Abstract
The aim of this study was to assess the relationship between breastfeeding and postponing introduction to solid food (SF) on children’s obesity and healthy weight status (WS), at 2 and 4 years. Drawing upon a nationally representative sample of children from the Early Childhood Longitudinal Study-Birth Cohort, we estimated the magnitude of the relationship between children’s WS and early feeding practices. Contingency tables and multinomial logistic regression were used to analyze obese and healthy WS for breastfed and never breastfed children and examine three timing categories for SF introduction. With both percentages and odds, breastfeeding and delaying introduction to SF until 4 months were associated with lower obesity rates and higher, healthy WS rates (typically 5–10 %). Analyses of feeding practice combinations revealed that when children were not breastfed, obesity odds decreased when SF introduction was postponed until 4 months. Obesity odds were further reduced when SF delay was combined with breastfeeding. Consistent increases in healthy WS were also observed. Benefits were stable across both follow-up periods. Breastfeeding and delaying complementary foods yielded consistently and substantially lower likelihood of obesity and greater probability of healthy WS. Health policies targeting early feeding practices represent promising interventions to decrease preschool obesity and promote healthy WS.
Similar content being viewed by others
Abbreviations
- ECLS-B:
-
Early childhood longitudinal study-birth cohort
- WS:
-
Weight status
- SF:
-
Solid food
References
Barlow, S. E. (2007). Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report. Pediatrics, 120, S164–S192.
Arenz, S., Ruckerl, R., Koletzko, B., & von Kries, R. (2004). Breast-feeding and childhood obesity—a systematic review. International Journal of Obesity, 28, 1247–1256.
Huh, S. Y., Rifas-Shiman, S. L., Taveras, E. M., Oken, E., & Gillman, M. W. (2011). Timing of solid food introduction and risk of obesity in preschool-aged children. Pediatrics, 127, e544–e551.
Owen, C. G., Martin, R. M., Whincup, P. H., Smith, G. D., & Cook, D. G. (2005). Effect of infant feeding on the risk of obesity across the life course: A quantitative review of published evidence. Pediatrics, 115, 1367–1377.
Reilly, J. J., Methven, E., McDowell, Z. C., Hacking, B., Alexander, D., Stewart, L., et al. (2003). Health consequences of obesity. Archives of Disease in Childhood, 88(9), 748–752.
American Academy of Pediatrics (AAP). (2012). Breastfeeding and the use of human milk. Pediatrics, 129, e827–e841.
Casazza, K., Fontaine, K. R., Astrup, A., Birch, L. L., Brown, A. W., Bohan Brown, M. M., et al. (2013). Myths, presumptions, and facts about obesity. New England Journal of Medicine, 368, 446–454.
Dewey, K. G. (2003). Is breastfeeding protective against child obesity? Journal of Human Lactation, 19, 9–18.
Gillman, M. W., Rifas-Shiman, S. L., Camargo, C. A., Berkeley, C. S., Frazier, A. L., Rockett, H. R., et al. (2001). Risk of overweight among adolescents who were breastfed as infants. The journal of the American Medical Association, 285, 2461–2467.
Moorcraft, K. E., Marshall, J. L., & McCormick, F. M. (2011). Association between timing of introducing solid foods and obesity in infancy and childhood. A systematic review. Maternal & Child Nutrition, 7, 3–26.
Moss, B. G., & Yeaton, W. H. (2011). Young children’s weight trajectories and associated risk factors: results from the Early Childhood Longitudinal Study-Birth Cohort. American Journal of Health Promotion, 25, 190–198.
Moss, B. G., & Yeaton, W. H. (2012). US children’s preschool weight status trajectories: Patterns from 9-month, 2-year, and 4-year Early Childhood Longitudinal Study-Birth Cohort data. American Journal of Health Promotion, 26, 172–175.
Institute of Medicine (IOM). (2011). Early childhood obesity prevention policies. Washington, DC: The National Academies Press.
World Health Organization (WHO). (2001). The optimal duration of exclusive breastfeeding: Report of an expert consultation. Geneva: World Health Organization.
Brophy, S., Cooksey, R., Gravenor, M. B., Mistry, R., Thomas, N., Lyons, R. A., et al. (2009). Risk factors for childhood obesity at age 5: Analysis of the millennium cohort study. BMC Public Health, 9, 467.
Seach, K. A., Dharmage, S. C., Lowe, A. J., & Dixon, J. B. (2010). Delayed introduction of solid feeding reduces child overweight and obesity at 10 years. International Journal of Obesity, 34, 1475–1479.
Wilson, A. C., Forsyth, J. S., Greene, S. A., Irvine, L., Hau, C., & Howie, P. W. (1998). Relation of infant diet to childhood health: Seven year follow up of cohort of children in Dundee infant feeding study. BMJ, 316, 21–25.
Ionnidis, J. P. A. (2005). Why most published research findings are false. PLoS Medicine, 2, e124.
Hack, M., Schluchter, M., Cartar, L., Rahman, M., Cuttler, L., & Borawski, E. (2003). Growth of very low birth weight infants to age 20 years. Pediatrics, 112(1), e30–e38.
US Department of Education. (2011). Restricted use data procedures manual. (NCES No. 96860rev) Washington, DC: National Center for Education Statistics.
Kuczmarski, R. J., Ogden, C. L., Guo, S. S., Grummer-Strawn, L. M., Flegal, K. M., Mei, Z., et al. (2000). CDC growth charts for the United States: Methods and development. National Center for Health Statistics. Vital and Health Statistics, 11(246), 2002.
Ogden, C. L., & Flegal, K. M. (2010). Changes in terminology for childhood overweight and obesity. National health statistics reports, no 25. Hyattsville, MD: National Center for Health Statistics.
StataCorp. (2009). Stata statistical software: Release 11. College Station, TX: StataCorp LP.
Dewey, K. G., & Lonnerdal, B. (1986). Infant self-regulation of breast milk intake. Acta Paediatrica Scandinavica, 75, 893–898.
Fisher, J. O., Birch, L. L., Smiciklas-Wright, H., & Picciano, M. F. (2000). Breast-feeding through the first year predicts maternal control in feeding and subsequent toddler energy intake. Journal of the American Dietetic Association, 100, 641–646.
Grummer-Strawn, L. M., Scanlon, K. S., & Fein, S. B. (2008). Infant feeding and feeding transitions during the first year of life. Pediatrics, 122(suppl 2), S36–S42.
Pac, S., McMahon, K., Ripple, M., Reidy, K., Ziegler, P., & Meyers, E. (2004). Development of the start healthy feeding guidelines for infants and toddlers. Journal of the American Dietetic Association, 104(3), 455–467.
Skinner, J. D., Carruth, B. R., Bounds, W., Ziegler, P., & Reidy, K. (2002). Do food-related experiences in the first 2 years of life predict dietary variety in school-aged children? Journal of Nutrition Education and Behavior, 34(6), 310–315.
Lopez, R. P. (2007). Neighborhood risk factors for obesity. Obesity, 15(8), 2111–2119.
Ludwig, J., Sanbonmatsu, L., Gennetian, L., Adam, E., Duncan, G. J., Katz, L. F., et al. (2011). Neighborhoods, obesity, and diabetes—a randomized social experiment. New England Journal of Medicine, 365, 1509–1519.
Kamath, C. C., Vickers, K. S., Ehrlich, A., McGovern, L., Johnson, J., Singhal, V., et al. (2008). Clinical review: behavioral interventions to prevent childhood obesity: A systematic review and meta analyses of randomized trials. Journal of Clinical Endocrinology and Metabolism, 93, 4606–4615.
Acknowledgments
Both Drs. Moss and Yeaton developed the study concept and design, participated with the interpretation of the data, as well as contributed to the manuscript’s content. Dr. Moss had access to the restricted data and takes responsibility for the integrity of the data analyses. Neither author claims a conflict of interest and approval was granted by the National Center for Health Statistics and State Institutional Review Boards. The authors wish to express appreciation to Drs. Janet Hankin and Riva Tukachinsky for feedback on earlier drafts of this manuscript.
Conflict of interest
The authors have no competing interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Moss, B.G., Yeaton, W.H. Early Childhood Healthy and Obese Weight Status: Potentially Protective Benefits of Breastfeeding and Delaying Solid Foods. Matern Child Health J 18, 1224–1232 (2014). https://doi.org/10.1007/s10995-013-1357-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-013-1357-z