Jane Bookout
KINE 4331
Clinical Question

Since the 1970’s, obesity in America has steadily been on the rise with a numerous amount of speculations as to what the cause could be. Not only are the adults suffering with this “obesity epidemic”, children are also quickly becoming victims of this deadly trend. Prevention has been a vital key at young ages to help children understand the importance of maintaining a healthy diet that could save them thousands of dollars, and more importantly their lives. “Many factors have been suggested as causes of the “obesity epidemic” among children- reduced physical education at school, increased homework loads, campus vending machines, television, larger portions sizes, fast-food restaurants, video games, and countless others.” (Sturm, Roland. 2005) However, recent findings also imply that obesity characteristics could start as early as the infant age in correlation with breastfeeding. I chose this topic because as a woman I know that I would want the best for my children and eventually I will reach that time when I make the decision on how to raise them, including what type of foods I put into their bodies. A healthy lifestyle starts with the parents and how they portray to their children the importance as well as how to continuously stay in that mindset when making decisions. Not many think to go back as far as breastfeeding, and that’s when I took it upon myself to try and fully understand how obesity begins beginning at that stage in life. Every research article that I have read about breast-feeding has stated that it has some type of positive effect on the baby whether it may have been a miniscule or large effect. Because of this, I wanted to understand as to what extent and how could breastfeeding possibly be a factor that leads to a decreased chance of obesity.
“For infants, not being breastfed is associated with an increased incidence of infectious morbidity, as well as elevated risks of childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden infant death syndrome (SIDS).” (Stuebe, Alison. 2009) According to the Academy of Breastfeeding Medicine, the risk of developing type 2 diabetes as well as ovarian and breast cancer is decreased for the mother along with the baby. ”Breastfeeding may reduce the variance of weight distribution, decreasing the prevalence of both overweight and underweight in later life.” (Bernardo, Horta. 2013) The first 6 months of life is suggested as the recommended time for breastfeeding to decrease the risk of disease and obesity according to The American College of Obstetricians and Gynecologists (ACOG); however, The World Health Organization (WHO) considers 2 years of breastfeeding to be the recommended time. “Data from a cross sectional study in Bavaria suggest that the risk of obesity in children at the time of school entry can be reduced by breast feeding: a 35% reduction occurs if children are breastfed for 3 to 5 months.” It is clear that the required duration of breastfeeding is unknown, but that it is healthy for the baby and the mother. “Epidemiologic studies suggest that children who are formula fed in infancy are more likely to become obese or develop type 2 diabetes. In a meta-analyses, children formula fed in infancy was 1.1 times as likely to become obese as children who had ever been breastfed.” (Stuebe, Alison. 2009) To explain the dissimilarities, researchers have suggested that the composition of formula versus human milk and feeding practices may have something to do with these risk factors that could potentially occur if the infant were not to be breastfed. Adipokines, found in human milk, contribute to the long-term risk of obesity as well as taking part in the role of regulating energy intake. An increase of 1.2 to 1.4-fold in type 1 diabetes was seen in association with infants who were breastfed for less than three months compared to those who were breastfed for more than three months. Again, the required time for breastfeeding is not quite clear, but according to this study, the longer the breastfeeding takes place, the less risk there is for obesity. The evidence that breastfeeding has more benefits than not is steadily on the rise. More and more women are choosing to breastfeed with this increase in knowledge of how valuable this practice could be for both the mother and the child. A research study was conducted to understand if breastfeeding along with lifestyle factors had an affect on childhood obesity; the results concluded that the effect of obesity is less related to lifestyle factors and more of the composition of breast milk fed to infants. However, lifestyle factors could potentially play a role in the mothers’ choice of whether or not she chooses to breastfeed. It is seen that most pregnant and obese women do not initiate breastfeeding compared to those women who are at a normal weight. The majority of these obese women are demographically in the same category; for example, lower income and less educated women are at a higher level of not breastfeeding the baby. (Verret-Chalifour, Julie. 2015) The level of breast-feeding, according to The International Journal of Obesity, implies that there may be a protective effect alongside childhood obesity; the effect is small but consistent. Evidence also suggests that there are protective effects among adolescents against type-2 diabetes with those who are breastfed. (Horta, Bernardo. 2013)
In conclusion, with so many factors contributing to an increase in weight that could potentially lead to obesity, individuals need to take into consideration how every decision they make may have some type of effect on them or their child. Although it may seem like a miniscule reason as to why children are becoming obese, prolonged breastfeeding indeed is shown to be a contributing factor to help prevent obesity, whether it is significant or not. Research is still being conducted in this area as to how much of significance breastfeeding may be on the mother and the child. As parents, it is vital to try in every way possible to prevent this obesity epidemic from becoming any larger and lethal than it already has.

References

Sturm, Roland. “Childhood Obesity — What We Can Learn From Existing Data on Societal Trends, Part 1.” Preventing Chronic Disease 2.1 (2005): A12. Print.

Stuebe, Alison. “The Risks of Not Breastfeeding for Mothers and Infants.” Reviews in Obstetrics and Gynecology 2.4 (2009): 222–231. Print.

Arenz, S., Rucker, R., Koletzko, B., and von Kries, R. “Breast-feeding and childhood obesity-a systematic review.” International Journal of Obesity (2005): 28, 1247-1256. Print.

Verret-Chalifour, Julie. Et al. “Breastfeeding Initiation: Impact of Obesity in a Large Canadian Perinatal Cohort Study.” PLOS ONE. (2015)

Horta, Bernardo., Victora, Cesar. “Long-term effects of breastfeeding.” World Health Organization. (2013)

Kries Rüdiger von. “Breast feeding and obesity: cross sectional study”