Original Article
Breastfeeding and Overweight: Longitudinal Analysis in an Australian Birth Cohort

https://doi.org/10.1016/j.jpeds.2005.03.038Get rights and content

Objective

To examine adiposity in relation to breastfeeding using longitudinal analysis in an Australian birth cohort.

Study design

Repeated surveys from 16 weeks gestation to 8 years in a cohort (N = 2087) recruited through antenatal clinics. Overweight was defined by National Center for Health Statistics 95th percentiles for weight-for-length at 1 year and body mass index (BMI) at 3, 6, and 8 years. Overweight was examined using Generalized Estimating Equations with results summarized as OR. BMI Z scores were analyzed in mixed models.

Results

At 1 year, infants breastfed >12 months were the leanest group (mean Z score −0.16, 95% CL −0.28, −0.04; not breastfed 0.16, 95% CL 0.02, 0.29; breastfed ≤4 months 0.31, 95% CL 0.22, 0.40; 5-8 months 0.17, 95% CL 0.06, 0.27; 9-12 months 0.11, 95% CL 0.01, 0.22). From 1 to 8 years, children breastfed ≤4 months had the greatest risk of overweight (OR 1.29, 95% CL 0.89, 1.97) and the highest prevalence of maternal obesity, smoking, and lower education.

Conclusions

Infants breastfed >12 months were leaner at 1 year but not at 8 years. Breastfeeding ≤4 months was associated with greatest risk of overweight and adverse maternal lifestyle. Familial factors may modify associations between breastfeeding and adiposity beyond infancy.

Section snippets

Methods

Participants in the Western Australian Pregnancy Cohort Study were serially recruited between 16 and 20 weeks gestation from the public antenatal clinic at King Edward Memorial Hospital or from nearby private practices in Perth, Western Australia, between 1989 and 1992.11 The initial cohort comprised 2860 live births. All mothers gave written informed consent, and the study was approved by the institutional ethics committee.

Information collected by midwives included birth weight (BW) and

Results

After exclusion of multiple pregnancies, congenital abnormalities, and children born before 37 weeks of gestation, the present analysis comprised 2087 infants at birth, 1710 children at 1 year, 1184 at 3 years, 1480 at 6 years, and 1430 at 8 years in whom weight and height (length) had been measured.

Mothers with tertiary education comprised 7% of non-attenders and 11% of attenders at 1 year (P <.001), 7% and 12%, respectively, at 3 years (P <.001), 17% and 11%, respectively, at 6 years (P

Discussion

Among 1-year-olds in this birth cohort study, which uses longitudinal analyses with data collected prospectively, children breastfed for >12 months were the leanest, whereas those breastfed ≤4 months had the highest mean Z scores for weight-for-length. From 1 to 8 years, BMI Z scores associated with duration of breastfeeding tended to converge and showed no statistically significant differences after adjustment for maternal factors.

Higher rates of overweight in infants breastfed for <3 months

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  • Cited by (0)

    Supported by the Raine Foundation and Western Australian Health Promotion Foundation (Healthway).

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