Subject: Obesity and Infant Feeding
            We know that breastfeeding provides adequate nutrition to infants.  Breast milk contains all the many different nutrients the developing infant needs.  There have been studies that were done and that were done and that continue to be conducted in comparing breastfed children to formula fed children.  I am interested in comparing breast milk to formula and the effects on long-term growth of infants related to obesity.
             Samuel J. Fomon (2001), believes breastfeeding may be more conducive than formula feeding to establishing habits of eating in moderation; and many nutritional and nonnutritional components of human milk, including some that have not yet been extensively evaluated, may have beneficial effects that persist in adulthood.  He believes that breastfed infants have more control over the amount of milk consumed at a feeding than formula fed infants.   In order to create good habits of eating in moderation, the infant should be encouraged to stop feeding at the earliest sign of hesitancy while eating.  Forced feeding should be avoided at all times.
               Thompson (2002) conducted a study, which addressed the impact of breastfeeding on the prevention of obesity and being overweight in childhood.  It concluded that breastfeeding prevents obesity and prevents overweight children.  Thompson concluded that breastfeeding reduced the risk of obesity by twenty-five percent.  Infants who were breastfed for longer periods of time had a lower risk of being overweight during childhood and adolescence.
                Hediger, Overpeck, Kuczmarski, & Ryan (2001) have also been suggested that breastfeeding is protective against children becoming overweight and that there is a dose dependent effect of its duration, shorter and less intensive periods of breastfeeding may be less protective.
                 Hediger et al (2001) studied a population of 5, 341 adolescents nine to fourteen years old.  This study looked at the risk of being overweight in these participants.  The characteristic that were looked at included: birth weight, sex, gestation, plurality, birth order, physical activity and time spending watching TV.  Breastfeeding in these children for at least seven months occurred in 48% of the cases and 31% of the cases were breastfed for three months or less.  It concluded that the effects of breastfeeding might not show a noticeable impact until later in the child's life.
                  King (2001) concluded that a metabolic response might be responsible for reducing the risk of obesity.  Breastfeeding may cause less of an insulin and insulin growth factor secretion due to the less energy contained in breast milk.  The increased protein/nitrogen content in infant formula as compared with breast milk may cause a metabolic response of insulin and insulin-like growth factor in formula fed infants leading to excessive weight gain.
                   Genetics in relation to obesity has to be considered.  It is unlikely that breastfeeding alone would be sufficient enough to prevent the development of being overweight or obese, when someone had a genetic tendency to be overweight (Hediger et al, 2001).
                    Obesity is beginning to be a major concern in the U.S.  In your practice have you found parents interested in breastfeeding because it lowers the risks of obesity?
References
        Fomon, S.J. (2001).  Feeding normal infants: Rationale for recommendations. Journal of the American Dietetic Association, 101, 1002-1005.
        Hediger, M.L., Overpeck, M.D., Kuczmarski, R.J., & Ruan, W.J. (2001).  Association between infant breastfeeding and overweight in young children.  The Journal of the American Medical Association, 285, 2453-2460.
        King, D.E. (2001).  Breastfeeding and overweight children and adolescents.  International Journal of Childbirth Education, 16, 42.
        Thompson, J. (2002).  The benefits of breastfeeding and current controversies: Part one.  Community Practioner, 75,  64.

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