Association between Infant Breastfeeding and Childhood Body Mass Index Público
Vellano, Kimberly (2011)
Abstract
Objective: In light of the growing prevalence of obesity in the United States, it is critical to identify effective interventions for obesity prevention. Evidence from observational studies suggests that breastfeeding may protect against obesity in later life. The aim of this study was to examine whether breastfeeding is associated with a decreased risk of overweight and obesity in a racially and economically diverse population of preschool aged children.
Methods: Data on infant feeding and child body mass index status were obtained from the Fetal Growth and Development Study. Participants included a cohort of infants born in two hospitals in Atlanta, Georgia from 1993-1994. After delivery, mothers were interviewed for demographic information, as well as behavioral, reproductive, and medical factors of interest. A sub-sample of the cohort was selected for the Follow-Up Development and Growth Experiences Study at preschool age. These subjects received a follow-up questionnaire and anthropometric measurements were obtained for calculation of BMI. Logistic regression analysis was conducted to compare the risks of childhood overweight (BMI between the 85th and 94th percentile) and childhood obesity (BMI in the 95th percentile or higher) among breastfed and non-breastfed children.
Results: During infancy, 50% of subjects were never breastfed, 28% were breastfed for less than 6 months, and 22% were breastfed for at least 6 months. At preschool age, 10% of the children were overweight and 7.6% were obese. After adjusting for potential confounders, breastfeeding for at least 6 months was associated with a significant reduction in the risk of childhood obesity (AOR, 0.32; 95% CI 0.09-0.99), compared with those never breastfed or breastfed for less than 6 months. There was no association between breastfeeding duration and childhood overweight.
Conclusion: The results highlight the
importance and possible protective effect of early nutrition in the
development of childhood obesity. Increasing the initiation and
duration of breastfeeding may provide an effective strategy to
reduce childhood obesity in the United States and
elsewhere.
Table of Contents
Introduction 1
The Obesity Epidemic in the United States 1
Breastfeeding Practices in the United States 2
The Association between Breastfeeding and Childhood Obesity 4
Methods 11
Study Design 11
Data Collection 11
Statistical Analysis 13
Results 15
Characteristics of the Sample 15
Feeding Mode and Early Growth 16
Discussion 18
Strengths and Weaknesses 18
Potential Biological Mechanisms 20
Future Directions 21
Recommendations for Intervention 22
References 24
Tables and Figures 29
Table 1: Characteristics of Preschool Age Children by Delivery
Hospital, Atlanta, Georgia, 1993-1994
Table 2: Characteristics of Preschool Age Children by Infant
Feeding Mode, Atlanta, Georgia, 1993-1994
Table 3: Weight Status of Preschool Age Children by Mother's Weight
Status
Table 4a: Duration of Breastfeeding and Prevalence of Overweight
and Obesity Among Preschool Age Children
Table 4b: Duration of Breastfeeding and Prevalence of Overweight
and Obesity Among Preschool Age Children, Stratified by Sex
Figure 1: Prevalence of Overweight and Obesity by Duration of
Breastfeeding in Preschool Age Children
Table 5: Crude and Adjusted Odds Ratios of the Duration of
Breastfeeding and Childhood Weight Status
Table 6: Adjusted Odds Ratios of the Duration of Breastfeeding and
Childhood Weight Status, Stratified by Sex
Table 7: Adjusted Odds Ratios of the Duration of Breastfeeding and
Childhood Weight Status, Stratified by SGA
Table 8: Adjusted Odds Ratios of the Duration of Breastfeeding and
Childhood Weight Status, Stratified by Delivery Hospital
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