Published online December 1, 2006
PEDIATRICS Vol. 118 No. 6 December 2006, pp. 2341-2348 (doi:10.1542/peds.2006-1814)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Taveras, E. M.
Right arrow Articles by Gillman, M. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Taveras, E. M.
Right arrow Articles by Gillman, M. W.
Related Collections
Right arrow Nutrition & Metabolism

ARTICLE

To What Extent Is the Protective Effect of Breastfeeding on Future Overweight Explained by Decreased Maternal Feeding Restriction?

Elsie M. Taveras, MD, MPHa,b, Sheryl L. Rifas-Shiman, MPHb, Kelley S. Scanlon, PhD, RDc, Laurence M. Grummer-Strawn, PhDc, Bettylou Sherry, PhD, RDc and Matthew W. Gillman, MD, SMa,b,d

a Obesity Prevention Program and Center for Child Health Care Studies
b Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, Boston, Massachusetts
c National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
d Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts

OBJECTIVE. Previous studies have found that breastfeeding may protect infants against future overweight. One proposed mechanism is that breastfeeding, as opposed to bottle feeding, promotes maternal feeding styles that are less controlling and more responsive to infant cues of hunger and satiety, thereby allowing infants greater self-regulation of energy intake. The objective of this study was to determine the extent to which the protective effect of breastfeeding on future overweight is explained by decreased maternal feeding restriction.

PATIENTS AND METHODS. We studied 1012 mother-infant pairs in Project Viva, an ongoing prospective cohort study of pregnant mothers and their children. The main exposure was breastfeeding duration, assessed at 1 year postpartum. At 3 years of age, the main outcomes were age- and gender-specific BMI z score and the sum of subscapular and triceps skinfold thicknesses, with overweight defined as a BMI ≥95th percentile. We defined maternal restriction of infant’s access to food as strongly agreeing or agreeing, with the following question from the Child Feeding Questionnaire: "I have to be careful not to feed my child too much." To examine the association between breastfeeding duration and our outcomes, we used multivariate linear and logistic models, adjusting for several potential confounders. In subsequent models, we also adjusted for maternal restriction of infant’s access to food.

RESULTS. The mean duration of breastfeeding was 6.5 months, and 12% of women strongly agreed or agreed with the restriction question. At age 3, mean for BMI z score was 0.47. Each 3-month increment in breastfeeding duration was associated with a reduction of 0.045 BMI z score. After adjusting for maternal restriction, the estimate was –0.039, a 13% attenuation.

CONCLUSION. The protective effect of breastfeeding on future overweight seems to be explained only partially by decreased maternal feeding restriction.

Key Words: breastfeeding • body mass index • BMI • infant feeding • maternal feeding restriction

Abbreviations: OR—odds ratio • CI—confidence interval • CFQ—Child Feeding Questionnaire

Accepted Aug 29, 2006.