Maternal and Child Health Journal

, Volume 19, Issue 3, pp 519–527 | Cite as

Breastfeeding Versus Formula-Feeding and Girls’ Pubertal Development

  • Aarti KaleEmail author
  • Julianna Deardorff
  • Maureen Lahiff
  • Cecile Laurent
  • Louise C. Greenspan
  • Robert A. Hiatt
  • Gayle Windham
  • Maida P. Galvez
  • Frank M. Biro
  • Susan M. Pinney
  • Susan L. Teitelbaum
  • Mary S. Wolff
  • Janice Barlow
  • Anousheh Mirabedi
  • Molly Lasater
  • Lawrence H. Kushi


To examine the association of breastfeeding or its duration with timing of girls’ pubertal onset, and the role of BMI as a mediator in these associations. A population of 1,237 socio-economically and ethnically diverse girls, ages 6–8 years, was recruited across three geographic locations (New York City, Cincinnati, and the San Francisco Bay Area) in a prospective study of predictors of pubertal maturation. Breastfeeding practices were assessed using self-administered questionnaire/interview with the primary caregiver. Girls were seen on at least annual basis to assess breast and pubic hair development. The association of breastfeeding with pubertal timing was estimated using parametric survival analysis while adjusting for body mass index, ethnicity, birth-weight, mother’s education, mother’s menarcheal age, and family income. Compared to formula fed girls, those who were mixed-fed or predominantly breastfed showed later onset of breast development [hazard ratios 0.90 (95 % CI 0.75, 1.09) and 0.74 (95 % CI 0.59, 0.94), respectively]. Duration of breastfeeding was also directly associated with age at onset of breast development (p trend = 0.008). Associations between breastfeeding and pubic hair onset were not significant. In stratified analysis, the association of breastfeeding and later breast onset was seen in Cincinnati girls only. The association between breast feeding and pubertal onset varied by study site. More research is needed about the environments within which breastfeeding takes place in order to better understand whether infant feeding practices are a potentially modifiable risk factor that may influence age at onset of breast development and subsequent risk for disease in adulthood.


Puberty Puberty-early onset Breastfeeding Body mass index 



This study was funded by U01ES012770, U01ES012771, U01ES012800, U01ES012801, U01ES019435, U01ES019453, U01ES019454, and U01ES019457 from the National Institute of Environmental Health Sciences (NIEHS) and the National Cancer Institute (NCI); P01ES009584 and P30ES006096 from NIEHS; and UL1RR024131, UL1RR029887 and UL1RR026314 from the National Center for Research Resources (NCRR). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIEHS, the NCI, the NCRR, the National Institutes of Health, or the California Department of Public Health. We also gratefully acknowledge support of the Avon Foundation for this research.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Aarti Kale
    • 1
    Email author
  • Julianna Deardorff
    • 1
  • Maureen Lahiff
    • 1
  • Cecile Laurent
    • 2
  • Louise C. Greenspan
    • 3
  • Robert A. Hiatt
    • 4
  • Gayle Windham
    • 5
  • Maida P. Galvez
    • 6
  • Frank M. Biro
    • 7
  • Susan M. Pinney
    • 8
  • Susan L. Teitelbaum
    • 9
  • Mary S. Wolff
    • 9
  • Janice Barlow
    • 10
  • Anousheh Mirabedi
    • 2
  • Molly Lasater
    • 2
  • Lawrence H. Kushi
    • 2
  1. 1.School of Public HealthUniversity of California, BerkeleyBerkeleyUSA
  2. 2.Division of ResearchKaiser Permanente Northern CaliforniaOaklandUSA
  3. 3.Department of PediatricsKaiser Permanente San FranciscoSan FranciscoUSA
  4. 4.Department of Epidemiology and Biostatistics and Helen Diller Family Comprehensive Cancer CenterUniversity of California, San FranciscoSan FranciscoUSA
  5. 5.California Department of Public HealthRichmondUSA
  6. 6.Department of Community and Preventive MedicineMount Sinai School of MedicineNew YorkUSA
  7. 7.Cincinnati Children’s Hospital Medical CenterCincinnatiUSA
  8. 8.University of Cincinnati College of MedicineCincinnatiUSA
  9. 9.Mount Sinai School of MedicineNew YorkUSA
  10. 10.Zero Breast CancerSan RafaelUSA

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