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Breast-feeding and childhood obesity—a systematic review

Abstract

OBJECTIVE: To investigate the relationship between breast-feeding and obesity in childhood.

DESIGN: Systematic review and meta-analysis of published epidemiological studies (cohort, case–control or cross-sectional studies) comparing early feeding-mode and adjusting for potential confounding factors. Electronic databases were searched and reference lists of relevant articles were checked. Calculations of pooled estimates were conducted in fixed- and random-effects models. Heterogeneity was tested by Q-test. Publication bias was assessed from funnel plots and by a linear regression method.

OUTCOME MEASURES: Odds ratio (OR) for obesity in childhood defined as body mass index (BMI) percentiles.

RESULTS: Nine studies with more than 69 000 participants met the inclusion criteria. The meta-analysis showed that breast-feeding reduced the risk of obesity in childhood significantly. The adjusted odds ratio was 0.78, 95% CI (0.71, 0.85) in the fixed model. The assumption of homogeneity of results of the included studies could not be refuted (Q-test for heterogeneity, P>0.3), stratified analyses showed no differences regarding different study types, age groups, definition of breast-feeding or obesity and number of confounding factors adjusted for. A dose-dependent effect of breast-feeding duration on the prevalence of obesity was reported in four studies. Funnel plot regression gave no indication of publication bias.

CONCLUSION: Breast-feeding seems to have a small but consistent protective effect against obesity in children.

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Acknowledgements

This study has been carried out with support from the Bavarian Ministry for Environment, Health and Consumer Protection, Germany and partial financial support from the Commission of the European Communities, specific RTD programme ‘Quality of Life and Management of Living Resources’, QLK1-2001-00389 ‘Childhood Obesity: Early Programming by Infant Nutrition?’ (CHOPIN). It does not necessarily reflect its views and in no way anticipates the Commission's future policy in this area.

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Correspondence to R von Kries.

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Arenz, S., Rückerl, R., Koletzko, B. et al. Breast-feeding and childhood obesity—a systematic review. Int J Obes 28, 1247–1256 (2004). https://doi.org/10.1038/sj.ijo.0802758

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  • DOI: https://doi.org/10.1038/sj.ijo.0802758

Keywords

  • meta-analysis
  • breast-feeding
  • overweight
  • childhood

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