Association of early feeding patterns with physical growth and neurodevelopment in term high-risk infants: a retrospective study

Background and objectives The relationship between early feeding patterns and growth and neurodevelopment in term high-risk infants remains unclear. This study aimed to investigate the associations between feeding patterns during the first 6 months of life and physical growth and neurodevelopment in term high-risk infants. Subjects and methods A total of 108 term high-risk infants were retrospectively included and classified according to feeding patterns during the first 6 months of life into an exclusive breastfeeding group ( n = 32), a mixed feeding group ( n = 45), and a formula feeding group ( n = 31). Data on weight, length, and head circumference at 6, 8, and 12 months were collected. Weight-for-age Z score (WAZ), length-for-age Z score (LAZ), and head circumference-for-age Z score (HCZ) were calculated using WHO Anthro software. Neurodevelopment at 8 and 12 months was assessed using the Developmental Screening Test (DST) for children aged 0–6 years in China. Linear mixed-effects models were used to analyze the associations between feeding patterns and physical growth trajectories, with adjustment for sex, birth weight, fetal/neonatal risk factors, and maternal risk factors. Results In unadjusted analyses, the exclusive breastfeeding group had higher WAZ and LAZ at 6 months, higher WAZ and HCZ at 8 months, and higher WAZ at 12 months than the formula feeding group (all p < 0.05). After adjustment for potential confounders, the feeding group × time interaction was significant for LAZ ( p = 0.004), but not for WAZ ( p = 0.265) or HCZ ( p = 0.168). At 6 months, WAZ (adjusted MD = 0.721, 95% CI: 0.126–1.316; p = 0.012) and LAZ (adjusted MD = 0.602, 95% CI: 0.059–1.144; p = 0.024) remained higher in the exclusive breastfeeding group than in the formula feeding group, whereas no significant between-group differences were observed at 8 or 12 months. No significant differences in DQ or developmental classification were observed among the feeding groups at 8 or 12 months (all p > 0.05). Conclusion Early feeding patterns were associated with growth trajectories in term high-risk infants, and breastfeeding may have been associated with more favorable physical growth in early life. No clear differences in neurodevelopmental outcomes were observed among feeding patterns; however, these findings should be interpreted cautiously because of the limited sample size available for neurodevelopmental assessment.