Prolonging breast feeding to reduce obesity may be a burden

http://www.bmj.com/cgi/content/full/319/7224/1576

EDITORVon Kries et al have shown that the prevalence of obesity in
children aged 5 and 6 is dependent on the duration of
breast feeding.1 A clear dose-response effect was observed even after
adjustment for potential confounding factors. The
authors concluded that in industrialised countries prolonged breast
feeding may help reduce the prevalence of obesity in
childhood. However, future studies should attempt to address the issue
of why mothers do not start breast feeding or why they
discontinue it, as these issues were not addressed by von Kries et al.

If a mother is overweight or obese this may interfere with both the
initiation and duration of breast feeding.2 In a study of
514 women who were followed up for six months after the birth of their
child, almost half of the women who started breast
feeding felt at some stage that they did not have enough milk; 49% of
those who subsequently sought advice from a health
professional were advised to feed more often, and 42% said that they had
been advised to bottle feed.3 An inadequate supply
of breast milk was the most common reason given by mothers for
discontinuing breast feeding.

In the light of findings that indicate that energy intake and nutritive
sucking behaviour contribute significantly to measures of body
weight and composition at 1 year of age,4 it seems likely that the
mothers of heavier children are more likely to switch to bottle
feeding earlier than mothers of less heavy children who have a lower
energy intake. Thus, the recommendation that prolonging
breast feeding might reduce the risk of obesity in childhood might put a
considerable strain on both mother and child.

Johannes Hebebrand, professor.
Clinical Research Group, Department of Child and Adolescent Psychiatry,
University of Marburg, Schützenstrasse 49, D-35033 Marburg,
Germany


--

Denny Rice, RN, IBCLC
Dallas Texas USA

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