Breast-feeding and childhood obesity--a systematic review

Int J Obes Relat Metab Disord. 2004 Oct;28(10):1247-56. doi: 10.1038/sj.ijo.0802758.


Objective: To investigate the relationship between breast-feeding and obesity in childhood.

Design: Systematic review and meta-analysis of published epidemiological studies (cohort, case-control or cross-sectional studies) comparing early feeding-mode and adjusting for potential confounding factors. Electronic databases were searched and reference lists of relevant articles were checked. Calculations of pooled estimates were conducted in fixed- and random-effects models. Heterogeneity was tested by Q-test. Publication bias was assessed from funnel plots and by a linear regression method.

Outcome measures: Odds ratio (OR) for obesity in childhood defined as body mass index (BMI) percentiles.

Results: Nine studies with more than 69,000 participants met the inclusion criteria. The meta-analysis showed that breast-feeding reduced the risk of obesity in childhood significantly. The adjusted odds ratio was 0.78, 95% CI (0.71, 0.85) in the fixed model. The assumption of homogeneity of results of the included studies could not be refuted (Q-test for heterogeneity, P>0.3), stratified analyses showed no differences regarding different study types, age groups, definition of breast-feeding or obesity and number of confounding factors adjusted for. A dose-dependent effect of breast-feeding duration on the prevalence of obesity was reported in four studies. Funnel plot regression gave no indication of publication bias.

Conclusion: Breast-feeding seems to have a small but consistent protective effect against obesity in children.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Breast Feeding*
  • Child
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena
  • Infant, Newborn
  • Obesity / epidemiology
  • Obesity / prevention & control*
  • Research Design