Breastfeeding has many advantages, but population strategies to increase the duration and exclusivity of breastfeeding are unlikely to curb the obesity epidemic. That is the conclusion of a study published on the Web site of the Journal of the American Medical Association on March 13, 2013.
Thirty-one Belarusian maternity hospitals and their affiliated clinics were included in the cluster-randomized controlled trial. The subjects were randomized into 1 of 2 groups: breastfeeding promotion intervention (n=16) or usual practices (n=15). Participants were 17,046 breastfeeding mother-infant pairs enrolled in 1996 and 1997, of whom 13,879 (81.4%) were followed up between January 2008 and December 2010 at a median age of 11.5 years.
The children were evaluated for body mass index (BMI), fat and fat-free mass indices (FMI and FFMI), percent body fat, waist circumference, triceps and subscapular skinfold thicknesses, overweight and obesity, and whole-blood IGF-I.
Although the experimental intervention substantially increased breastfeeding duration and exclusivity when compared with the control group (43% vs 6% exclusively breastfed at 3 months and 7.9% vs 0.6% at 6 months), it did not prevent overweight or obesity in the children who had been breastfed.
Cluster-adjusted mean differences in outcomes at age 11.5 years between the experimental and control groups were: 0.19 (95% CI, –0.09 to 0.46) for BMI; 0.12
(–0.03 to 0.28) for FMI; 0.04 (–0.11 to 0.18) for FFMI; 0.47% (–0.11% to 1.05%) for percent body fat; 0.30 cm (–1.41 to 2.01) for waist circumference; –0.07 mm (–1.71 to 1.57) for triceps and –0.02 mm (–0.79 to 0.75) for subscapular skinfold thicknesses; and –0.02 standard deviations (–0.12 to 0.08) for IGF-I.
Martin RM, Patel R, Kramer MS, et al. Effects of promoting longer-term and exclusive breastfeeding on adiposity and insulin-like growth factor-I at age 11.5 years: A randomized trial. JAMA. 2013;309(10):1005-1013.