Using Food to Soothe in Infancy is Prospectively Associated with Childhood BMI in a Population-Based Cohort

Background: Feeding practices have been implicated in childhood overweight, but the long-term effects of using food to comfort a distressed child remain unknown. Objective: This study examined whether the use of food to soothe in infancy was associated with later body composition, and whether children’s eating behaviors mediate this relation. Methods: Participants were 3960 children of Generation R, a population-based birth cohort in the Netherlands. Parents reported on the use of food to soothe when infants were 6 mo old and on child eating behavior (food responsiveness, emotional eating) at ages 4 and 10 y. Body mass index (BMI), fat mass, and fat-free mass were measured at ages 6 and 10 y. Linear regression and mediation analyses were conducted, accounting for various potential confounding factors. Results: The use of food to soothe when infants were 6 mo old predicted a higher BMI from age 6 y onwards, independently of infant weight, maternal BMI, and other confounders. Specifically, frequent use was associated with a BMI z score 0.13 higher at age 10 y (95% CI: 0.03, 0.22) as compared with never use. Children’s emotional eating mediated this association (indirect effect B = 0.04; 95% CI: 0.02, 0.06). The feeding–body composition association was most evident for fat mass (P for trend = 0.014) and somewhat less for fat-free mass (P for trend = 0.079). Conclusions: The use of food to comfort a distressed infant was consistently associated with obesogenic eating behaviors and an unhealthy body composition throughout middle and late childhood. As our design precludes conclusions on causal associations, we recommend further studies with precise, repeated assessments of infant feeding practices. Such research can help ascertain the direction of effect, which is needed for establishing evidence-based guidelines for parents regarding the use of food to soothe early in life. J Nutr 2019;149:788–794.