Breast Feeding
Conditions
Keywords
Body Composition, Adipose Tissue, Intrahepatocellular Lipid, Infant, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy
Brief summary
Breast feeding is believed to be beneficial to long-term health but how these effects are mediated is unknown. I suggest that this may be through effects on body composition and metabolism. I will compare adipose tissue and liver fat deposition in healthy, full term breast and formula fed infants babies shortly after birth and around 12 weeks.
Interventions
None listed
Sponsors
Chelsea and Westminster NHS Foundation Trust
Imperial College London
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
No minimum to 4 Weeks
Healthy volunteers
Yes
Inclusion criteria
* Healthy baby * Term baby * Appropriate weight for gestational age (UK - WHO 2009 growth charts)
Exclusion criteria
* Infants of diabetic mothers * Infants of smokers * Infants fed non-commercial or non-cows milk based infant formulae
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Total Adipose Tissue Volume | Between birth and 6-12 weeks age | Difference in total adipose tissue volume, measured using whole body magnetic resonance imaging. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Regional Adipose Tissue Distribution Compared to Breastfed Infants. | Between birth and 6-12 weeks age | Change in regional adipose tissue distribution (ratio of internal abdominal to total subcutaneous abdominal adipose tissue) measured using whole body magnetic resonance imaging |
| Change in Intrahepatocellular Lipid Compared to Breastfed Infants. | Between birth and 6-12 weeks age | Change in intrahepatocellular lipid (IHCL) compared to breastfed infants, measured using in-vivo hepatic magnetic resonance spectroscopy |
Countries
United Kingdom
Participant flow
Recruitment details
Participants consisted of healthy, full term, appropriate weight-for-gestational age infants from 2 cohorts: recruited between November 1999 and October 2001 at the Hammersmith Hospital, and between March 2010 and May 2012 from the postnatal ward at Chelsea and Westminster Hospital.
Participants by arm
| Arm | Count |
|---|---|
| Breastfed Infants \>80% of feeds consisting of breast milk at both scanning points | 36 |
| Mixed-fed Infants 20%-80% of feeds consisting of breast milk. | 9 |
| Formula-fed Infants \>80% of feeds consisting of formula milk at both scanning points | 25 |
| Total | 70 |
Baseline characteristics
| Characteristic | Breastfed Infants | Mixed-fed Infants | Formula-fed Infants | Total |
|---|---|---|---|---|
| Age, Categorical <=18 years | 36 Participants | 9 Participants | 25 Participants | 70 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Continuous | 13 Days | 2 Days | 16 Days | 13 Days |
| Deep subcutaneous abdominal adipose tissue | 0.015 Litres | 0.013 Litres | 0.019 Litres | 0.016 Litres |
| Deep subcutaneous non-abdominal adipose tissue | 0.012 Litres | 0.012 Litres | 0.013 Litres | 0.013 Litres |
| Head circumference | 36.5 cm STANDARD_DEVIATION 1.4 | 35.0 cm STANDARD_DEVIATION 1.7 | 36 cm STANDARD_DEVIATION 1.6 | 36.1 cm STANDARD_DEVIATION 1.6 |
| Internal abdominal adipose tissue | 0.017 Litres | 0.022 Litres | 0.017 Litres | 0.017 Litres |
| Internal non-abdominal adipose tissue | 0.054 Litres | 0.061 Litres | 0.052 Litres | 0.054 Litres |
| Intrahepatocellular lipid | 0.662 Ratio of CH2 (methylene) to H2O (water) | 1.126 Ratio of CH2 (methylene) to H2O (water) | 1.197 Ratio of CH2 (methylene) to H2O (water) | 0.949 Ratio of CH2 (methylene) to H2O (water) |
| Length | 0.533 m STANDARD_DEVIATION 0.023 | 0.510 m STANDARD_DEVIATION 0.025 | 0.523 m STANDARD_DEVIATION 0.025 | 0.527 m STANDARD_DEVIATION 0.025 |
| Region of Enrollment United Kingdom | 36 participants | 9 participants | 25 participants | 70 participants |
| Sex: Female, Male Female | 11 Participants | 4 Participants | 15 Participants | 30 Participants |
| Sex: Female, Male Male | 25 Participants | 5 Participants | 10 Participants | 40 Participants |
| Superficial subcutaneous abdominal adipose tissue | 0.098 Litres | 0.110 Litres | 0.103 Litres | 0.101 Litres |
| Superficial subcutaneous non-abdominal adipose tissue | 0.512 Litres | 0.572 Litres | 0.521 Litres | 0.512 Litres |
| Total adipose tissue | 0.710 l | 0.802 l | 0.722 l | 0.718 l |
| Total adipose tissue mass % | 17.5 Percentage of mass | 21.3 Percentage of mass | 18.3 Percentage of mass | 18.1 Percentage of mass |
| Total internal adipose tissue | 0.070 Litres | 0.084 Litres | 0.069 Litres | 0.070 Litres |
| Total subcutaneous adipose tissue | 0.633 Litres | 0.718 Litres | 0.654 Litres | 0.644 Litres |
| Weight | 3.647 kg STANDARD_DEVIATION 0.421 | 3.332 kg STANDARD_DEVIATION 0.478 | 3.622 kg STANDARD_DEVIATION 0.595 | 3.598 kg STANDARD_DEVIATION 0.5 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 36 | 0 / 9 | 0 / 25 |
| other Total, other adverse events | 0 / 36 | 0 / 9 | 0 / 25 |
| serious Total, serious adverse events | 0 / 36 | 0 / 9 | 0 / 25 |
Outcome results
Primary
Change in Total Adipose Tissue Volume
Difference in total adipose tissue volume, measured using whole body magnetic resonance imaging.
Time frame: Between birth and 6-12 weeks age
Population: Reduced participant number for this analysis represents missing data for some infants at one scan point
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Breastfed | Change in Total Adipose Tissue Volume | 0.718 Litres |
| Mixed-fed Infants | Change in Total Adipose Tissue Volume | 0.901 Litres |
| Formula-fed Infants | Change in Total Adipose Tissue Volume | 0.775 Litres |
Secondary
Change in Intrahepatocellular Lipid Compared to Breastfed Infants.
Change in intrahepatocellular lipid (IHCL) compared to breastfed infants, measured using in-vivo hepatic magnetic resonance spectroscopy
Time frame: Between birth and 6-12 weeks age
Population: Reduced number of participants due to missing intrahepatocellular lipid data in some cases
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Breastfed | Change in Intrahepatocellular Lipid Compared to Breastfed Infants. | 1.192 ratio of CH2 to water |
| Mixed-fed Infants | Change in Intrahepatocellular Lipid Compared to Breastfed Infants. | -0.054 ratio of CH2 to water |
| Formula-fed Infants | Change in Intrahepatocellular Lipid Compared to Breastfed Infants. | 1.095 ratio of CH2 to water |
Secondary
Change in Regional Adipose Tissue Distribution Compared to Breastfed Infants.
Change in regional adipose tissue distribution (ratio of internal abdominal to total subcutaneous abdominal adipose tissue) measured using whole body magnetic resonance imaging
Time frame: Between birth and 6-12 weeks age
Population: Reduced participant number for this analysis represents missing data for some infants at one scan point
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Breastfed | Change in Regional Adipose Tissue Distribution Compared to Breastfed Infants. | -0.07 no unit (ratio) |
| Mixed-fed Infants | Change in Regional Adipose Tissue Distribution Compared to Breastfed Infants. | -0.06 no unit (ratio) |
| Formula-fed Infants | Change in Regional Adipose Tissue Distribution Compared to Breastfed Infants. | -0.03 no unit (ratio) |