Feeding Method, Nicotine Exposure, and Growth during Infancy

Objective: To answer 3 questions: (1) Are infants breastfed by smokers at risk of rapid weight and length gain? (2) Is rapid growth during infancy partially attributable to ingestion of smokers’ breastmilk? (3) If so, what are the implications for breastfeeding by smokers? Study design: Using data f...

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Main Authors: Edmond D. Shenassa, ScD, MA, FACE, Edoardo Botteri, PhD, Hanne Stensheim, MD
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Pediatrics: Clinical Practice
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2950541024000334
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author Edmond D. Shenassa, ScD, MA, FACE
Edoardo Botteri, PhD
Hanne Stensheim, MD
author_facet Edmond D. Shenassa, ScD, MA, FACE
Edoardo Botteri, PhD
Hanne Stensheim, MD
author_sort Edmond D. Shenassa, ScD, MA, FACE
collection DOAJ
description Objective: To answer 3 questions: (1) Are infants breastfed by smokers at risk of rapid weight and length gain? (2) Is rapid growth during infancy partially attributable to ingestion of smokers’ breastmilk? (3) If so, what are the implications for breastfeeding by smokers? Study design: Using data from the Norwegian Mother, Father and Child Cohort Study and Medical Birth Registry of Norway (n = 54 522), we examined changes in weight, length, weight-for-length z-score (WFLZ) during infancy in the context of maternal smoking (0, 1-10, or >10 cigarettes/day) and feeding method during the first 6 months (breastfed, formula fed, mixed fed). We fit generalized linear models, adding a smoking by feeding method interaction term to evaluate the effect of ingesting smokers’ breastmilk. Results: Breastfed infants of both light and heavy smokers experienced WFLZ gains of 0.05 (95% CI, 0.01-0.09) and 0.13 (95% CI, 0.07-0.18), respectively. Among mixed-fed infants, only heavy maternal smoking predicted WFLZ gain (0.10; 95% CI, 0.05-0.16). Among exclusively formula-fed infants, maternal smoking did not predict rapid growth. Interaction models suggest that infants ever breastfed (ie, breastfed and mixed-fed groups combined) by heavy smokers gained weight (100 g; 95% CI, 30-231) and length (2.8 mm; 95% CI, 0.1-5.6), attributable to ingesting smoker's breastmilk. Conclusions: Infants breastfed by smokers experience rapid growth; some of these gains are attributable to ingesting smokers’ breastmilk. Among infants breasted by light smokers, these gains are within the range of normative growth patterns for healthy, breastfed infants.
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spelling doaj-art-84e7725d34ac419ab884b05e19c774042025-08-20T02:35:50ZengElsevierJournal of Pediatrics: Clinical Practice2950-54102024-12-011420012710.1016/j.jpedcp.2024.200127Feeding Method, Nicotine Exposure, and Growth during InfancyEdmond D. Shenassa, ScD, MA, FACE0Edoardo Botteri, PhD1Hanne Stensheim, MD2Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD; Department of Epidemiology and Biostatistics, School of Public Health, Brown University, Providence, RI; Department of Epidemiology and Biostatistics, School of Medicine, University of Maryland, Baltimore, MD; Reprint requests: Edmond D. Shenassa, ScD, MA, FACE, Department of Epidemiology and Biostatistics, School of Public Health, 4254 Stadium Dr, College Park, MD 20742.Department of Research, Cancer Registry of Norway, Oslo, Norway; Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, NorwayDepartment of Research, Cancer Registry of Norway, Oslo, NorwayObjective: To answer 3 questions: (1) Are infants breastfed by smokers at risk of rapid weight and length gain? (2) Is rapid growth during infancy partially attributable to ingestion of smokers’ breastmilk? (3) If so, what are the implications for breastfeeding by smokers? Study design: Using data from the Norwegian Mother, Father and Child Cohort Study and Medical Birth Registry of Norway (n = 54 522), we examined changes in weight, length, weight-for-length z-score (WFLZ) during infancy in the context of maternal smoking (0, 1-10, or >10 cigarettes/day) and feeding method during the first 6 months (breastfed, formula fed, mixed fed). We fit generalized linear models, adding a smoking by feeding method interaction term to evaluate the effect of ingesting smokers’ breastmilk. Results: Breastfed infants of both light and heavy smokers experienced WFLZ gains of 0.05 (95% CI, 0.01-0.09) and 0.13 (95% CI, 0.07-0.18), respectively. Among mixed-fed infants, only heavy maternal smoking predicted WFLZ gain (0.10; 95% CI, 0.05-0.16). Among exclusively formula-fed infants, maternal smoking did not predict rapid growth. Interaction models suggest that infants ever breastfed (ie, breastfed and mixed-fed groups combined) by heavy smokers gained weight (100 g; 95% CI, 30-231) and length (2.8 mm; 95% CI, 0.1-5.6), attributable to ingesting smoker's breastmilk. Conclusions: Infants breastfed by smokers experience rapid growth; some of these gains are attributable to ingesting smokers’ breastmilk. Among infants breasted by light smokers, these gains are within the range of normative growth patterns for healthy, breastfed infants.http://www.sciencedirect.com/science/article/pii/S2950541024000334infancy growthfeeding methodmaternal smokingbreastfeedingbreast milk
spellingShingle Edmond D. Shenassa, ScD, MA, FACE
Edoardo Botteri, PhD
Hanne Stensheim, MD
Feeding Method, Nicotine Exposure, and Growth during Infancy
Journal of Pediatrics: Clinical Practice
infancy growth
feeding method
maternal smoking
breastfeeding
breast milk
title Feeding Method, Nicotine Exposure, and Growth during Infancy
title_full Feeding Method, Nicotine Exposure, and Growth during Infancy
title_fullStr Feeding Method, Nicotine Exposure, and Growth during Infancy
title_full_unstemmed Feeding Method, Nicotine Exposure, and Growth during Infancy
title_short Feeding Method, Nicotine Exposure, and Growth during Infancy
title_sort feeding method nicotine exposure and growth during infancy
topic infancy growth
feeding method
maternal smoking
breastfeeding
breast milk
url http://www.sciencedirect.com/science/article/pii/S2950541024000334
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