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Breastfeeding to 12 mo and beyond: nutrition outcomes at 3 to 5 y of age
Cornelia M Borkhoff1,2,3, David W H Dai4, Jennifer A Jairam1
1Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Breastfeeding for up to 12 months is linked to better nutrition and eating habits in preschoolers. Extended breastfeeding beyond one year showed no additional nutritional benefits for children aged 3-5 years.
Area of Science:
- Pediatric Nutrition
- Child Health Outcomes
- Public Health Research
Background:
- Limited understanding of breastfeeding's impact on preschooler nutrition beyond 12 months.
- Previous research has not extensively explored long-term nutritional outcomes associated with extended breastfeeding durations.
Purpose of the Study:
- To investigate the association between total breastfeeding duration and nutrition outcomes in children aged 3 to 5 years.
- To determine if breastfeeding beyond 12 months offers additional nutritional advantages.
Main Methods:
- Cross-sectional study involving 2987 healthy children aged 3-5 years in Toronto.
- Utilized the Nutrition Screening for Every Preschooler (NutriSTEP) tool to assess nutrition risk.
- Employed restricted cubic spline and segmented linear regression models to analyze the nonlinear relationship between breastfeeding duration and nutrition outcomes.
Main Results:
- A significant decrease in nutrition risk scores was observed for children breastfed between 6-12 months.
- Breastfeeding duration up to 12 months was associated with reduced nutrition risk, improved dietary intake, and healthier eating behaviors.
- No significant nutritional benefits were found for breastfeeding durations exceeding 12 months.
Conclusions:
- Breastfeeding for 12 months or less is associated with improved nutrition outcomes in preschoolers.
- Evidence suggests no additional nutritional advantages for breastfeeding beyond 12 months of age.
- Findings support current recommendations regarding breastfeeding duration for optimal child nutrition.
Background:
Little is known about nutrition outcomes in preschoolers associated with breastfeeding duration beyond 12 mo of age.
Objective:
The aim was to examine the association between total breastfeeding duration and nutrition outcomes at 3 to 5 y of age.
Design:
A cross-sectional study in healthy children, ages 3-5 y, recruited from 9 primary care practices in Toronto was conducted through the TARGet Kids! (The Applied Research Group for Kids) research network. Parents completed standardized surveys, including the Nutrition Screening for Every Preschooler (NutriSTEP) used to assess nutrition risk.
Results:
A total of 2987 children were included. Ninety-two percent of children were breastfed, and the mean ± SD breastfeeding duration was 11.4 ± 8.4 mo. The prevalence of nutrition risk (score >20) was 17.0%. We examined breastfeeding duration as a continuous variable. With the use of restricted cubic spline modeling, we confirmed a nonlinear relation between breastfeeding duration and NutriSTEP score, dietary intake and eating behavior subscores, and sugar-sweetened beverage and sweet-savory snack consumption. Segmented linear regression was used to examine this nonlinear relation in a piecewise approach. We found a decreasing trend in NutriSTEP score for children who were breastfed for 0-6 mo (β = -0.14; 95% CI: -0.29, 0.004), a significant decrease in NutriSTEP score for children breastfed for 6-12 mo (β = -0.20; 95% CI: -0.33, -0.07), and no significant change after 12 mo (β = 0.09; 95% CI: -0.07, 0.24) and beyond. The mean ± SD NutriSTEP scores were 17.1 ± 7.4 for no breastfeeding, 15.9 ± 6.5 for breastfeeding >0-6 mo, 13.9 ± 6.2 for >6-12 mo, 13.7 ± 6.3 for >12-18 mo, 14.6 ± 6.7 for >18-24 mo, and 14.3 ± 6.8 for >24-36 mo.
Conclusions:
Breastfeeding for ≤12 mo was associated with decreased nutrition risk and healthier eating behaviors and dietary intake at 3-5 y of age. We found insufficient evidence of additional benefit for breastfeeding beyond 12 mo of age. The TARGet Kids! practice-based research network is registered at www.clinicaltrials.gov as NCT01869530.
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