Babies who are never or only partially breastfed have an increased risk of becoming obese as children compared to babies who are exclusively breastfed, according to research* presented at the European Congress on Obesity. The World Health Organisation (WHO) Europe study investigated the association between early-life factors, namely breastfeeding, exclusive breastfeeding and birth weight, and obesity.
The analysis, which included 16 countries and 29,245 children, found a protective effect: compared to children who were breastfed for six months, children who were never breastfed were 22% more likely to be obese; whereas those who breastfed for less than six months were 12% more likely to be obese. Similar figures arose also for exclusive breastfeeding (which means that an infant received only breast milk and no other liquids or solids) based on data from eight countries (15,371 children).
Although this study published in the journal Obesity Facts does not include UK data, according to preliminary WHO data, the UK has some of the lowest levels of exclusive breastfeeding. Some 81% of mothers in the UK begin to breastfeed but at six months that drops to just 1% exclusively breastfeeding.
At the country level, statistical significance was found in six individual countries confirming this relationship with increased risks for obesity for never-breastfed children, compared to having been breastfed for six months: Montenegro (90%), Malta (69%), Croatia (62%), Georgia (53%), Spain (25%) and Italy (21%).
Regarding the association between obesity and characteristics at birth, the analysis revealed a 50% higher risk of being obese in case of preterm birth. Low birthweight was associated with a lower risk of future obesity by 35%, while high birthweight increased it by 9%.
Despite the consistent flow of research evidence showing the health benefits from breastfeeding, along with numerous policy initiatives aimed to promote optimal breastfeeding practices, adoption of exclusive breastfeeding in Europe remains below global recommendation. This study showed that, while in nearly all countries, more than 77% of children were breastfed, there were exceptions - in Ireland, France and Malta, 46%, 38% and 35% of children, respectively, were never breastfed. Only four out of 12 countries had a 25% or higher prevalence of exclusive breastfeeding (for six months or more), namely Georgia (35%); Kazakhstan (51%); Turkmenistan (57%) and Tajikistan (73%).
The research was led by Dr Ana Rito of the National Institute of Health, Lisbon, Portugal, and colleagues. The authors say: "Considering that promoting breastfeeding presents a 'window of opportunity' for obesity policy prevention to respond to the problem of childhood obesity in Europe, the existence of national policies to promote breastfeeding practices and how these policies are developed, can lead some countries to be more or less successful. In general, breastfeeding practices in Europe fall short of WHO recommendations, due to inefficient policies to encourage breastfeeding; lack of preparation of health professionals to support breastfeeding, intensive marketing of breast milk substitutes, and problems in legislation on maternity protection, among others."
They conclude: "This study confirms the beneficial effect of breastfeeding with regard to the odds of becoming obese, which was statistically significant increased if children were never breastfed or breastfed for less than six months. Nevertheless, adoption of exclusive breastfeeding is below the global recommendations and far from the target to increase the prevalence of exclusive breastfeeding in the first six months up to at least 50% by 2025, a goal endorsed by the WHO's Member States at the World Health Assembly Global Targets for Nutrition".
Kate Brintworth, from the Royal College of Midwives, said the work contributes to the strong evidence about the benefits of breastfeeding for mother and baby and "reinforces the need to increase the resources that are put into supporting women to begin and maintain breastfeeding for at least the first six months of the baby’s life".
“This means we need both more specialist breastfeeding support for women after the birth and more time for midwives to offer the support women are telling us they need.
“We know that in the postnatal period many women are saying they don’t feel midwives and midwifery support workers have the time to give them the support that would enable many more to continue breastfeeding.
"However, it is important that we respect a woman's infant feeding choices, and that if a woman chooses not to breastfeed, for whatever reason, she will need to be supported her in that choice."
*Rito AI, Buoncristiano M, Spinelli A, et al. Association between Characteristics at Birth, Breastfeeding and Obesity in 22 countries. The WHO European Childhood Obesity Surveillance Initiative - COSI 2015/2017.