Abstract

This study aimed to examine the association between breastfeeding and childhood obesity. A multinational cross‐sectional study of 4,740 children aged 9–11 years was conducted from 12 countries. Infant breastfeeding was recalled by parents or legal guardians. Height, weight, waist circumference, and body fat were obtained using standardized methods. The overall prevalence of obesity, central obesity, and high body fat were 12.3%, 9.9%, and 8.1%, respectively. After adjustment for maternal age at delivery, body mass index (BMI), highest maternal education, history of gestational diabetes, gestational age, and child's age, sex, birth weight, unhealthy diet pattern scores, moderate‐to‐vigorous physical activity, sleeping, and sedentary time, exclusive breastfeeding was associated with lower odds of obesity (odds ratio [OR] 0.76, 95% confidence interval, CI [0.57, 1.00]) and high body fat (OR 0.60, 95% CI [0.43, 0.84]) compared with exclusive formula feeding. The multivariable‐adjusted ORs based on different breastfeeding durations (none, 1–6, 6–12, and > 12 months) were 1.00, 0.74, 0.70, and 0.60 for obesity (P trend = .020) and 1.00, 0.64, 047, and 0.64 for high body fat (P trend = .012), respectively. These associations were no longer significant after adjustment for maternal BMI. Breastfeeding may be a protective factor for obesity and high body fat in 9‐ to 11‐year‐old children from 12 countries.

Highlights

  • Jian Ma and Yijuan Qiao contributed to this work and should be considered co-first authors

  • We found that breastfeeding is associated with significantly reduced odds of general obesity and high body fat in 9- to 11-year-old children from 12 diverse countries

  • Participants who were excluded from the present analysis did not differ in body mass index (BMI)-for-age z-scores but had a higher proportion of boys than those who were included in the analysis

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Summary

Objectives

This study aimed to examine the association between breastfeeding and childhood obesity. The aim of the present study was to examine the association between breastfeeding and the odds of obesity in 9to 11-year-old children from 12 countries while controlling for these purported confounders

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