Association between breastfeeding and obesity risk: A meta-analysis

Objective: The association between breastfeeding and obesity is of great public health interest. Yet, research findings to date have been inconsistent in the literature. The objective of this meta-analysis was to investigate the association between breastfeeding and the risk of obesity in children. Methods: PubMed, EMBASE and CHNAHL Plus with Full Text databases in English were systematically searched and all articles that assessed the relationship between breastfeeding and obesity were reviewed. Based on meta-analysis, pooled adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated using both fixed-effects and random-effects models. Q-test was used to evaluate the between-study heterogeneity, and funnel plots were used to assess publication bias. Results: Sixteen studies were eligible for meta-analysis, and a total of 72,595 participants were included in the final analysis. Meta-analysis showed that breastfeeding was associated with a significantly reduced risk of obesity in children (AOR=0.807; 95% CI: 0.747, 0.872; Q=19.69, df=15, P=0.184). Subgroup analyses were performed and showed similar trends. The studies included in this analysis were also categorized by study design, sample size, and adjustment for confounding factors, such as watching TV and physical activities. Four of five studies, which analyzed the correlation of breastfeeding duration with obesity risk, showed a decreasing risk of obesity with the duration of breastfeeding. Based on the shape of funnel plot, no publication bias was found in this meta-analysis (P=0.13735, Begg test). Conclusions: Results from our meta-analysis suggest that breastfeeding was a significant protective factor against obesity in children.