Effect of Infant Feeding on the Risk of Obesity across the Life Course: A Quantitative Review of Published Evidence

University of Bristol, Bristol, England, United Kingdom
PEDIATRICS (Impact Factor: 5.3). 05/2005; 115(5):1367-77. DOI: 10.1542/peds.2004-1176
Source: PubMed

ABSTRACT To examine the influence of initial infant feeding on obesity in later life.
A systematic review of published studies investigating the association between infant feeding and a measure of obesity was performed with Medline (1966 onward) and Embase (1980 onward) databases, supplemented with manual searches. Data extraction was conducted by 2 authors. Analyses were based on odds ratios of obesity among initially breastfed subjects, compared with formula-fed subjects, pooled with fixed-effects models.
Sixty-one studies reported on the relationship of infant feeding to a measure of obesity in later life; of these, 28 (298900 subjects) provided odds ratio estimates. In these studies, breastfeeding was associated with a reduced risk of obesity, compared with formula feeding (odds ratio: 0.87; 95% confidence interval [CI]: 0.85-0.89). The inverse association between breastfeeding and obesity was particularly strong in 11 small studies of <500 subjects (odds ratio: 0.43; 95% CI: 0.33-0.55) but was still apparent in larger studies of > or =500 subjects (odds ratio: 0.88; 95% CI: 0.85-0.90). In 6 studies that adjusted for all 3 major potential confounding factors (parental obesity, maternal smoking, and social class), the inverse association was reduced markedly (from an odds ratio of 0.86 to 0.93) but not abolished. A sensitivity analysis examining the potential impact of the results of 33 published studies (12505 subjects) that did not provide odds ratios (mostly reporting no relationship between breastfeeding and obesity) showed little effect on the results.
Initial breastfeeding protects against obesity in later life. However, a further review including large unpublished studies exploring the effect of confounding factors in more detail is needed.

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    • "Behaviors of mothers and the choice to smoke during pregnancy and to breastfeed or not, were clearly significant risk factors of childhood obesity. These finding has been documented elsewhere (Owen et al., 2005). This study only included a two choice answer to breastfeeding (yes/no) so therefore a more detailed description and risk association on duration of breastfeeding could not be found like in previous studies (Padez et al., 2005; Ryan, 2007). "
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    • "As breastfeeding is important for child health (Gartner et al. 2005), it is interesting to investigate the relationship between different maternal body compositions and associated infant feeding outcome. Recent systematic reviews have shown the association between duration of breastfeeding and the reduced risk for development of obesity and overweight in later life (Harder et al. 2005; Owen et al. 2005). Therefore, it seems important to focus on breastfeeding in the post-partum period, in particular with obese mothers, because children of obese women have an additional increased risk to develop obesity or overweight in later life (Boney et al. 2005; Dabelea & Crume 2011). "
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