The association between early-life nutrition and palatine tonsil grading in preschool children: a cross-sectional study.

BACKGROUND

Early-life nutritional factors play a crucial role in child health, but their association with palatine tonsil grading is not well understood. This study aimed to investigate the relationship between early-life nutrition and palatine tonsil grading in preschool children.

METHODS

A cross-sectional study of 2,786 children from 17 kindergartens in Yulin City was conducted. Palatine tonsil grading was assessed via physical examination, and early-life nutritional data were collected through parent questionnaires, with 816 valid matches to examination records. Associations between early-life nutrition and palatine tonsil grading were analyzed using age-adjusted ordered logistic regression, stratified by sex.

RESULTS

Among 2,786 preschool children aged 2-7 years, palatine tonsillar hypertrophy (grades III-IV) was observed in 5.28%. Females aged 2-4 years had a significantly lower risk than males (OR = 0.438, p = 0.028), with no sex difference in older children. Univariate analysis of 454 males revealed no significant associations between feeding patterns (0-6, 6-12, 12-24 months), durations of breastfeeding and formula feeding, timing of formula milk introduction, or timing of complementary food introduction feeding and palatine tonsil grading. In 362 females, exclusive formula feeding during 0-6 months was significantly associated with increased risk of higher palatine tonsil grading (OR = 2.625, p = 0.013), whereas formula introduction at 6-12 months was linked to a decreased risk (OR = 0.494, p = 0.047). Multivariable analysis suggests a possible increased risk for exclusive formula feeding during the first 6 months (OR = 2.409, p = 0.066), whereas formula introduction between 6 and 12 months showed no statistically significant (OR = 0.729, p = 0.494).

CONCLUSION

Our results suggested a possible association between exclusive formula feeding during 0-6 months and a higher palatine tonsil grading in females, while larger studies are needed for confirmation. Other early nutritional exposures showed no significant effect, and no associations were observed in males.