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IJE Advance Access published online on August 20, 2009
International Journal of Epidemiology, doi:10.1093/ije/dyp274
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

Does breastfeeding protect against childhood overweight? Hong Kong's ‘Children of 1997’ birth cohort

Man Ki Kwok, C Mary Schooling*, Tai Hing Lam and Gabriel M Leung

Department of Community Medicine and School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.

* Corresponding author. Department of Community Medicine and School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Unit 624–627, Level 6, Core F, Cyberport 3, 100 Cyberport Road, Hong Kong, China. E-mail: cms1{at}hkucc.hku.hk


  Abstract

Background Observational studies from mainly Western settings suggest breastfeeding may protect against childhood adiposity; however, breastfeeding and adiposity share social patterning potentially generating confounding, making evidence from other settings valuable.

Methods We used multivariable linear regression to examine the prospective adjusted associations of breastfeeding with body mass index (BMI), height and weight z-scores at 7 years of age relative to the 2007 World Health Organization (WHO) growth reference, in a large (n = 8327), population-representative Hong Kong Chinese birth cohort, recruited between April and May 1997 with high follow-up (n = 7026).

Results Low socio-economic position (SEP) was associated with never breastfeeding and with exclusive breastfeeding for ≥3 months. We did not find any association between breastfeeding and BMI [z-score mean difference 0.07, 95% confidence interval (CI) –0.05 to 0.19], height (0.02, 95% CI –0.07 to 0.11) or weight (0.07, 95% CI –0.05 to 0.18), adjusted for sex, birth weight, gestational age, SEP, second-hand smoke (SHS) exposure, parity, mother's age at birth, mother's place of birth and serious infant morbidity.

Conclusions In a non-European setting, breastfeeding was not associated with child adiposity, suggesting that observed protective effects may be due to socially patterned confounding by SEP, maternal adiposity and maternal smoking.

Keywords Breastfeeding, childhood overweight, cohort study

Accepted 13 July 2009


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