Is Breastfeeding Protective for Blood Pressure in Schoolchildren? A Cohort Study in Northeast Brazil

Abstract

Objective: This study assessed the influence of breastfeeding and nutritional status of full-term infants on blood pressure at school age. Subjects and Methods: This was a cross-sectional study nested in a cohort of 375 infants recruited at birth between 1993 and 1994 in the state of Pernambuco, Brazil. A sample of 213 8-year-old children had their blood pressure measured. A multivariate linear regression analysis was used to identify the influence of low birth weight and breastfeeding duration on blood pressure, adjusting for socioeconomic conditions, maternal nutritional status, eating habits, growth rate (0-6 months), and the children's anthropometry at 8 years.Results: Mean values of children's blood pressure were significantly higher with lower duration of breastfeeding. Higher per capita family income, maternal body mass index and height, child's weight and length at birth, and child anthropometric dimensions at 8 years of age were associated with higher levels of blood pressure. The multivariate linear regression analysis showed that children who were breastfed for less than 40 days had higher systolic blood pressures, explaining 2.2% of its variation. Anthropometry at 8 years of age explained the higher variance in systolic blood pressure (12.6%) with emphasis on waist circumference (9.5%), followed by per capita income (3.2%) and maternal height (2.1%). Birth weight and length had no influence on blood pressure levels in this age group. Conclusions: Children's waist circumference, duration of breastfeeding, socioeconomic conditions, and maternal nutritional status influenced blood pressure levels of schoolchildren born full term, rather than low birth weight.

Association between birth weight and childhood cardiovascular disease risk factors in West Virginia

“…Likewise, our findings regarding DBP are in general agreement with studies that reported a significant positive association between birth weight and childhood DBP in the unadjusted analysis 29,66 that became nonsignificant (but remained positive) after adjusting for the child's current BMI. 33 Azadbakht and collegues also found significant positive bivariate association between birth weight and DBP as observed in our study. However, in contrast to our findings, this positive association remained statistically significant after adjusting for the child's current BMI in both this 9 and other previous studies.…”

“…In addition, due to the unique population characteristics of WV, a predominantly Caucasian rural state entirely within the Appalachian region of the US, results may not be generalizable to other populations, although previous studies have yielded similar findings. 9,28,29,31,33,36,39,66 Lastly, the magnitude of association seems extremely small though statistically significant (small p-values) perhaps due to the large sample size, cautions us about the clinical and population health importance of this association. However, the occurrence of CVD risk factor in childhood is an important concern as these risk factors persist, track, and amplify with age, leading to potentially serious CVDs in later adulthood.…”

“…[23][24][25] LBW has shown to be an independent risk factor for childhood CVD risk factors such as obesity, 26 high blood pressure, 9,[27][28][29][30] and poor lipid profile. 31 However, some studies have found a weak association or no association between birth weight and subsequent risk of developing high blood pressure [32][33][34] or childhood hypertension. 35 Additionally, some studies have reported this relationship in overweight, but not in non-overweight children.…”

Association Between Breastfeeding and Childhood Cardiovascular Disease Risk Factors

“…Previous research examining the associations between breastfeeding and later childhood CVD risk factors has yielded conflicting results. For example, while some studies have found a significant protective effect of breastfeeding on child CVD risk factors such as systolic blood pressure (SBP) (Amorim Rde et al 2014;Hosaka et al 2013;Lawlor et al 2004), diastolic blood pressure (DBP) (Martin et al , 2004Owen et al 2003), and lipid levels in childhood (Plagemann and Harder 2005;Plancoulaine et al 2000;Thorsdottir et al 2003), others have not (Bekkers et al 2011;de Jonge et al 2010;Fall et al 2011;Horta et al , 2015Izadi et al 2013;Kramer 2010;Kramer et al 2007;Kwok et al 2013;Owen et al 2002Owen et al , 2008Rudnicka et al 2007). These discrepancies may in part reflect the role of childhood adiposity, a factor associated with blood pressure and cholesterol (McMurray et al 1995).…”

“…These discrepancies may in part reflect the role of childhood adiposity, a factor associated with blood pressure and cholesterol (McMurray et al 1995). Some studies that did adjust for childhood obesity found that the association between breastfeeding and childhood CVD risk factors became non-significant in the adjusted models (Bekkers et al 2011), whereas others found that even after controlling for body mass index (BMI) the association attenuated but remained statistically significant (Amorim Rde et al 2014;Lawlor et al 2004;Martin et al 2004). These conflicting results suggest that childhood obesity could potentially be a partial or full mediator between the observed effects.…”