A protective effect of breastfeeding on progression of nonalcoholic fatty liver disease

Valerio Nobili ^1*, Giorgio Bedogni ², Anna Alisi ¹, Andrea Pietrobattista ¹, Arianna Alterio ¹, Claudio Tiribelli ² and Carlo Agostoni ³

¹ Liver Unit, "Bambino Gesù" Children’s Hospital and Research Institute, Rome, Italy
² Liver Research Center, Basovizza, and Department. of Life Sciences, University of Trieste, Italy
³ Department of Pediatrics, San Paolo Hospital, University of Milan, Milan, Italy

^* To whom correspondence should be addressed. E-mail: nobili66{at}yahoo.it.

Accepted 16 June 2009

Abstract

Objective: Nonalcoholic fatty liver disease (NAFLD) is a spectrum of liver disease characterized by accumulation of large-droplet fat in hepatocytes with possible progression to inflammation and fibrosis. Breastfeeding has benefits on child health, both during infancy and later in life, reducing the risk of manifestations of the metabolic syndrome. Here we investigated the association between early type of feeding (breast- vs. formula-fed and duration of breastfeeding) and later NAFLD development.

Study design: We investigated 191 young Caucasian children (3-18 years) with NAFLD consecutively enrolled between January 2003 and September 2007 in our Centre. Forty eight percent of them (n = 91) had been breastfed for a median (interquartile range) time of 8 (7) months.

Results: After correction for age, waist circumference, gestational age and neonatal weight, the odds of NASH (OR = 0.04, 95%CI 0.01 to 0.10) and fibrosis (OR = 0.32, 95%CI 0.16 to 0.65) were lower in breastfed vs. not breastfed infants. Moreover, the odds of NASH (OR = 0.70, exact 95%CI 0.001 to 0.87) and fibrosis (OR = 0.86, exact 95%CI 0.75 to 0.98) decreased for every month of breastfeeding.

Conclusions: This observational study suggests that earlier feeding habits might affect the clinical expression of NASH from 3 to 18 years later, with an apparent drug-like preventive effect of breastfeeding.