Infant Feeding And The Development Of Obesity
Main Category: Obesity / Weight Loss / Fitness
Also Included In: Nutrition / Diet;  Pediatrics / Children's Health
Article Date: 14 Apr 2008 - 1:00 PDT


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On Wednesday, April 9, 2008, a symposium at the American Society for 
Nutrition's annual meeting at Experimental Biology was held in which noted 
scientists discussed new infant feeding studies that used methodology such 
as randomized clinical trials (involving breastfeeding promotion) as well 
as sibling pairs analysis. These studies may offer new insights into 
possible associations between infant feeding and health outcomes such as 
obesity. 

The symposium, "Infant Feeding and the Development of Obesity: What Does 
the Science Tell Us?," sponsored by the International Formula Council 
(IFC)* and chaired by Linda Adair, Ph.D., professor of nutrition at the 
University of North Carolina at Chapel Hill, brought together 
international experts in the field of infant nutrition to present their 
recent findings. 

Featured researchers included David Barker, M.D., Ph.D., professor of 
clinical epidemiology at the University of Southampton, UK and professor 
of Cardiovascular in the Department of Medicine at the Oregon Health and 
Science University, whose soon-to-be published study examines 
breastfeeding in a large group of sibling pairs that were followed into 
their late 60s. 

"This type of study design controls for maternal factors," according to 
Dr. Barker. "Differences in the long-term effects of breast and bottle 
feeding may reflect differences in the mothers rather than the effects of 
feeding itself." Maternal factors include maternal health status, maternal 
care-giving, mother-child interactions or other health-related behaviors 
of the mother that may interfere with determining the association of 
infant feeding and health outcomes and the strength of any possible 
associations. 

Other study designs such as the randomized clinical trial on breastfeeding 
and health outcomes in infants in Belarus recently conducted by Michael 
Kramer, M.D., a pediatrician and perinatal epidemiologist at McGill 
University in Montreal, provide evidence that research design can have a 
significant impact on infant feeding study results. In a randomized infant 
feeding clinical trial, known as the gold standard in research, infants 
would be randomly assigned to be breastfed or formula-fed; however, such 
trials are generally not feasible in infant feeding research, since most 
mothers determine their infant's feeding method. Dr. Kramer randomly 
assigned hospitals to implement breastfeeding promotion practices and 
standard care. He found that despite the substantial increase in prolonged 
and exclusive breastfeeding among mothers receiving the intervention, 
there were no differences between their children (n= 7,108 subjects) and 
the children of mothers from the control h! ospitals (n= 6,781 subjects), 
that did not implement breastfeeding promotion practices, on several 
measures of adiposity at 6.5 years of age. 

These findings challenge the concept that breastfeeding reduces the risk 
of obesity in childhood, as some other studies have found. Speaking of the 
strength of his study design and the fact that other studies due to their 
design may have been prone to inherent bias, Dr. Kramer noted, "Previously 
reported beneficial effects on these outcomes (measurements of obesity) 
may be the result of uncontrolled confounding and selection bias." The 
study performed by Dr. Kramer represents the largest randomized trial done 
to date in the area of human lactation. 

Other researchers at the symposium presented the outcomes of more 
traditional epidemiologic studies that were based on observational designs 
and thus had limitations such as not being able to control subjects' 
behavior. Beth Mayer-Davis, Ph.D., R.D., professor of nutrition and 
diabetes researcher at University of North Carolina at Chapel Hill, 
discussed findings from her research on infant feeding and diabetes in 
ethnic groups in a United States population. In her observational study of 
less than 300 subjects, mothers of children with diabetes were asked to 
recall if and for how long they breastfed their infant. Dr. Mayer-Davis 
reported that breastfeeding appeared to reduce the risk for development of 
type 2 diabetes in youth, possibly mediated in part by weight status in 
childhood. 

Nancy Butte, Ph.D., professor of pediatrics at the Children's Nutrition 
Research Center at Baylor College of Medicine, discussed early infant 
feeding practices and effects on obesity. Dr. Butte presented her work 
from the VIVA LA FAMILIA study, an observational study with a cohort of 
1,030 Hispanic children. Dr. Butte noted that although breastfeeding 
appeared to have a small protective effect against childhood obesity, 
other genetic and environmental factors "far supersede infant feeding 
practices as risk factors for childhood obesity." 

Please note conference proceedings will be published in an upcoming 
peer-reviewed journal. For updates on the publication of this conference 
in the future, please visit http://www.infantfornula.org. 

Experimental Biology is a multi-society, interdisciplinary, scientific 
meeting attended by 12,000 independent scientists and sponsored by the 
Federation of American Societies for Experimental Biology (FASEB). This 
research was presented as part of the American Society for Nutrition 
section of FASEB on April 9, 2008. 

* This conference was sponsored by IFC, an international association of 
manufacturers and marketers of formulated nutrition products (e.g., infant 
formulas and adult nutritionals), whose members are predominantly based in 
North America. IFC members are: Abbott Nutrition; Mead Johnson 
Nutritionals; Nestle Nutrition - USA; and Wyeth Nutrition. 

International Formula Council 





Liz Maseth RN, IBCLC
Outpatient Lactation Services
Maternal Fetal Medicine
Akron Children's Hospital
(330) 543-4531
Fax (330) 543-4508
Pager (330) 914-0096
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