Breastfeeding in the prevention of long term overweight and obesity in children - a population-based cohort study

Abstract

Background: Breast milk can have a protective effect on the development of obesity and overweight and promotes the development of the gastrointestinal system, the central nervous system (CNS), the endocrine system and the immune system. The World Health Organisation (WHO) recommends exclusive breastfeeding for the first 6 months of life and until at least 2 years of age. The main goal of this study is to evaluate the impact of exclusive breastfeeding up to 6 months of age on reducing the incidence of overweight and obesity among children aged up to 10 years; and to estimate the annual incidence of obesity and overweight in the study population. Methods: A retrospective cohort analysis using electronic health records of children aged zero to ten years, born between 01/01/2006 and 31/12/2022, followed at the Unidade Local de Saúde e Matosinhos (ULSM), in child health appointments. Through electronic health records data was collected of weight (in kg), length (in cm) or height (in m) and Body Mass Index (BMI) (in kg/m2) and exclusive breastfeeding or not, until six months of age. Information on pathological antecedents was collected from the clinical file and defined as positive or negative control results. Clinical information was also collected from family members of the children involved in the study. Results: In the first year of life, approximately 29% of children under exclusive breastfeeding were obese and 20% were overweight. This trend was reversed throughout the study period, with 14% and 10%, respectively, at 9 years of age. At 4 years old, none of the family risk factors were significant to the development of obesity. At the age of 4, the family risk factor most likely to be related to the development of overweight was hypertension. For the obesity and overweight outcomes of interest, there was no effect of exclusive breastfeeding. Conclusions: This study shows that obesity and overweight are a public health problem. Health professionals have a key role to play in stemming this trend and encouraging healthy habits in families. The fact that this study showed that exclusive breastfeeding did not reduce obesity and overweight up to the age of 10, but did show positive outcomes for asthma and allergic rhinitis, emphasises the importance of further studies in this area of interest.