Early Childhood Overweight Research Articles

Projecting the impact of hypothetical early life interventions on adiposity in children living in low-income households.

It is difficult to evaluate the effectiveness of interventions aimed at reducing early childhood obesity using randomized trials. Objective To illustrate how observational data can be analysed using causal inference methods to estimate the potential impact of behavioural 'interventions' on early childhood adiposity. Methods We used longitudinal data from 1054 children 1-5 years old enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children and followed (WIC) from 2008 to 2010 for a mean duration of 23 months. The data came from a random sample of WIC families living in Los Angeles County in 2008. We used the parametric g-formula to estimate the impact of various hypothetical behavioural interventions. Results Adjusted mean weight-for-height Z score at the end of follow-up was 0.73 (95% CI 0.65, 0.81) under no intervention and 0.63 (95% CI 0.38, 0.87) for all interventions given jointly. Exclusive breastfeeding for 6 months or longer was the most effective intervention [population mean difference = -0.11 (95% CI -0.22, 0.01)]. Other interventions had little or no effect. Conclusions Compared with interventions promoting healthy eating and physical activity behaviours, breastfeeding was more effective in reducing obesity risk in children aged 1-5 years. When carefully applied, causal inference methods may offer viable alternatives to randomized trials in etiologic and evaluation research.

The Relationship between Milk Fat Content, Vitamin D and Adiposity in Early Childhood

Abstract BACKGROUND: Fortified cow’s milk is the main dietary source of vitamin D and an important source of dietary fat for North American children. Current guidelines recommend reduced milk fat consumption to reduce childhood obesity, yet the relationship between lower milk fat, vitamin D stores and adiposity is unclear. OBJECTIVES: The objective of this study was to determine the association between percent fat content of milk and both zBMI and 25-hydroxyvi-tamin D; secondly, to explore if volume of milk consumed modified this relationship. DESIGN/METHODS: A cross-sectional study of healthy urban children 12-72 months of age was conducted. Bivariate multiple linear regression was used to test the association between percent milk fat content and child 25-hydroxyvitamin D and zBMI concurrently. The interaction between volume of milk consumed and percent milk fat content was examined to explore how milk volume might modify these relationships. RESULTS: 2745 children were included in the analysis. Percent fat content of milk was positively associated with 25-hydroxyvitamin D (p=0.006), and negatively associated with zBMI (p<0.0001). Children who drank homogenized milk (3.25% fat) had 6.6 nmol/L (95% CI 5.49 to 7.71) higher median 25(OH)D concentration and 0.72 lower (95% CI 0.68 to 0.76) zBMI score than children who drank skim milk (0.1% fat). Volume of milk consumed potentiated the effect of percent fat content of milk on 25-hydroxyvitamin D (p=0.003) but not on zBMI (p=0.77). Children who drank 1 cup of homogenized milk each day had a similar 25-hydroxyvita-min D as children who drank 2.85 cups (95% CI 2.71 to 2.99) of skim milk, but had zBMI score 0.78 (95% CI 0.63, 0.93) units lower. CONCLUSION: Homogenized milk may be more appropriate than reduced fat milk in maximizing serum 25-hydroxyvitamin D and minimizing adiposity in early childhood. Current guidelines for reduced milk fat consumption in childhood may require further study to achieve desired outcomes.

Differences in the Protective Effect of Exclusive Breastfeeding on Child Overweight and Obesity by Mother's Race.

Objectives To examine the relationship between infant feeding and risk of child overweight and obesity across race and ethnicity in a diverse community-based cohort. Methods 2172 mother baby dyads were drawn from a prospective cohort constructed using data from electronic medical records linked to birth records. The primary exposure was exclusive breastfeeding at 2months of age; outcome was BMI Z-score and BMI≥85th percentile (overweight and obese) at 4years of age. Regression models were adjusted for confounding using covariance balanced propensity score and inverse probability weighting. Results At age 4, exclusively breast fed children had lower BMI Z-score (-0.109, SE=0.048) and a decreased odds of a BMI≥85th percentile (0.832; 95% CI 0.792, 0.994), when compared to those exclusively formula-fed or had mixed feeding. Race and ethnicity significantly moderated these associations. Sub-population analysis showed the effect was significant for BMI Z-score (p=0.0002) and BMI≥85th percentile (p<0.0001) only for children of NH white mothers. For children of NH black mothers exclusive breastfeeding was not associated with a significant difference in BMI Z-score, however there was an increased odds of overweight or obesity (p=0.0145). Conclusions The protective effect of breastfeeding against early childhood overweight and obesity may differ by race and ethnicity. This suggests that programs aiming to reduce obesity by increasing rates of breastfeeding may have limited impact for some groups and should be coupled with other racially and ethnically focused efforts to encourage healthy feeding practices in infancy and early childhood.

Mediterranean dietary pattern in pregnant women and offspring risk of overweight and abdominal obesity in early childhood: the INMA birth cohort study.

Animal models have suggested that maternal diet quality may reduce offspring obesity risk regardless of maternal body weight; however, evidence from human studies is scarce. The aim of this study was to evaluate associations between adherence to the Mediterranean diet (MD) during pregnancy and childhood overweight and abdominal obesity risk at 4 years of age. We analysed 1827 mother-child pairs from the Spanish 'Infancia y Medio Ambiente' cohort study, recruited between 2003 and 2008. Diet was assessed during pregnancy using a food frequency questionnaire and MD adherence by the relative Mediterranean diet score (rMED). Overweight (including obesity) was defined as an age-specific and sex-specific body mass index ≥85th percentile (World Health Organization referent), and abdominal obesity as a waist circumference (WC) >90th percentile. Multivariate adjusted linear and logistic regression models were used to evaluate associations between pregnancy rMED and offspring overweight and abdominal obesity. There was no association between rMED and body mass index z-score, whereas there was a significant association between higher adherence to MD and lower WC (β of high vs. low rMED: -0.62 cm; 95% confidence interval: -1.10, -0.14 cm, P for trend = 0.009). Pregnancy adherence to the MD was not associated with childhood overweight risk, but it was associated with lower WC, a marker of abdominal obesity.

MC3R gene polymorphisms are associated with early childhood adiposity gain and infant appetite in an Asian population.

SummaryBackgroundPolymorphic variants within human melanocortin‐3 receptor gene (MC3R) gene have been associated with obesity. However, its influence on infancy and early childhood adiposity has not been reported before.ObjectivesWe assessed associations between genotype at polymorphic sites within MC3R with early childhood adiposity and interaction with early childhood appetitive traits.MethodsWe studied 1090 singletons in an Asian mother–offspring cohort genotyped for MC3R and in a subgroup (n = 422) who had completed Child Eating Behaviour Questionnaires (CEBQ) at 12 months. Children were followed from birth to 48 months, and up to 10 measurements of body mass index and five measures of triceps and subscapular skin‐folds were obtained.ResultsIndependent of potential confounders, each additional MC3R minor allele copy was associated with greater body mass index standard deviation score [B{95% confidence interval}: 0.004 units/month {0.001,0.007}; p = 0.007], triceps [0.009 mm/month {0.001,0.02}; p = 0.021] and subscapular skin‐fold [0.008 mm/month {0.002,0.01}; p = 0.011] gain velocity in the first 48 months. Each additional MC3R minor allele copy was also associated with increased odds of overweight [odds ratio {95% confidence interval}: 1.48{1.17–1.88}] and obesity [1.58{1.10–2.28}] in the first 48 months. Every additional copy of MC3R minor allele was positively associated with ‘slowness‐in‐eating’ appetitive trait [0.24{0.06,0.39}, p = 0.006]; however, the relationship between ‘slowness‐in‐eating’ with adiposity gain was not statistically significant.ConclusionsOur findings support the role of MC3R genetic variants in adiposity gain during early childhood.

Prevalence and Risk Factors of Overweight and Obesity among Children Aged 6-59 Months in Cameroon: A Multistage, Stratified Cluster Sampling Nationwide Survey.

BackgroundChildhood obesity is one of the most serious public health challenges of the 21st century. The prevalence of overweight and obesity among children (<5 years) in Cameroon, based on weight-for-height index, has doubled between 1991 and 2006. This study aimed to determine the prevalence and risk factors of overweight and obesity among children aged 6 months to 5 years in Cameroon in 2011.MethodsFour thousand five hundred and eighteen children (2205 boys and 2313 girls) aged between 6 to 59 months were sampled in the 2011 Demographic Health Survey (DHS) database. Body Mass Index (BMI) z-scores based on WHO 2006 reference population was chosen to estimate overweight (BMI z-score > 2) and obesity (BMI for age > 3). Regression analyses were performed to investigate risk factors of overweight/obesity.ResultsThe prevalence of overweight and obesity was 8% (1.7% for obesity alone). Boys were more affected by overweight than girls with a prevalence of 9.7% and 6.4% respectively. The highest prevalence of overweight was observed in the Grassfield area (including people living in West and North-West regions) (15.3%). Factors that were independently associated with overweight and obesity included: having overweight mother (adjusted odds ratio (aOR) = 1.51; 95% CI 1.15 to 1.97) and obese mother (aOR = 2.19; 95% CI = 155 to 3.07), compared to having normal weight mother; high birth weight (aOR = 1.69; 95% CI 1.24 to 2.28) compared to normal birth weight; male gender (aOR = 1.56; 95% CI 1.24 to 1.95); low birth rank (aOR = 1.35; 95% CI 1.06 to 1.72); being aged between 13–24 months (aOR = 1.81; 95% CI = 1.21 to 2.66) and 25–36 months (aOR = 2.79; 95% CI 1.93 to 4.13) compared to being aged 45 to 49 months; living in the grassfield area (aOR = 2.65; 95% CI = 1.87 to 3.79) compared to living in Forest area. Muslim appeared as a protective factor (aOR = 0.67; 95% CI 0.46 to 0.95).compared to Christian religion.ConclusionThis study underlines a high prevalence of early childhood overweight with significant disparities between ecological areas of Cameroon. Risk factors of overweight included high maternal BMI, high birth weight, male gender, low birth rank, aged between 13–36 months, and living in the Grassfield area while being Muslim appeared as a protective factor. Preventive strategies should be strengthened especially in Grassfield areas and should focus on sensitization campaigns to reduce overweight and obesity in mothers and on reinforcement of measures such as surveillance of weight gain during antenatal consultation and clinical follow-up of children with high birth weight. Meanwhile, further studies including nutritional characteristics are of great interest to understand the association with religion, child age and ecological area in this age group, and will help in refining preventive strategies against childhood overweight and obesity in Cameroon.

Association of Maternal Working Status with Early Childhood Overweight in Brazil.

Association of Maternal Working Status with Early Childhood Overweight in Brazil.

Ethnic Differences in Effects of Maternal Pre-Pregnancy and Pregnancy Adiposity on Offspring Size and Adiposity.

Maternal adiposity and overnutrition, both before and during pregnancy, plays a key role in the subsequent development of obesity and metabolic outcomes in offspring. We explored the hypothesis that maternal adiposity (pre-pregnancy and at 26-28 weeks' gestation) and mid-pregnancy gestational weight gain (GWG) are independently associated with offspring size and adiposity in early childhood, and determined whether these effects are ethnicity dependent. In a prospective mother-offspring cohort study (N = 976, 56% Chinese, 26% Malay, and 18% Indian), we assessed the associations of offspring size (weight, length) and adiposity (subscapular and triceps skinfolds), measured at birth and age 6, 12, 18, and 24 mo, with maternal pre-pregnancy body mass index (ppBMI), mid-pregnancy GWG, and mid-pregnancy four-site skinfold thicknesses (triceps, biceps, subscapular, suprailiac). ppBMI and mid-pregnancy GWG were independently associated with postnatal weight up to 2 y and skinfold thickness at birth. Weight and subscapular and triceps skinfolds at birth increased by 2.56% (95% confidence interval, 1.68-3.45%), 3.85% (2.16-5.57%), and 2.14% (0.54-3.75%), respectively for every SD increase in ppBMI. Similarly, a one-SD increase in GWG increased weight and subscapular and triceps skinfolds at birth by 2.44% (1.66-3.23%), 3.28% (1.75-4.84%), and 3.23% (1.65-4.84%), respectively. ppBMI and mid-pregnancy suprailiac skinfold independently predicted postnatal skinfold adiposity up to 2 years of age, whereas only GWG predicted postnatal length. The associations of GWG with postnatal weight and length were present only among Chinese and Indians, but not Malays (P < .05 for interaction). ppBMI and GWG are independent modifiable factors for child size and adiposity up to 2 years of age. The associations are ethnic-dependent, and underscore the importance of ethnic specific studies before generalizing the applicability of risk factors reported in other populations.

Characteristics of child health care practitioners in overweight prevention of children

ObjectivesTo identify behavioral and personal characteristics of child health care (CHC) practitioners that influences the effect of early overweight prevention in children. MethodsIn total 216 questionnaires were filled out by CHC practitioners from four organizations in the Netherlands. ResultsThere is a gap between awareness of the problem overweight in early childhood and actually discussing this with parents, as well as a gap between the existing recommendations and the perceived importance of early overweight prevention. Despite the fact that nurses have a more central task in life-style support than physicians, they reported to have less knowledge and skills than physicians. ConclusionsWhile both CHC physicians and nurses need support in improving their knowledge and skills, it is the nurses who need more support. A more structured and tailored implementation strategy with more emphasis on the needs of the nurses and physicians may improve early overweight management.

Systematic review of randomised controlled trials of interventions that aim to reduce the risk, either directly or indirectly, of overweight and obesity in infancy and early childhood.

The risk factors for childhood overweight and obesity are known and can be identified antenatally or during infancy, however, the majority of effective interventions are designed for older children. This review identified interventions designed to reduce the risk of overweight/obesity that were delivered antenatally or during the first 2 years of life, with outcomes reported from birth to 7 years of age. Six electronic databases were searched for papers reporting randomised controlled trials of interventions published from January 1990 to September 2013. A total of 35 eligible studies were identified, describing 27 unique trials of which 24 were behavioural and three were non‐behavioural. The 24 behavioural trials were categorised by type of intervention: (1) nutritional and/or responsive feeding interventions targeted at parents of infants, which improved feeding practices and had some impact on child weight (n = 12); (2) breastfeeding promotion and lactation support for mothers, which had a positive effect on breastfeeding but not child weight (n = 5); (3) parenting and family lifestyle (n = 4); and (4) maternal health (n = 3) interventions that had some impact on feeding practices but not child weight. The non‐behavioural trials comprised interventions manipulating formula milk composition (n = 3). Of these, lower/hydrolysed protein formula milk had a positive effect on weight outcomes. Interventions that aim to improve diet and parental responsiveness to infant cues showed most promise in terms of self‐reported behavioural change. Despite the known risk factors, there were very few intervention studies for pregnant women that continue during infancy which should be a priority for future research.

Reducing overweight and obesity in early childhood. A meta-analysis of intervention programs that involve parents

Reducing overweight and obesity in early childhood. A meta-analysis of intervention programs that involve parents

Association of Body Mass Index and Lipid Profiles in Children

We examined the lipid values of obese and normal-weight children, to look if there is an association between Body Mass Index (BMI) and lipid profiles. Our study group included 100 volunteers (50 children with normal BMI and 50 with high BMI) who were admitted to Kagithane State Hospital Pediatrics Clinic for various reasons between July 2010 and May 2011. The inclusion criteria were as follows: age between 2 and 14 years, no chronic disease and no developmental defects. The high BMI group had significantly higher Low Density Lipoprotein (LDL) levels in comparison to the normal BMI group (p < 0.05). We also found that the high BMI group had higher cholesterol levels close to upper limit than the normal BMI group. We found high triglyceride levels not only in the high BMI group but also in the normal BMI group with a rate of 26% and 24% respectively. The difference of 2% was not significant. We advise that identification and treatment of elevated LDL cholesterol levels is of tremendous significance for obese children or adolescents for future cardiovascular disease risk in adulthood. In the light of these findings, we must not overlook cardiovascular risk in the normal BMI group children. We believe that necessary precautions must be taken for preventing overweight and dyslipidemia in early childhood. Accordingly, it is of paramount importance not only to reduce obesity in children and adolescents but also to monitor dyslipidemia in normal BMI children to avoid the subsequent risk for cardiovascular disease.

Association of infant feeding with adiposity in early childhood in a WIC sample.

To evaluate the association of different infant feeding practices with adiposity in early childhood. Survey was conducted among 150 White, Black, and Hispanic low-income families with children ages 2–4. History of supplementing breast milk with formula (mixed feeding) was more prevalent among Hispanic children (67.4%) than either White (8.5%) or Black children (22.7%) (p<.001). African American children had the highest BMI percentile of the three groups (p=.043), although Hispanic children had slightly higher birth weight than the other two groups (p=.06). Among Hispanic children, after adjusting for confounding variables including maternal BMI, the mixed feeding group and the exclusive formula-feeding group had significantly higher BMI percentile (b=3.068 and b=2.936, respectively) than the exclusive breastfeeding group. These associations were not observed among Blacks and Whites. Further research is warranted on the impact of different feeding practices during infancy on subsequent adiposity during pre-school years

Race/ethnic disparities in early childhood BMI, obesity and overweight in the United Kingdom and United States.

Objective:Racial/ethnic patterning in the risk of obesity and overweight has been observed in early childhood; however, little research has compared these disparities between the United Kingdom (UK) and United States (US) using detailed ethnic classifications. We use comparable nationally representative cohort studies to examine racial/ethnic disparities in mean body mass index (BMI) and in the odds of obesity/overweight in the UK and US. The contribution of sociodemographic, cultural and family routine factors are assessed.Methods:Data on BMI, obesity and overweight in 5-year-old children from the MCS (Millennium Cohort Study) and ECLS-B (Early Childhood Longitudinal Study, Birth Cohort) were examined. We investigated race/ethnic disparities in mean BMI and in the odds of obesity and overweight, as compared to normal weight. We assessed the independent contribution of sociodemographic, cultural and family routine factors to observed disparities.Results:In the UK, after adjustment for sociodemographic, cultural and family routine factors and maternal BMI, we found Black Caribbean children to have higher odds ratio (OR=1.7, confidence interval (CI)=1.1–2.6), Pakistani children to have lower odds of obesity (OR=0.60, CI=0.37–0.96) and Black African children were more likely to be overweight (OR=1.40, CI=1.04–1.88). In the US, in fully adjusted models, there were no race/ethnic disparities in children's odds of obesity and overweight.Conclusion:Disparities for Bangladeshi children in the UK and Mexican, other Hispanic and American Indian children in the US can be explained by socioeconomic disadvantage, whereas a range of cultural and family characteristics partially explain disparities for other groups in the UK. Future public health initiatives focused on reducing risk of overweight and obesity should consider the diverse socioeconomic and cultural profiles of all race/ethnic groups.

Influences of the neighbourhood food environment on adiposity of low-income preschool-aged children in Los Angeles County: a longitudinal study

BackgroundFew studies have examined the association between the food environment and adiposity in early childhood, a critical time for obesity prevention. The objective of this study was to examine the...

Obesity and type 2 diabetes in children: epidemiology and treatment.

The incidence of overweight and obesity among children has increased dramatically in recent decades, with about one-third of children in the U.S. currently being either overweight or obese. Being overweight in early childhood increases risk for later obesity. There is evidence for the efficacy of family-based behavioral treatment to control weight and improve health outcomes. Obesity-related health risks have been documented, including metabolic syndrome. There is also increasing incidence of type 2 diabetes (T2D) among youth in recent years, with obesity and family history of T2D generally present. Lower income and ethnic minority status are associated with both obesity and T2D in youth. Most youth with T2D do not achieve optimal glycemic control, and are at high risk for later health complications. Obesity and T2D represent significant public health issues with potentially great personal and societal cost. Research addressing the prevention of obesity and T2D among youth is urgently needed.

Breastfeeding, infant gut microbiota, and early childhood overweight (637.4)

RATIONALE: Breastfeeding may be protective against obesity, but existing evidence is inconsistent. The gut microbiota, which itself is shaped by breastfeeding and other early‐life exposures, may also contribute to the development of obesity.OBJECTIVE: To determine whether breastfeeding is protective against early childhood overweight, and to explore related associations with the gut microbiota.METHODS: The study involved 346 full term infants from the Canadian Healthy Infant Longitudinal Development (CHILD) national birth cohort. Mothers reported breastfeeding by standardized questionnaire, and child overweight was defined by weight‐for‐length z‐score (WFLz) according to World Health Organization standards. In a subset of 158 infants, the gut microbiota was characterized by Illumina 16S rRNA sequencing of fecal samples collected at 3 months.RESULTS: Breastfeeding rates (any breastfeeding) were 81%, 73%, and 46% at 3, 6 and 12 months, respectively. By 12 months, 16% of children were at risk for overweight (&gt; 85th percentile WFLz). After adjusting for birth mode and maternal overweight, breastfeeding &gt;6 months was associated with a significantly lower risk of child overweight (OR 0.35, 95%CI 0.18‐0.68). Gut microbiota composition and diversity were strongly influenced by breastfeeding (p&lt;0.01 by permutational multivariate ANOVA), and were also associated with child overweight: breastfeeding promoted lower diversity and decreased abundance of Clostridiales (both p&lt;0.01), characteristics which subsequently predicted a reduced risk of overweight (both p&lt;0.05).CONCLUSIONS: Our results suggest that breastfeeding beyond 6 months protects against early childhood overweight, possibly by modifying the gut microbiota. These findings are relevant to infant nutrition‐based obesity prevention strategies. Future research will incorporate extended microbiota analyses, detailed nutrition assessments, and longitudinal measures of obesity throughout childhood.Grant Funding Source: Supported by the Candian Institutes of Health Research and AllerGen NCE.

Early childhood nutritional status in CARICOM countries: an overview with respect to five nutrition related millennium development goals.

Previous reviews of nutritional status in children under 5 years describe the Caribbean grouped with Latin America. This paper focuses specifically on the Caribbean and the goals and targets of the Millennium Declaration that have bearing on childhood development. The results indicate that CARICOM countries have made progress in terms of child health as assessed by gross health indicators. Yet, the millennium generation experiences coexistence of undernutrition and overweight in early childhood. The associations of GNI with markers such as poverty indices are somewhat inconsistent with traditional findings and highlight a need to reassess the causes of infant mortality and low birth weight. However, a lack of systematic local data has hampered progress on an individual country basis. Interventions that deal more pointedly with country specific needs are required including those targeting obesity if the MDGs are to be attained by all member states.

Obese parents--obese children? Psychological-psychiatric risk factors of parental behavior and experience for the development of obesity in children aged 0-3: study protocol.

BackgroundThe incidences of childhood overweight and obesity have increased substantially and with them the prevalence of associated somatic and psychiatric health problems. Therefore, it is important to identify modifiable risk factors for early childhood overweight in order to develop effective prevention or intervention programs. Besides biological factors, familial interactions and parental behavioral patterns may influence children’s weight development. Longitudinal investigation of children at overweight risk could help to detect significant risk and protective factors. We aim to describe infants’ weight development over time and identify risk and protective factors for the incidence of childhood obesity. Based on our findings we will draw up a risk model that will lay the foundation for an intervention/prevention program.Methods/DesignWe present the protocol of a prospective longitudinal study in which we investigate families with children aged from 6 months to 47 months. In half of the families at least one parent is obese (risk group), in the other half both parents are normal weight (control group). Based on developmental and health-psychological models, we consider measurements at three levels: the child, the parents and parent–child-relationship. Three assessment points are approximately one year apart. At each assessment point we evaluate the psychological, social, and behavioral situation of the parents as well as the physical and psychosocial development of the child. Parents are interviewed, fill in questionnaires, and take part in standardized interaction tasks with their child in a feeding and in a playing context in our research laboratory. The quality of these video-taped parent–child interactions is assessed by analyzing them with standardized, validated instruments according to scientific standards.DiscussionStrengths of the presented study are the prospective longitudinal design, the multi-informant approach, including the fathers, and the observation of parent–child interaction. A limitation is the variation in children’s age.

Exclusive breastfeeding for 4 versus 6 months and growth in early childhood

To investigate the growth and the prevalence of overweight in early childhood among infants exclusively breastfed for 6months (EBF) compared with those receiving complementary foods from 4months of age in addition to breast milk (CF). A total of 119 mother-infant pairs were randomised either in the CF or in the EBF group. Weight, length and head circumference of the infants were measured at birth, 6weeks, and 3-6months of age. In the follow-up, the children's weight, length and head circumference were measured at 8, 10, 12 and 18months and weight and height at 29-38months. There were no differences between groups in the anthropometric outcome measures of weight-for-age (p=0.78), length-for-age (p=0.59), head-circumference-for-age (p=0.82) and BMI-for-age (p=0.61), using repeated measurements ANOVA. Furthermore, no difference was seen in the prevalence between groups in risk of being overweight or in those who were overweight at 18months and 29-38months of age. Exclusive breastfeeding for the first 4 or 6months of life does not seem to affect the risk of being overweight or the prevalence of those who were overweight in early childhood.