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. 2024 Jan 1;153(1):e2023061466.
doi: 10.1542/peds.2023-061466.

Maternal Pre-Pregnancy BMI, Breastfeeding, and Child BMI

Gayle M Shipp  1 , Adaeze C Wosu  2 , Emily A Knapp  2 , Katherine A Sauder  3 , Dana Dabelea  4 , Wei Perng  3 , Yeyi Zhu  5 , Assiamira Ferrara  5 , Anne L Dunlop  6 , Sean Deoni  7 , James Gern  8 , Christy Porucznik  9 , Izzuddin M Aris  10 , Margaret R Karagas  11 , Sheela Sathyanarayana  12 , Tom G O'Connor  13 , Kecia N Carroll  14 , Rosalind J Wright  14 , Christine W Hockett  15   16 , Christine C Johnson  17 , John D Meeker  18 , José Cordero  19 , Nigel Paneth  20   21 , Sarah S Comstock  22 , Jean M Kerver  20   21 ; program collaborators for Environmental influences on Child Health Outcomes
Affiliations

Maternal Pre-Pregnancy BMI, Breastfeeding, and Child BMI

Gayle M Shipp et al. Pediatrics. .

Abstract

Objectives: Breastfeeding practices may protect against offspring obesity, but this relationship is understudied among women with obesity. We describe the associations between breastfeeding practices and child BMI for age z-score (BMIz), stratified by maternal BMI.

Methods: We analyzed 8134 dyads from 21 cohorts in the Environmental Influences on Child Health Outcomes Program. Dyads with data for maternal pre-pregnancy BMI, infant feeding practices, and ≥1 child BMI assessment between the ages of 2 and 6 years were included. The associations between breastfeeding practices and continuous child BMIz were assessed by using multivariable linear mixed models.

Results: Maternal pre-pregnancy BMI category prevalence was underweight: 2.5%, healthy weight: 45.8%, overweight: 26.0%, and obese: 25.6%. Median child ages at the cessation of any breastfeeding and exclusive breastfeeding across the 4 BMI categories were 19, 26, 24, and 17 weeks and 12, 20, 17, and 12 weeks, respectively. Results were in the hypothesized directions for BMI categories. Three months of any breastfeeding was associated with a lower BMIz among children whose mothers were a healthy weight (-0.02 [-0.04 to 0.001], P = .06), overweight (-0.04 [-0.07 to -0.004], P = .03), or obese (-0.04 [-0.07 to -0.006], P = .02). Three months of exclusive breastfeeding was associated with a lower BMIz among children whose mothers were a healthy weight (-0.06 [-0.10 to -0.02], P = .002), overweight (-0.05 [-0.10 to 0.005], P = .07), or obese (-0.08 [-0.12 to -0.03], P = .001).

Conclusions: Human milk exposure, regardless of maternal BMI category, was associated with a lower child BMIz in the Environmental Influences on Child Health Outcomes cohorts, supporting breastfeeding recommendations as a potential strategy for decreasing the risk of offspring obesity.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES: Dr Dunlop reports NIH grant funding as a source of salary to perform aspects of this work. Dr Deoni reports salary and grant support, and speaker honorarium from Nestle Research and Wyeth Nutrition. Dr Porucznik served on the Board of Directors for the International Board of Lactation Consultant Examiners from 2016 to 2022.

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