by Anne Eglash MD, IBCLC, FABM
How does breastfeeding effect risk factors for heart disease among young children? Early childhood obesity is a risk factor for obesity and heart disease as an adult. The evidence seems pretty clear that breastfeeding prevents early childhood obesity, but does it alter other bodily characteristics that are risk factors for heart disease later on?
A group of researchers recruited 1539 healthy children, 3-6 years of age, between October 2009 and August 2015. All children attended routine well child visits at pediatric and family medicine offices associated with The Applied Research Group for Kids in Toronto Canada. The parents were asked to complete a survey regarding sociodemographic, lifestyle, and dietary information, and the mothers were asked about duration of breastfeeding.
The children were measured for various risk factors of heart disease, including weight, height, waist circumference, blood pressure, glucose and cholesterol. The average breastfeeding duration among the subjects was 12 months.
What do you think the researchers found regarding the association between the duration of breastfeeding and the measured risk factors for heart disease? Choose 1 or more:
- There was no association between breastfeeding duration and systolic blood pressure.
- Duration of breastfeeding was associated with lower blood sugars.
- Breastfeeding beyond 24 months did not confer any further benefits for cardiometabolic risks.
- The longer a child breastfed, the lower the waist circumference, up to 24 months of breastfeeding.
- Duration of breastfeeding was not associated with total cholesterol of HDL levels.
See the Answer
The answers are C,D,E
The Association of Breastfeeding Duration and Early Childhood Cardiometabolic Risk
Wong PD, Anderson LN, Dai DDW, Parkin PC, Maguire JL, Birken CS; TARGet Kids! Collaboration
To evaluate the association between breastfeeding duration and early childhood cardiometabolic risk.
A cross-sectional study of 1539 healthy children, 3-6 years of age, recruited through The Applied Research Group for Kids! practice-based research network between October 2009 and August 2015. Adjusted multivariable linear regression was used to examine the association between breastfeeding duration and cardiometabolic risk z score and individual cardiometabolic risk factors of waist circumference, systolic blood pressure, glucose, high-density lipoprotein cholesterol, and triglycerides.
The mean breastfeeding duration was 12.5 months (SD = 8.4). Breastfeeding duration was associated with lower cardiometabolic risk z score (beta = -0.03; 95% CI -0.05, -0.01). In analysis of cardiometabolic risk factors, each additional 3 months of breastfeeding was associated with a 0.13 cm (95% CI -0.20, -0.05) lower waist circumference and 0.16 mm Hg (95% CI -0.30, -0.02) lower systolic blood pressure. Compared with children who breastfed for 6-12 months, those who breastfed for 12-24 months had a lower systolic blood pressure of 1.07 mm Hg (95% CI -2.04, -0.10). There was no association between breastfeeding duration and cardiometabolic risk for those who breastfed beyond 24 months.
Breastfeeding duration is associated with lower cardiometabolic risk, although the magnitude of association is small. Causation cannot be inferred. Breastfeeding beyond 24 months may not have an added benefit for cardiometabolic health.
Copyright © 2017 Elsevier Inc. All rights reserved.
Milk Mob Comment by Anne Eglash MD, IBCLC, FABM
This study found that breastfeeding duration was associated with a decrease in cardiometabolic risk factors because of a decrease in waist circumference and a slight lowering of systolic blood pressure, The authors calculate that every additional 3 months of breastfeeding duration is associated with a decrease in waist circumference by 0.13 cm and a decrease in systolic blood pressure by 0.16mmHg.
Some studies show breastfeeding’s protection against childhood obesity gradually declines as the child ages. This may be at least associated with lack of optimal diet and activity behaviors after breastfeeding is over. Breastfeeding is essential for launching the metabolic health of infants, especially infants who have a strong family history of diabetes and heart disease. Health care providers and other breastfeeding supporters ought to encourage families to learn optimal feeding strategies once complementary foods are introduced, to help prevent obesity and the risk of heart disease. Often this needs to start with the parents’ own diets. They may need resources to learn the components of a healthy diet, and develop skills to prepare balanced meals. For families who do not receive this counseling thru WIC, these conversations are best started during pregnancy, and continue thru the early well-child visits.