May 07, 2019
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Breastfeeding at least 6 months protects against childhood obesity

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Children who were never breastfed as infants are 22% more likely to have obesity in childhood when compared with children who were breastfed for 6 months, according to an analysis of WHO data presented at the European Congress on Obesity.

João Breda

“It is very important to promote and protect breastfeeding exclusively for 6 months, in line with WHO recommendations, in all countries,” João Breda, PhD, MPH, MBA, head of the WHO European Office for Prevention and Control of Noncommunicable Diseases, told Endocrine Today. “Breastfeeding not only contributes to better development of infants, but to the prevention of obesity and other noncommunicable diseases later in life. This requires health professionals do a job in helping mothers and families to benefit from the protective effects of breastfeeding.”

Breda and colleagues analyzed data from 100,583 children aged 6 to 9 years from 22 countries participating in the WHO European Childhood Obesity Surveillance Initiative (2015/2017), a study investigating the associations between childhood obesity and early-life factors, such as breastfeeding, exclusive breastfeeding (defined as only breast milk with no other liquids or solid foods) and birth weight.

The children’s standardized weight and height measurements followed a common WHO protocol. Information on children’s birth weight, breastfeeding practice and duration was collected through a family record form. Researchers used multilevel logistic regression analysis to assess the influence on childhood obesity of breastfeeding practice (both general and exclusive) and characteristics at birth.

Researchers found that among the countries evaluated, Spain had the highest prevalence of childhood obesity at 17.7%, followed by Malta at 17.2% and Italy at 16.8%, and breastfeeding rates were among the lowest in those countries. Researchers observed a wide between-country disparity in the prevalence of breastfeeding. Breastfeeding rates were highest in Tajikistan, where 94.4% of children were breastfed as infants for at least 6 months and 73.3% of children were exclusively breastfed for at least 6 months. However, in France, Ireland and Malta, 1 in 4 children were breastfed for at least 6 months.

“Italy and Malta showed the highest prevalence of obesity among children who have never been breastfed (21.2%), followed by Spain (21%),” the researchers wrote in an abstract.

In pooled analysis, children who were never breastfed were more likely to have obesity at age 6 to 9 years when compared with children who were breastfed generally for 6 months (adjusted OR = 1.22; 95% CI, 1.16-1.28) and with children who were breastfed exclusively for 6 months (aOR = 1.25; 95% CI, 1.17-1.36).

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Additionally, a small but greater risk for obesity persisted among children who were never breastfed when compared with children who were breastfed for less than 6 months, both generally (aOR = 1.12; 95% CI, 1.07-1.16) and exclusively (aOR = 1.05; 95% CI, 0.99-1.12).

The researchers noted that higher birth weight was associated with a higher risk for being overweight, which was reported in 11 of the 22 countries. In Bulgaria, Croatia, France, Italy, Poland and Romania, data showed that children who were born preterm had higher odds for obesity when compared with children born full term.

“This study confirms the beneficial effect of breastfeeding with regard to the odds of becoming obese, which was statistically significantly increased if children were never breastfed or breastfed for less than 6 months,” Breda said in a press release. “Nevertheless, adoption of exclusive breastfeeding is below the global recommendations and far from the target to increase the prevalence of exclusive breastfeeding in the first 6 months up to at least 50% by 2025, a goal endorsed by the WHO’s member states at the World Health Assembly Global Targets for Nutrition.” – by Regina Schaffer

Reference:

Rito AI, et al. Association between characteristics at birth, breastfeeding and obesity in 22 countries. Presented at: European Congress on Obesity; April 28-May 1, 2019; Glasgow, Scotland.

Disclosure: Breda reports no relevant financial disclosures.