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Advisory Committee Chair

Paula Chandler-Laney

Advisory Committee Members

Brenda Bertrand

Meghan Tipre

Document Type

Thesis

Date of Award

2021

Degree Name by School

Master of Science (MS) School of Health Professions

Abstract

Background: Non-Hispanic black (NHB) infants are disproportionately affected by rapid weight gain compared to non-Hispanic white (NHW) infants, which in turn, is associated with future disparities including obesity and cardiometabolic disease. Feeding practices, such as the use of formula or bottles, differ by race and are associated with rate of weight gain. Data from the Pregnancy and Early Life in the South (PEARLS) birth-cohort study was used to test the hypotheses that change in body weight and weight-for-age z-scores (WAZ) from birth to 6 weeks would be greater for (1) NHB versus NHW infants; and (2) infants fed formula (exclusively or mixed) versus breastfed infants. Further, we hypothesized that any race difference in weight or WAZ change would be at least partly attributable to differences in feeding mode.Methods: Child weight was measured at birth and 6 weeks of age and used to derive WAZ. Mothers reported feeding mode (breast, formula, or mixed) when infants were 6 weeks old. A logit model was used to evaluate differences in feeding mode by race. Mixed models were used to evaluate whether race and feeding mode were associated with changes in infant weight and WAZ from birth to 6 weeks. All models were adjusted for potential covariates including maternal employment status, income, marital status, education, pre-pregnancy BMI, maternal smoking, maternal age, infant sex, gestational age and infant age at the 6-week study visit. Results: This study included 160 infants (n=117 NHB and n=43 NHW). Among mothers, fewer NHB were married than NHW, and income and education were lower for NHB versus NHW. More NHB infants were formula fed as compared to NHW infants (P=0.0031). There was no significant effect of race, feeding practice, or the race x feeding practice interaction on the change in body weight or WAZ from birth to 6 weeks. Conclusion: Contrary to the hypothesis, neither race nor feeding mode predicted the rate of weight gain from birth to 6 weeks. Future studies should investigate timing of when race differences in the rate of weight gain emerge, along with mechanisms that impact different growth rates during infancy. Key Words: infancy, race, feeding practices, weight gain

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