This prospective study assessed the relation of breastfeeding (BF) and infant sugar-sweetened beverages (SSBs) intake to subsequent obesity among children (2-5y) exposed to gestational diabetes (GDM) in utero.
Methods: The analysis utilized data from the Study of Women, Infant Feeding and Type 2 Diabetes after GDM (SWIFT), a prospective, observational cohort of 1,035 women (20-45y) diagnosed with GDM who delivered ≥35 wks. gestation from 2008-2011. SWIFT participants consented to 3 in-person research visits from 6-9 wks. thru 2 y postpartum and completed monthly mailed surveys on infant diet, including BF intensity/duration and SSB intake from birth to 1 y categorized as Any SSB, Any 100% Juice, or No SSB/juice. Child weights and heights at 2-5 y (2013-2016) were obtained from electronic health records (n=815). Logistic regression models estimated the odds ratio (95%CI) for infant diet with child Overweight/Obese (>85th vs.≤85th %tile).
Of 815 GDM offspring, 52% were male, 30% Hispanic, 24% Non-Hispanic White and 38% Asian, 59% were BF≥6 mos., 38% reported Any SSB intake before 1 y, and 53% reported any juice. Compared to normal weight children (2-5 y), those overweight/obese had shorter BF duration (7.3 vs 9.4 mos.; all p<0.001) and were fed SSB (16% vs 22%) and juice during infancy (51% vs 56%; all p<0.01). Compared to children who BF≥6 mos. with no SSB, those BF<6 mos. with Any SSB intake were 3-fold more likely to be overweight/obese (OR=3.4, 95%CI:1.8-6.4, p<0.001), and those BF≥6 mos with Any juice, and thoseBF <6mos with ANY juicehad higher odds of being overweight/obese, respectively,(OR=1.8 95%CI:1.04-3.0; p=0.04), and (OR=2.3; 95%CI:1.3-3.9; p=0.003).
This first prospective study to evaluate BF and infant SSB intake among GDM offspring showed that longer BF combined with avoidance of SSB and juice during early postnatal life may ameliorate future obesity in this high-risk population.