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Breast-feeding duration may decrease risk for childhood obesity
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For every extra week an infant is breast-fed, the likelihood of becoming obese by age 2 years declines slightly, recent study findings show.
In a longitudinal analysis, Sepideh Modrek, PhD, professor in the department of medicine at Stanford University School of Medicine in Palo Alto, California, and colleagues analyzed population-based data from all births in Oregon in 2009, using data from the Oregon Pregnancy Risk Assessment Monitoring System (Oregon PRAMS; 76% white), and the 2011-2012 follow-up survey (PRAMS2). Primary outcome was the child’s weight status at age 2 years; BMI was calculated based on parent-reported weight and height. Breast-feeding was stratified into three self-reported variables: ever breast-fed, number of weeks of breast-feeding and number of weeks of exclusive breast-feeding. In regression models, researchers assessed associations between ever breast-feeding, breast-feeding duration and breast-feeding duration exclusively and child obesity status at age 2 years, controlling for factors including household income, education level, employment, marital status, age and insurance status, as well as maternal weight and health status. Mothers were also asked about their breast-feeding experience during the newborn hospitalization.
Within the cohort, 25% were categorized as overweight at age 2 years; 11% were categorized as obese; 96% of these children were reported to be ever breast-fed. Median duration of breast-feeding was 40 weeks; median duration of exclusive breast-feeding was 20 weeks; 74% of children were exclusively breast-fed during newborn hospitalization.
Researchers found likelihood for childhood obesity declined by 0.82% (95% CI, –1.8 to 0.1) for every extra week a child was breast-fed; likelihood for childhood obesity declined by 0.66% (95% CI, –1.4 to 0.06) for every extra week a child was exclusively breast-fed.
“Given that the obesity rate in the sample is 11%, the estimated magnitudes translate to a clinically significant reduction of 7.4% and 6.6% per week, respectively,” the researchers wrote.
In reduced form regression analysis, researchers also found that children fed only breast milk during their newborn hospitalization were 6.7% points less likely to be overweight and 5.1% points less likely to be obese at age 2 years vs. children not exclusively fed breast milk.
“Our results suggest that hospital practices that support breast-feeding ... may be effective in promoting breast-feeding duration, and particularly exclusivity, and thereby have the capacity to influence rates of childhood obesity, especially at young ages,” the researchers wrote.
The researchers also noted that Oregon mothers ranked second in the United States in breast-feeding initiation rate and longest duration of breast-feeding. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Nancy Crimmins, MD
As we learn more about the microbiota and metabolic programming, it no longer seems crazy to begin obesity prevention in the infancy period. The timing of introduction to solid foods in infancy has been proposed as a modifiable risk factor for obesity development; however, this large study found no association with solid food timing and obesity at age 6 after controlling for sociodemographic factors. That certainly doesn’t mean it isn’t important for pediatricians to address healthy eating behaviors in the first year of life. As we tease out all the biological and psychosocial moving parts that play into obesity development, we do know this: It is important to introduce whole, unprocessed foods when developmentally appropriate. Infants grow into picky toddlers in 6 or less well-child visits, and the food environment can change significantly in a short amount of time. If a healthy diet is not reinforced from infancy on, the likelihood increases that the infant will develop into an obese 4-year-old who will only eat chicken nuggets and macaroni and cheese and won’t touch a vegetable.
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