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A Meta-Analysis of the Association Between Breastfeeding and Early Childhood Obesity
Jia Qiao1, Li-Jing Dai1, Qing Zhang1
1School of Health Sciences, Wuhan University, Wuhan, China.
Insights
Breastfeeding significantly reduces the risk of obesity in preschoolers. Longer duration and exclusive breastfeeding show a dose-response effect, lowering obesity risk in early childhood.
Area of Science:
- Pediatrics
- Public Health
- Nutritional Science
Background:
- Childhood obesity is a growing concern globally.
- Previous studies suggest breastfeeding may protect against obesity, but evidence is inconsistent.
Purpose of the Study:
- To clarify the association between breastfeeding and the risk of obesity in preschoolers through a meta-analysis.
Main Methods:
- Systematic review of prospective cohort studies published before December 1, 2019.
- Inclusion of 26 publications with 332,297 participants.
- Meta-analysis performed using Stata 15.1.
Main Results:
- Ever-breastfed preschoolers had a reduced risk of obesity (OR=0.83).
- A significant inverse dose-response relationship was found between breastfeeding duration and obesity risk (regression coefficient = -0.032, p=0.001).
- Exclusive breastfeeding was associated with a substantial reduction in obesity risk (OR=0.53).
Conclusions:
- Breastfeeding is inversely associated with obesity risk in children aged two to six years.
- A dose-response effect exists, where longer breastfeeding duration and exclusivity further reduce obesity risk.
- Clinical guidance promoting prolonged and exclusive breastfeeding is crucial for preventing childhood obesity.
Problem:
Several studies have indicated a protective effect of breastfeeding on reducing the risk of childhood obesity, however, this remains controversial. The aim of this meta-analysis is to clarify the association between breastfeeding and the risk of preschoolers' obesity.
Eligibility Criteria:
Prospective cohort studies published prior to December 1, 2019 were systematically searched in PubMed, EMBASE, the Web of Science and the Cochrane Library databases. Meta-analysis was performed using Stata 15.1.
Sample:
Twenty-six publications involving 332,297 participants were eligible for inclusion.
Results:
The pooled odds ratio (OR) of the risk of obesity in ever-breastfed preschoolers was 0.83 (95%CI [0.73,0.94]) compared with their never-breastfed counterparts. Random-effects dose-response model revealed a negative correlation between the duration of breastfeeding and risk of obesity (regression coefficient = -0.032, p = .001). Categorical analysis confirmed this dose-response association (1 day to <3 months of breastfeeding: OR = 1.07, 95%CI [0.94,1.21]; 3 months to <6 months: OR = 0.96, 95%CI [0.60,1.54]; ≥6 months: OR = 0.67, 95%CI [0.58,0.77]). One month of breastfeeding was associated with a 4.0% decrease in risk of obesity (OR = 0.96/month of breastfeeding, 95% CI [0.95, 0.97]). Under the reference of never breastfeeding, the summary OR of exclusive breastfeeding was 0.53 (95%CI [0.45,0.63]).
Conclusions:
Breastfeeding is inversely associated with a risk of early obesity in children aged two to six years. Moreover, there is a dose-response effect between duration of breastfeeding and reduced risk of early childhood obesity.
Implications:
Clinical nurses' guidance and advice that prolong the duration of breastfeeding and promote exclusive breastfeeding are needed to prevent the development of later childhood obesity.
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