Background: Pediatric obesity is an important risk factor for chronic diseases in adulthood. Some infant feeding practices may contribute to childhood obesity.
Objective: To investigate whether the introduction of milk thickeners to bottle-fed infants between 3 and 6 months of age was associated with higher anthropometric measurements and indices at 1 and 4 years of age.
Methods: A population-based birth cohort study was conducted in 1993 in the urban area of Pelotas, Brazil. Information was obtained at birth, at 1, 3, 6, and 12 months, and at 4 years. Data were analyzed from the 596 children for whom information was available from all follow-up visits. The exposure of interest was the use of milk thickener (flour added to cow's milk) between the third and sixth months of life. The outcomes investigated were weight and length/height and the anthropometric indices weight-for-age, length/height-for-age, and weight-for-length/height z-scores at 1 and 4 years.
Results: The prevalence of use of milk thickener at any time between the third and sixth months was 44.6%. In the adjusted analysis, children who received milk thickener were, on average, 160 g heavier and 0.5 cm longer at I year than those who did not receive it. Weight-for-age and length-for-age z-scores were positively associated with use of milk thickener. No association was observed between this feeding practice and weight-for-length z-score. In the adjusted analysis, no effect of use of milk thickener on any of the anthropometric outcomes studied was observed at 4 years.
Conclusions: No association was found between the use of milk thickeners and weight-for-length/height z-scores in the first and fourth years of life. Future studies in other contexts would be helpful to further test this hypothesis.