225926 Can early childhood lifestyle factors explain the relationship between breastfeeding and risk for overweight and obesity?

Wednesday, November 10, 2010 : 12:30 PM - 12:50 PM

Ann Middleton, MPH , New York City Department of Health & Mental Hygiene, Evaluation Consultant, Physical Activity and Nutrition Program, Long Island City, NY
Kathryn E. Henderson, PhD , Rudd Center for Food Policy and Obesity, Yale University, New Haven, CT
Tatiana Andreyeva, PhD , Rudd Center for Food Policy and Obesity, Yale University, New Haven, CT
Purpose: A growing body of research suggests that breastfed children are at lower risk for childhood overweight. This relationship could be explained by factors correlated with breastfeeding such as childhood nutrition, physical activity and screen time. Our objective was to determine whether the relationship between breastfeeding duration and childhood overweight remains after accounting for these important lifestyle factors. Methods: We analyzed data from the Early Childhood Longitudinal Study-Birth Cohort, a nationally representative sample of American children born in 2001 (n~5,450). Linear regression characterized associations between lifestyle factors and breastfeeding duration (exclusively or mixed) in months. Logistic regression models predicted the probability of overweight (BMI ≥85th percentile) and obesity (BMI ≥95th percentile) in kindergarteners that were never breastfed, breastfed 1-4 months, and breastfed >4 months, controlling for child characteristics (e.g., race/ethnicity, birth weight, SES), maternal characteristics and behaviors (e.g., age, smoking during pregnancy, pre-pregnancy BMI), preschool diet and lifestyle. Results: Longer breastfeeding duration was significantly associated with healthier diet, more physical activity, and less screen time in preschool. After multivariate adjustment for controls, those who were breastfed >4 months had a significantly lower prevalence of overweight (33%, p<0.01) and obesity (15%, p<0.05) than those never breastfed (38% and 20% respectively). Compared to never breastfed kindergartners, those breastfed 1-4 months had a lower but insignificant probability of overweight and obesity. Conclusion: Breastfed children in the United States have healthier childhood lifestyles, but these lifestyle differences do not appear to explain the protective relationship between breastfeeding >4 months and obesity in kindergarten.

Learning Areas:
Chronic disease management and prevention

Learning Objectives:
1) Explain the relationship between breastfeeding and early childhood nutrition and lifestyle in the United States. 2) Discuss the relationship between breastfeeding duration and overweight and obesity in early childhood.

Keywords: Breastfeeding, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have six years of experience studying and working in obesity prevention. I also attended a training on the ECLS-B dataset and conducted the analyses for the project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.