title: Association between Breastfeeding and Childhood Obesity: Analysis of a Linked Longitudinal Study of Rural Appalachian Fifth-Grade Children.
abstract: BACKGROUND
  Although breastfeeding is associated with improving numerous health outcomes for the child, its role in reducing childhood obesity is contested. Despite this controversy, both the CDC and the US Department of Health and Human Services promote breastfeeding as one of the strategies for reducing childhood obesity. Rural Appalachia has one of the highest rates of childhood obesity and low rates of breastfeeding, compared to rest of the nation. The aim of this study was to examine the association between breastfeeding and childhood obesity at 11 years in the rural Appalachian state of West Virginia (WV).
  
  
  METHODS
  The study used linked data from two cross-sectional data sets to examine this relationship longitudinally in fifth-grade WV children. The main outcome variable was BMI adjusted percent (BMI%) and the main exposure was defined as occurrence of breastfeeding. Mean BMI% of children who were not breastfed was significantly higher, compared to children who were breastfed.
  
  
  RESULTS
  The result of the multiple regression analysis showed that breastfeeding significantly predicted BMI% of children after controlling for maternal education, health insurance, family history of hypercholesterolemia and diabetes, child's asthma status, and birth weight of the infant.
  
  
  CONCLUSIONS
  Our results are consistent with other studies that have shown a significant, but small, inverse association between breastfeeding and childhood obesity. Findings from this study suggest the need to improve breastfeeding rates in the rural Appalachian state of WV as one of the potential strategies to prevent obesity during childhood and adolescence.
authors.affiliation: 1 Department of Epidemiology, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV.
authors.forename: Amna
authors.initials: A
authors.lastname: Umer
authors.affiliation: 2 Department of Pediatrics, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV.
authors.forename: Candice
authors.initials: C
authors.lastname: Hamilton
authors.affiliation: 2 Department of Pediatrics, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV.
authors.forename: Cris M
authors.initials: CM
authors.lastname: Britton
authors.affiliation: 2 Department of Pediatrics, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV.
authors.forename: Martha D
authors.initials: MD
authors.lastname: Mullett
authors.affiliation: 2 Department of Pediatrics, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV.
authors.forename: Collin
authors.initials: C
authors.lastname: John
authors.affiliation: 2 Department of Pediatrics, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV.
authors.forename: William
authors.initials: W
authors.lastname: Neal
authors.affiliation: 3 Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV.
authors.forename: Christa L
authors.initials: CL
authors.lastname: Lilly
mesh_terms: D001061:Appalachian Region / Q000453:epidemiology; D015992:Body Mass Index; D001942:Breast Feeding / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008137:Longitudinal Studies; D008297:Male; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D012424:Rural Population; D014481:United States / Q000453:epidemiology