Breast-feeding and childhood obesity--a systematic review.
OBJECTIVE
To investigate the relationship between breast-feeding and obesity in childhood.


METHODS
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.


METHODS
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.


CONCLUSIONS
Breast-feeding seems to have a small but consistent protective effect against obesity in children.
Arenz
S
S
Institute for Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians University, D-81377 Munich, Germany.
Rückerl
R
R
Koletzko
B
B
von Kries
R
R
D001942:Breast Feeding; D002648:Child; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D012107:Research Design