Impact of Infant Milk-Type and Childhood Eating Behaviors on Functional Constipation in Preschool Children

Objective To investigate the association between functional constipation, infant feeding in early infancy and eating behavior in preschool children. Methodology A cross-sectional study was undertaken in public and private schools in the state of Sergipe (Northeast of Brazil). The sample calculation was based on a 25% estimate of constipation prevalence in Brazilian children, resulting in a sample size of 1051 children. Functional constipation was assessed using Rome IV criteria. Eating behavior was assessed using the Children's Eating Behavior Questionnaire. Adjusted odds ratios were estimated using a multivariate model. Results The prevalence of functional constipation was 23%. After adjusting for water intake, children with food fussiness were > 6 times likely to have constipation (OR = 6.65; 95% CI = 5.19-8.52). Children who were fed with cow's milk in the first 6 months of age were up to 15.2 times more likely to have functional constipation. Bottle feeding at 0-6 months of age increased the risk of functional constipation at preschool age (whole cow's milk: OR = 17.02; 95% CI = 7.33-39.51, infant formula: OR = 6.35; 95%; CI = 3.42-11.79, mixed breastfeeding: OR = 10.83; 95% CI = 4.57-25.69). Conclusion Food fussiness and the use of cow's milk-based feeding bottles at 0-6 months of age were associated with functional constipation in preschool children.