The impact of neonatal breast-feeding on growth trajectories of youth exposed and unexposed to diabetes in utero: the EPOCH Study

Int J Obes (Lond). 2012 Apr;36(4):529-34. doi: 10.1038/ijo.2011.254. Epub 2012 Jan 31.


Objective: To evaluate the influence of breast-feeding on the body mass index (BMI) growth trajectory from birth through 13 years of age among offspring of diabetic pregnancies (ODP) and offspring of non-diabetic pregnancies (ONDP) participating in the Exploring Perinatal Outcomes Among Children Study.

Subjects: There were 94 ODP and 399 ONDP who had multiple BMI measures obtained from birth throughout childhood. A measure of breast milk-months was derived from maternal self-report to categorize breast-feeding status as adequate (≥6 breast milk-months) or low (<6 breast milk-months). Mixed linear-effects models were constructed to assess the impact of breast-feeding on the BMI growth curves during infancy (birth to 27 months) and childhood (27 months to 13 years).

Results: ODP who were adequately breast-fed had a slower BMI growth trajectory during childhood (P=0.047) and slower period-specific growth velocity with significant differences between 4 and 6 years of age (P=0.03) and 6 to 9 years of age (P=0.01) compared with ODP with low breast-feeding. A similar pattern was seen in the ONDP, with adequate breast-feeding associated with lower average BMI in infancy (P=0.03) and childhood (P=0.0002) and a slower growth trajectory in childhood (P=0.0002). Slower period-specific growth velocity was seen among the ONDP associated with adequate breast-feeding with significant differences between 12-26 months (P=0.02), 4-6 years (P=0.03), 6-9 years (P=0.0001) and 9-13 years of age (P<0.0001).

Conclusion: Our study provides novel evidence that breast-feeding is associated with long-term effects on childhood BMI growth that extend beyond infancy into early and late childhood. Importantly, these effects are also present in the high-risk offspring, exposed to overnutrition during pregnancy. Breast-feeding in the early postnatal period may represent a critical opportunity to reduce the risk of childhood obesity.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Body Mass Index*
  • Breast Feeding* / statistics & numerical data
  • Child
  • Child of Impaired Parents / statistics & numerical data*
  • Child, Preschool
  • Cohort Studies
  • Colorado / epidemiology
  • Diabetes, Gestational*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Obesity / epidemiology*
  • Obesity / prevention & control*
  • Pregnancy
  • Pregnancy in Diabetics*
  • Retrospective Studies