Exclusive Breastfeeding Is Inversely Associated with Risk of Childhood Overweight in a Large Chinese Cohort

Abstract

The association between breastfeeding status and childhood overweight is inconclusive. The aim of the present study was to investigate the relation between exclusive breastfeeding and childhood overweight risk in children 4-5 y of age in Southeast China. Among 97,424 children enrolled between 1999 and 2009 in the Jiaxing Birth Cohort, 42,550 of them were included in the final analysis with complete records on breastfeeding status and anthropometric measurements at 4-5 y of age (48-60 mo). Overweight and being at risk of overweight were identified as a body mass index (BMI)-for-age Z-score ≥ 2 and between 1 and 2, respectively. After 4-5 y of follow-up, 4845 (11.4%) children were identified as being at risk of overweight, and 1343 (3.16%) children were overweight. Adjusting for important child and maternal characteristics, longer duration of breastfeeding was associated with lower risk of childhood overweight (P-trend = 0.009) and being at risk of overweight (P-trend < 0.001). Children exclusively breastfed for 3-5 mo and ≥6 mo had 13% (RR = 0.87; 95% CI: 0.77, 0.99) and 27% (RR = 0.73; 95% CI: 0.56, 0.95) lower risk of becoming overweight compared with children exclusively breastfed for <1 mo, respectively. In boys, there were inverse associations of 3-5 mo (RR = 0.83; 95% CI: 0.71, 0.98) or ≥6 mo (RR = 0.65; 95% CI: 0.47, 0.91) of exclusive breastfeeding against becoming overweight, but there were no significant associations in girls (3-5 mo: RR = 0.96, 95% CI: 0.76, 1.22; ≥6 mo: RR = 0.92, 95% CI: 0.60, 1.41). In conclusion, the present findings suggest that longer duration of exclusive breastfeeding is associated with lower risk of becoming overweight in Chinese children.

Fatores sociodemográficos e excesso de peso em crianças participantes de programa governamental de distribuição de leite fortificado

“…The factors associated with a greater prevalence of overweight were the child not breastfeeding at six months and the absence of paid maternal employment. This result corroborates the conclusions of previous studies in which breastfed infants had a lower likelihood of being obese 11,17 . However, this finding differs to the results of other studies concluding that infant overweight was associated with maternal employment outside the home 14,18 .…”

Association Between Artificially Sweetened Beverage Consumption During Pregnancy and Infant Body Mass Index

“…Sex specificity has been reported for other obesogenic exposures in early life, with males being disproportionately affected by maternal smoking, 38 antibiotic exposure, 39,40 and formula feeding. 41 This sexual dimorphism may be related to sex differences in gut microbiota, 42 which contribute to host metabolism and weight gain. 43 Our findings may support this intriguing hypothesis because NNSs have been shown to modify gut microbiota, 15 although this has not yet been demonstrated for prenatal NNS exposure in humans.…”

Impact of maternal pre‐pregnancy overweight on infant overweight at 1 year of age: associations and sex‐specific differences

“…Consistent with older studies (19), exclusive breastfeeding until 3 months of age was inversely associated with infant WFL z-score; it substantially lowered the risk of child overweight at 1 year in male and especially in female infants. More recently, a study of Asian infants found breastfeeding to be more protective against overweight in male infants (17). Several studies have now linked infant antibiotic use and child overweight, including one by Saari et al that reported an association with overweight development during the first 24 months of life (19).…”