Breastfeeding Duration and High Blood Pressure in Children and Adolescents: Results from a Cross-Sectional Study of Seven Provinces in China

Abstract

This study was aimed to investigate the associations between breastfeeding duration and blood pressure (BP) levels, BP Z scores and high BP (HBP) in children and adolescents. A total of 57,201 participants including 29,491 boys and 27,710 girls aged 7–18 years were recruited from seven provinces in China in 2012. HBP was defined as BP levels of ≥95th percentiles of the referent age-, sex-, and height-specific population. Breastfeeding duration was divided into non-breastfeeding, 0–5 months, 6–12 months, and >12 months. Information on demographic, parental or family factors and dietary behaviors was collected through a self-administered questionnaire. Multivariable linear regression and logistic regression models were applied to assess the relationships of breastfeeding duration with BP levels and BP Z scores and with HBP, respectively. Stratified analyses were performed to further investigate the potential subgroup-specific associations. The reported prolonged breastfeeding (>12 months) rate was 22.53% in the total population. After full adjustment, compared to the non-breastfeeding group, breastfeeding for 6–12 months was correlated with 0.43 (95% CI: −0.75, −0.11) and 0.36 (95% CI: −0.61, −0.12) mmHg lower levels of SBP and DBP, respectively. Similar decrease trends were found for BP Z scores. Prolonged breastfeeding (>12 months) was associated with 1.33 (95% CI: 1.12, 1.58) and 1.12 (95% CI: 0.94, 1.33) higher odds of HBP in boys and girls, respectively. Based on nationally representative data, there was no evidence that a longer duration of breastfeeding is protective against childhood HBP. Breastfeeding for 6–12 months may be beneficial to BP, while prolonged breastfeeding durations might increase the odds of HBP in children and adolescents.

Breastfeeding, Gestational Diabetes Mellitus, Size at Birth and Overweight/Obesity in Early Childhood

“…However, this phenomenon is not consistent in previous studies. For example, a study involving 57,201 children from seven provinces in China showed that boys appeared to receive a longer duration of breastfeeding [35], while another study suggested that girls might receive more breastfeeding [36]. Although we cannot determine the exact reasons for the longer duration of breastfeeding in the female offspring in this study, it may be because mothers perceive their sons as needing more nutrients, potentially leading to the earlier introduction of formula milk or other foods, as speculated by a nationwide study conducted in the United States [37].…”

Cardiovascular Risk Factors in China

“…Data of 943,128 Chinese children and adolescents aged 7-17 years (boys 49.7%) were obtained from CNSSCH 1995-2014. [38] The population attributable risk (PAR) for hypertension because of overweight and obesity steadily increased from 6.3% in 1995 to 19.2% in 2014. The PAR for systolic hypertension because of overweight and obesity was always 2-fold greater than that for diastolic hypertension (7.4%−26.2% vs. 6.2%−13.4%) (Figure 13).…”

The association of breastfeeding duration on metabolic syndrome among children and adolescents, stratified by birth weight for gestational age

“…Parents were also asked to provide information on feeding (breastfeeding or not) and its duration (in months), which was divided into: non-breastfeeding, <6, 6-12 and >12 months. 21,22 We defined breastfeeding >12 months as a prolonged breastfeeding duration. Parents were also asked to provide information on the children's birth weight.…”