Background
Methods
Literature search
Study selection
Data extraction
Obesity and breastfeeding definition
Statistical analysis
Results
Study selection and characteristics
Reference | Origin | Study design | Age | Sample sizea
| Definition of feeding patterns | Definition of obesity | Confounders |
---|---|---|---|---|---|---|---|
Armstrong 2002 [39] | Great Britain | IHC | 39-42 months | 32,200 | Formula-fed, BF | BMI ≥ 95th
| Gender, birth weight, SES |
Bergmann 2003 [40] | Germany | PC | 6 years | 480 | Bottle-fed, BF | BMI ≥ 97th
| Overweight mother, SESc
|
Beyerlein 2008 [41] | Germany | CS | 54-88 months | 9,368 | Never & ever BF | BMI ≥ 97th
| Weight gain from birth to years of life, maternal BMI, parents’ graduatebc
|
Burke 2005 [42] | Australia | PC | 1-8 years | 1,672 | Never, BF ≤ 4 mo, BF ≤ 8 mo, BF ≤ 12 mo, BF > 12 mo | BMI ≥ 95th
| Birth weight, gestational age, ethnicity, sex, maternal BMI, first child, and maternal educationc
|
Gillman 2001 [43] | United States | CS | 9-14 years | 14,377 | Mostly or only fed formula, mostly or only BF | BMI ≥ 95th
| Age, sex, birth weight, birth order, Tanner stage, exercises, daily energy intake, mother’s BMI, and household income, dietary restraint, weight cycling, and weight concernsbc
|
Grummer-Strawn 2004 [44] | United States | IHC | 4 years | 12,587 | Never, BF < 1 mo, BF ≤ 2.9 mo, BF ≤ 5.9 mo, BF ≤ 11.9 mo, BF ≥ 12 mo | BMI ≥ 95th
| Gender, race/ethnicity, birth weight, and mother’s age, education, prepregnancy BMI, and weight gain during pregnancy c
|
Hawkins 2009 [45] | Great Britain | PC | 3 years | 13,172 | Never, BF < 4 mo, BF ≥ 4 mo | IOTF | Birth weight, gender, ethnicity, introduction of solid foods, maternal SES, education, lone motherhood status, age at first live birth, number of children, household income, parental overweight, country, et al.bc
|
Hediger 2001 [46] | United States | CS | 3-5 years | 2,656 | Never & ever EBF | BMI ≥ 95th
| Birth weight, race/ethnicity, gender, age group, mother’s BMI, timing of introduction to solid foods |
Jwa 2014 [47] | Japan | PC | 1.5-8 years | 41,572 | Formula feeding, mixed feeding, EBF | IOTF | Birth weight, having elder sibling(s), maternal educational level, age and total house-hold income at 0.5 years old c
|
Koletzko 2009 [48] | Germany | CS | 5-6 years | 9,357 | Never & ever BF | BMI ≥ 97th
| Parental education, low birth weight, own bedroom, frequent consumption of butterc
|
Kwok 2010 [49] | Hong Kong | PC | 7 years | 7,026 | Never, partially or EBF <3 mo, EBF ≥ 3 mo | IOTF | Sex, birth weight, gestational age, birth order, mother’s age at birth, birthplace, number of hospital admissions at 0–3 months, parental education, occupation, incomec
|
Li 2003 [50] | Great Britain | CS | 4-18 years | 2,631 | Never, BF ≤ 1 mo, BF ≤ 3 mo, BF ≤ 6 mo, BF ≤ 9 mo, BF > 9 mo | BMI ≥ 95th
| Sex, parent’s BMI, birth weight, and social classc
|
Liese 2001 [51] | Germany | CS | 9-10 years | 2,108 | Formula-fed, BF | BMI > 90th
| Age, gender, city, nationality, SES, number of siblingsc
|
McCrory 2012 [52] | Republic of Ireland | IHC | 9 years | 7,798 | Never, BF ≤ 4 wk, BF ≤ 8 wk, BF ≤ 12 wk, BF ≤ 25 wk, BF ≥ 26 wk | IOTF | Dietary quality, exercise, maternal education, gestational age, nationality, weight status, household incomebc
|
Moschonis 2008 [53] | Greek | IHC | 1-5 years | 2,374 | Exclusive formula-fed, mixed, EBF | BMI ≥ 95th
| Parental education, weight status, maternal gestational diabetes mellitus, alcohol consumption patterns during pregnancy, age at birth, birth rankc
|
Moss 2014 [54] | United States | PC | 2-4 years | 14,150 | Never & ever BF | BMI ≥ 95th
| Maternal education, maternal age, maternal race, family poverty, children’s birth weight and gender |
Novaes 2011 [55] | Brazilian | CS | 6-10 years | 764 | Never & ever BF | BMI > 2SD | Gender, physical education classes, siblings, maternal nutritional state during pregnancybc
|
O’Challaghan 1997 [56] | Australia | PC | 5 years | 2,034 | Formula fed, BF ≥ 6 mo, exclusiveness unclear | BMI ≥ 94th
| Birth weight, gander, small for gestational age, feeding problems, sleeplessness, parental BMI, maternal education, household income |
Scholtens 2008 [57] | Dutch | PC | 8 years | 2,043 | Never, BF ≤ 16 wk, BF > 16 wk | IOTF | Maternal education, overweight, diet at 7 years of agebc
|
Scott 2012 [58] | Australia | IHC | 9-16 years | 2,066 | Never, BF < 2 mo, BF < 4 mo, BF < 6 mo, BF ≥ 6 mo | IOTF | Age, gender, energy intake, physical activity, sleep duration, maternal age, education, ethnicityb
|
Toschke 2002 [59] | Czech Republic | CS | 6-14 years | 33,768 | Never & ever BF | BMI ≥ 97th
| Parental education and obesity, birth weight, sports outside school, number of siblingsbc
|
Twells 2010 [60] | Canada | CS | 4 years | 1,026 | formula feeding ≥ 3 mo, mixed feeding ≥3 mo, EBF ≥ 3 mo | BMI ≥ 95th
| Birth weight, gender, age, maternal education, whether the baby was preterm or full termc
|
Van Rossem 2010 [61] | United States | PC | 3 years | 884 | Never, any BF <6 mo, partial BF ≥ 6 mo, EBF ≥ 6 mo | BMI ≥ 95th
| Age, sex, maternal educational, race, BMI, pregnancy weight gain, birth weight, gestational agec
|
Von Kries 1999 [62] | Germany | CS | 5-6 years | 9,206 | Never, EBF ≤ 2 mo, EBF ≤ 5 mo, EBF ≤ 12 mo, BF > 12 mo | BMI ≥ 97th
| Parental education, low birth weight, own bedroom, consumption of butterc
|
Zhao 2013 [63] | China | PC | 2-8.4 years | 1,189 | Formula feeding, mixed feeding, EBF | Boys’ BMI ≥96.3th Girls’ BMI ≥98th
| Maternal weight and BMI before pregnancy, maternal weight increase and the level of blood glucose during pregnancy, gender, birth weight, father weight |
Main meta-analysis results
Sensitivity analysis
Component | No. of studies (sample size a) | AOR (95% CI) fixed-effected |
---|---|---|
Study design | ||
Cohort | 15 (141,247) | 0.78 (0.73,0.82) |
Cross-sectional | 10 (85,261) | 0.78 (0.72,0.84) |
Whether consider amount of TV viewing and exercise of children as adjusted confounders | ||
Yes | 8 (83,356) | 0.79 (0.73,0.85) |
No | 17 (143,152) | 0.77 (0.73,0.82) |
Obesity definition | ||
IOTF | 6 (73,677) | 0.81 (0.73, 0.89) |
BMI ≥ 95th
| 10 (84,557) | 0.78 (0.74, 0.83) |
BMI ≥ 97th
| 5 (62,179) | 0.75 (0.67, 0.85) |
Others | 4 (6,095) | 0.66 (0.53, 0.82) |
Breastfeeding definition | ||
Never-ever | 11 (126,512) | 0.80 (0.76, 0.85) |
Exposure: breastfeeding duration | 14 (99,996) | 0.73 (0.67, 0.79) |
Breastfeeding type | ||
Exclusive breastfeeding | 8 (65,933) | 0.80 (0.71, 0.90) |
Others | 17 (160,575) | 0.77 (0.74, 0.81) |
Publication bias
Breastfeeding duration
Breastfeeding duration | No. of studies | AOR (95% CI) fixed-effected |
---|---|---|
<3 months | 16 | 0.90 (0.84, 0.95) |
3-4.9 months | 8 | 0.88 (0.79, 0.97) |
5-6.9 months | 9 | 0.83 (0.76, 0.90) |
≥7 months | 18 | 0.79 (0.70, 0.88) |