Breastfeeding may help prevent early puberty

Children who were breastfed during the first 4–6 months of life are less likely to have central precocious puberty (CPP), with the protective association being partially mediated by prepubertal adiposity, according to a retrospective study.

Researchers used health claims data from the South Korean National Health Insurance Service Database. They identified children who underwent routine health checkups at 4 to 6 months (examination 1) and 66 to 71 months (examination 7). Exclusion criteria included the presence of comorbidities, death during the follow-up period, missing information, and a diagnosis of CPP before age 6 years.

The primary outcome of CPP was examined in relation to feeding practice patterns during infancy, the data for which were collected through a primary caregiver–reported questionnaire during examination 1.

A total of 322,731 children (58.1 percent girls) were included in the analysis. Of these, 46 percent were exclusively breastfed, 34.9 percent were formula-fed, and 19.1 percent were mixed-fed.

In multivariable Cox proportional hazards models, the risk of CPP was highest among formula-fed boys (adjusted hazard ratio [aHR], 1.16, 95 percent confidence interval [CI], 1.10–1.21) and girls (aHR, 1.60, 95 percent CI, 1.24–2.06), followed by mixed-fed boys (aHR, 1.14, 95 percent CI, 1.07–1.20) and girls (AHR, 1.45, 95 percent CI, 1.07–1.97), relative to exclusively breastfed children.

Mediation analysis indicated that prepubertal adiposity accounted for 7.2 percent and 17.8 percent of the association between formula feeding and CPP in boys and girls, respectively.

The present data highlight the importance of early-life nutrition in pubertal timing.