Association Between Exclusive Breastfeeding and Mixed Feeding With Craniofacial Growth in Infants Aged 0–6 Months: A Prospective Longitudinal Study

BACKGROUND: Further studies are needed to better characterize the association between craniofacial growth and feeding methods in infants aged 0-6 months. OBJECTIVE: To evaluate the longitudinal association between feeding modality (exclusive breastfeeding versus mixed feeding) and craniofacial growth in infants aged 0-6 months. STUDY DESIGN: Observational, analytical, longitudinal cohort study. SUBJECTS: A total of 120 infants were evaluated four times. OUTCOME MEASURES: Nine craniofacial variables were assessed: four width, two height, and three depth measurements. STATISTICAL ANALYSIS: Growth increments were estimated by feeding type, and linear mixed models were used to assess associations with craniofacial development. RESULTS: Exclusively breastfed infants showed greater increases in anthropometric and craniofacial measures compared with mixed feeding. Significant differences were observed in total craniofacial height (3.50 ± 0.08 vs. 3.25 ± 0.01 cm; p = 0.046), anterior facial height (2.08 ± 0.40 vs. 1.76 ± 0.07 cm; p = 0.016), maxillary depth (2.33 ± 0.04 vs. 2.21 ± 0.11 cm; p = 0.007), and mandibular depth (2.55 ± 0.02 vs. 2.41 ± 0.12 cm; p = 0.040). CONCLUSION: Exclusive breastfeeding was associated with greater craniofacial growth from 0 to 6 months compared with mixed feeding, supporting its role in early craniofacial development.