Differences in the Protective Effect of Exclusive Breastfeeding on Child Overweight and Obesity by Mother’s Race

Abstract

Objectives To examine the relationship between infant feeding and risk of child overweight and obesity across race and ethnicity in a diverse community-based cohort. Methods 2172 mother baby dyads were drawn from a prospective cohort constructed using data from electronic medical records linked to birth records. The primary exposure was exclusive breastfeeding at 2 months of age; outcome was BMI Z-score and BMI ≥ 85th percentile (overweight and obese) at 4 years of age. Regression models were adjusted for confounding using covariance balanced propensity score and inverse probability weighting. Results At age 4, exclusively breast fed children had lower BMI Z-score (-0.109, SE = 0.048) and a decreased odds of a BMI ≥ 85th percentile (0.832; 95 % CI 0.792, 0.994), when compared to those exclusively formula-fed or had mixed feeding. Race and ethnicity significantly moderated these associations. Sub-population analysis showed the effect was significant for BMI Z-score (p = 0.0002) and BMI ≥ 85th percentile (p < 0.0001) only for children of NH white mothers. For children of NH black mothers exclusive breastfeeding was not associated with a significant difference in BMI Z-score, however there was an increased odds of overweight or obesity (p = 0.0145). Conclusions The protective effect of breastfeeding against early childhood overweight and obesity may differ by race and ethnicity. This suggests that programs aiming to reduce obesity by increasing rates of breastfeeding may have limited impact for some groups and should be coupled with other racially and ethnically focused efforts to encourage healthy feeding practices in infancy and early childhood.

Prospective associations of age at complementary feeding and exclusive breastfeeding duration with body mass index at 5–6 years within different risk groups

“…We observed that, compared with exclusive breastfeeding for less than 3 months, exclusive breastfeeding for 6 months or longer was associated (after adjustment for confounders) with lower BMI and lower risk of overweight at age 5–6 years in risk groups of medium education, Dutch ethnicity (indicated by logistic regression and adjusted linear regression models) and normal BMI. Similar to our study, studies in the USA and Sweden stratified their analyses by maternal ethnicity and concluded that the protective effect of breastfeeding (any duration, non‐exclusive) on overweight/obesity or BMI development was limited to children of White mothers and not observed in Blacks, Hispanics or non‐Swedish immigrants . One of these studies also examined a low‐income population in which the effect was limited only to White children who were breastfed at least for 4 months and whose mothers did not smoke .…”

Effect of HTST and Holder Pasteurization on the Concentration of Immunoglobulins, Growth Factors, and Hormones in Donor Human Milk

“…In addition, there are a high number of maternal and infant factors that influence the levels of bioactive compounds in human milk and their functions in the infant gut. These factors pinpoint the difficulty in relating unequivocally the variation of one compound to a specific infant outcome ( 86 , 92 ). From a methodological point of view, care must be taken to compare some of the obtained results because of the strong association of some compounds to the milk fat fraction, which was discarded during sample preparation.…”

Mother and Infant Body Mass Index, Breast Milk Leptin and Their Serum Leptin Values

“…Children with obese mothers seem to be at higher risk to become obese themselves [ 35 ]. The protective effect of breastfeeding against early childhood obesity may differ with race and ethnicity [ 36 ].…”