There have been conflicting reports in the past about the association between breastfeeding and later childhood obesity and blood pressure (BP). The authors studied the Siyakhula cohort (2012–2014), a population-based prospective cohort study that collected data over three visits from HIV-negative children aged 7–11 years in rural South Africa. The authors examined weight (body mass index [BMI]), fat and BP as outcome variables, and included early life (including mother’s age at delivery and HIV status) and current life factors (including maternal education and current BMI). The primary exposure was breastfeeding duration. Three outcome measures were examined: (1) overfat, ≥85th percentile of body fat; (2) overweight, >1 SD BMI z score and (3) prehypertension, ≥90th percentile for systolic BP (SBP) or diastolic BP (DBP). Of 1536 children studied (mean age 9.3 years, 872 girls, 664 boys), 7% were overfat, 13.2% overweight and 9.1% prehypertensive. 60% of the mothers reported continued breastfeeding for ≥12 months. Multivariate analyses found that continued breastfeeding between 6–11 months was associated with halved odds of both being overfat (adjusted odds ratio [aOR] 0.43, 95%CI 0.21–0.91) and overweight (aOR 0.46, 95%CI 0.26–0.82), but the association with prehypertension was not significant (aOR 0.72, 95%CI 0.38–1.37). Children with an obese mother were fivefold more likely (aOR 5.02, 95%CI 2.47–10.20) to be overfat and over fourfold more likely to be overweight (aOR 4.33, 95%CI 2.65–7.09) than children with normal weight mothers. Therefore breastfeeding is independently associated with reduced childhood obesity for both HIV-exposed and unexposed children.
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