3), Hein Raat (a4), Albert Hofman (a1), Oscar H. Franco (a1), Fernando Rivadeneira (a1) (a5) and Vincent W. V. Jaddoe (a1) (a2) (a3)...

Abstract

Breast-feeding has been associated with later bone health, but results from previous studies are inconsistent. We examined the associations of breast-feeding patterns and timing of introduction of solids with bone mass at the age of 6 years in a prospective cohort study among 4919 children. We collected information about duration and exclusiveness of breast-feeding and timing of introduction of any solids with postnatal questionnaires. A total body dual-energy X-ray absorptiometry scan was performed at 6 years of age, and bone mineral density (BMD), bone mineral content (BMC), area-adjusted BMC (aBMC) and bone area (BA) were analysed. Compared with children who were ever breast-fed, those never breast-fed had lower BMD (−4·62 mg/cm2; 95 % CI −8·28, −0·97), BMC (−8·08 g; 95 % CI −12·45, −3·71) and BA (−7·03 cm2; 95 % CI −12·55, −1·52) at 6 years of age. Among all breast-fed children, those who were breast-fed non-exclusively in the first 4 months had higher BMD (2·91 mg/cm2; 95 % CI 0·41, 5·41) and aBMC (3·97 g; 95 % CI 1·30, 6·64) and lower BA (−4·45 cm2; 95 % CI −8·28, −0·61) compared with children breast-fed exclusively for at least 4 months. Compared with introduction of solids between 4 and 5 months, introduction <4 months was associated with higher BMD and aBMC, whereas introduction between 5 and 6 months was associated with lower aBMC and higher BA. Additional adjustment for infant vitamin D supplementation did not change the results. In conclusion, results from the present study suggest that ever breast-feeding compared with never breast-feeding is associated with higher bone mass in 6-year-old children, but exclusive breast-feeding for 4 months or longer was not positively associated with bone outcomes.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Associations of breast-feeding patterns and introduction of solid foods with childhood bone mass: The Generation R Study
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Associations of breast-feeding patterns and introduction of solid foods with childhood bone mass: The Generation R Study
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Associations of breast-feeding patterns and introduction of solid foods with childhood bone mass: The Generation R Study
      Available formats
      ×

Copyright

Corresponding author

* Corresponding author: V. W. V. Jaddoe, fax +31 10 7044645, email v.jaddoe@erasmusmc.nl

References

Hide All
1. Foley, S, Quinn, S & Jones, G (2009) Tracking of bone mass from childhood to adolescence and factors that predict deviation from tracking. Bone 44, 752757.
2. Javaid, MK & Cooper, C (2002) Prenatal and childhood influences on osteoporosis. Best Pract Res Clin Endocrinol Metab 16, 349367.
3. Cooper, C, Westlake, S, Harvey, N, et al. (2006) Review: developmental origins of osteoporotic fracture. Osteoporos Int 17, 337347.
4. Agostoni, C, Carratu, B, Boniglia, C, et al. (2000) Free amino acid content in standard infant formulas: comparison with human milk. J Am Coll Nutr 19, 434438.
5. Ballard, O & Morrow, AL (2013) Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am 60, 4974.
6. Kennedy, K, Fewtrell, MS, Morley, R, et al. (1999) Double-blind, randomized trial of a synthetic triacylglycerol in formula-fed term infants: effects on stool biochemistry, stool characteristics, and bone mineralization. Am J Clin Nutr 70, 920927.
7. Litmanovitz, I, Davidson, K, Eliakim, A, et al. (2013) High beta-palmitate formula and bone strength in term infants: a randomized, double-blind, controlled trial. Calcif Tissue Int 92, 3541.
8. Specker, BL, Beck, A, Kalkwarf, H, et al. (1997) Randomized trial of varying mineral intake on total body bone mineral accretion during the first year of life. Pediatrics 99, E12.
9. Jones, G, Riley, M & Dwyer, T (2000) Breastfeeding in early life and bone mass in prepubertal children: a longitudinal study. Osteoporos Int 11, 146152.
10. Molgaard, C, Larnkjaer, A, Mark, AB, et al. (2011) Are early growth and nutrition related to bone health in adolescence? The Copenhagen Cohort Study of infant nutrition and growth. Am J Clin Nutr 94, 6 Suppl., 1865S1869S.
11. Jones, G, Hynes, KL & Dwyer, T (2013) The association between breastfeeding, maternal smoking in utero, and birth weight with bone mass and fractures in adolescents: a 16-year longitudinal study. Osteoporos Int 24, 16051611.
12. Harvey, NC, Robinson, SM, Crozier, SR, et al. (2009) Southampton Women’s Survey Study G. Breast-feeding and adherence to infant feeding guidelines do not influence bone mass at age 4 years. Br J Nutr 102, 915920.
13. Zuccotti, G, Vigano, A, Cafarelli, L, et al. (2011) Longitudinal changes of bone ultrasound measurements in healthy infants during the first year of life: influence of gender and type of feeding. Calcif Tissue Int 89, 312317.
14. Butte, NF, Wong, WW, Hopkinson, JM, et al. (2000) Infant feeding mode affects early growth and body composition. Pediatrics 106, 13551366.
15. Pirila, S, Taskinen, M, Viljakainen, H, et al. (2011) Infant milk feeding influences adult bone health: a prospective study from birth to 32 years. PLoS ONE 6, e19068.
16. Wagner, CL & Greer, FR American Academy of Pediatrics Section on Breastfeeding, et al. (2008) Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 122, 11421152.
17. Jaddoe, VW, van Duijn, CM, Franco, OH, et al. (2012) The Generation R Study: design and cohort update 2012. Eur J Epidemiol 27, 739756.
18. Durmus, B, van Rossem, L, Duijts, L, et al. (2011) Breast-feeding and growth in children until the age of 3 years: the Generation R Study. Br J Nutr 105, 17041711.
19. Miliku, K, Voortman, T, Bakker, H, et al. (2015) Infant breastfeeding and kidney function in school-aged children. Am J Kidney Dis 66, 421–428.
20. Heppe, DH, Medina-Gomez, C, Hofman, A, et al. (2013) Maternal first-trimester diet and childhood bone mass: the Generation R Study. Am J Clin Nutr 98, 224232.
21. Bianchi, ML, Baim, S, Bishop, NJ, et al. (2010) Official positions of the International Society for Clinical Densitometry (ISCD) on DXA evaluation in children and adolescents. Pediatr Nephrol 25, 3747.
22. Heaney, RP (2003) Bone mineral content, not bone mineral density, is the correct bone measure for growth studies. Am J Clin Nutr 78, 350351; author reply 351–352.
23. Prentice, A, Parsons, TJ & Cole, TJ (1994) Uncritical use of bone mineral density in absorptiometry may lead to size-related artifacts in the identification of bone mineral determinants. Am J Clin Nutr 60, 837842.
24. Warner, JT, Cowan, FJ, Dunstan, FD, et al. (1998) Measured and predicted bone mineral content in healthy boys and girls aged 6-18 years: adjustment for body size and puberty. Acta Paediatr 87, 244249.
25. Macdonald-Wallis, C, Tobias, JH, Smith, GD, et al. (2010) Relation of maternal prepregnancy body mass index with offspring bone mass in childhood: is there evidence for an intrauterine effect? Am J Clin Nutr 92, 872880.
26. Niklasson, A, Ericson, A, Fryer, JG, et al. (1991) An update of the Swedish reference standards for weight, length and head circumference at birth for given gestational age (1977–1981). Acta Paediatr Scand 80, 756762.
27. Statistics Netherlands (2004) Migrants in the Netherlands (in Dutch). http://www.cbs.nl/nr/rdonlyres/bd11b2ee-83de-47fb-9abc-f8fffe1f3c07/0/2004b52pub.pdf (accessed January 2013).
28. van den Hooven, EH, Heppe, DH, Kiefte-de Jong, JC, et al. (2015) Infant dietary patterns and bone mass in childhood: the Generation R Study. Osteoporos Int 26, 15951604.
29. Sterne, JA, White, IR, Carlin, JB, et al. (2009) Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ 338, b2393.
30. Bishop, NJ, Dahlenburg, SL, Fewtrell, MS, et al. (1996) Early diet of preterm infants and bone mineralization at age five years. Acta Paediatr 85, 230236.
31. Fewtrell, MS, Prentice, A, Jones, SC, et al. (1999) Bone mineralization and turnover in preterm infants at 8-12 years of age: the effect of early diet. J Bone Miner Res 14, 810820.
32. Fewtrell, MS, Williams, JE, Singhal, A, et al. (2009) Early diet and peak bone mass: 20 year follow-up of a randomized trial of early diet in infants born preterm. Bone 45, 142149.
33. Agostoni, C, Decsi, T, Fewtrell M, et al. (2008) Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr 46, 99110.
34. Mehta, KC, Specker, BL, Bartholmey, S, et al. (1998) Trial on timing of introduction to solids and food type on infant growth. Pediatrics 102, 569573.
35. Bainbridge, RR, Mimouni, FB, Landi, T, et al. (1996) Effect of rice cereal feedings on bone mineralization and calcium homeostasis in cow milk formula fed infants. J Am Coll Nutr 15, 383388.
36. World Health Organization (2003) Global Strategy for Infant and Young Child Feeding. Geneva: WHO. http://www.who.int/nutrition/publications/infantfeeding/9241562218/en (accessed November 2014).
37. ESPGHAN Committee on Nutrition, Agostoni, C, Braegger, C, et al. (2009) Breast-feeding: a commentary by the ESPGHAN committee on nutrition. J Pediatr Gastroenterol Nutr 49, 112125.
38. Health Council of the Netherlands (2008) Towards an adequate intake of vitamin D publication no. 2008/15. http://www.gezondheidsraad.nl/sites/default/files/200815E.pdf (accessed December 2014).

Keywords

Type Description Title
WORD
Supplementary materials

van den Hooven supplementary material
Table S1-S3

 Word (25 KB)
25 KB

Associations of breast-feeding patterns and introduction of solid foods with childhood bone mass: The Generation R Study

  • Edith H. van den Hooven (a1), Mounira Gharsalli (a1) (a2) (a3), Denise H. M. Heppe (a1) (a2) (a3), Hein Raat (a4), Albert Hofman (a1), Oscar H. Franco (a1), Fernando Rivadeneira (a1) (a5) and Vincent W. V. Jaddoe (a1) (a2) (a3)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed