Breast-Feeding and Risk for Childhood Obesity

Does maternal diabetes or obesity status matter?

  1. Elizabeth J. Mayer-Davis, PHD1,
  2. Sheryl L. Rifas-Shiman, MPH2,
  3. Li Zhou, MS1,
  4. Frank B. Hu, MD, PHD345,
  5. Graham A. Colditz, MD, DRPH34 and
  6. Matthew W. Gillman, MD, SM245
  1. 1Center for Research in Nutrition and Health Disparities, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
  2. 2Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts
  3. 3Channing Laboratory, Brigham and Women’s Hospital, Boston, Massachusetts
  4. 4Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
  5. 5Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
  1. Address correspondence and reprint requests to Elizabeth J. Mayer-Davis, PhD, Center for Research in Nutrition and Health Disparities, University of South Carolina, Arnold School of Public Health, 2718 Middleburg Dr., Columbia, SC 29208. E-mail: ejmayer{at}


OBJECTIVE— We sought to evaluate whether maternal diabetes or weight status attenuates a previously reported beneficial effect of breast-feeding on childhood obesity.

RESEARCH DESIGN AND METHODS— Growing Up Today Study (GUTS) participants were offspring of women who participated in the Nurses’ Health Study II. In the present study, 15,253 girls and boys (aged 9–14 years in 1996) were included. Maternal diabetes and weight status and infant feeding were obtained by maternal self-report. We defined maternal overweight as BMI ≥25 kg/m2. Childhood obesity, from self-reported height and weight, was based on the Centers for Disease Control and Prevention definitions as normal, at risk for overweight, or overweight. Maternal status categories were nondiabetes/normal weight, nondiabetes/overweight, or diabetes. Logistic regression models used generalized estimating equations to account for nonindependence between siblings.

RESULTS— For all subjects combined, breast-feeding was associated with reduced overweight (compared with normal weight) in childhood. Compared with exclusive use of formula, the odds ratio (OR) for exclusive breast-feeding was 0.66 (95% CI 0.53–0.82), adjusted for age, sex, and Tanner stage. Results did not differ according to maternal status (nondiabetes/normal weight OR 0.73 [95% CI 0.49–1.09]; nondiabetes/overweight 0.75 [0.57–0.99]; and diabetes 0.62 [0.24–1.60]). Further adjustment for potential confounders attenuated results, but results remained consistent across strata of maternal status (P value for interaction was 0.50).

CONCLUSIONS— Breast-feeding was inversely associated with childhood obesity regardless of maternal diabetes status or weight status. These data provide support for all mothers to breast-feed their infants to reduce the risk for childhood overweight.


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    • Accepted July 17, 2006.
    • Received May 11, 2006.
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