@sarebear1992 Hm, out of interest I grabbed one of your links at random (this one:
https://pubmed.ncbi.nlm.nih.gov/34445041/). More context from the authors seems pertinent…
“In spite of the solid evidence demonstrating major health benefits associated with BF, including risk reduction for overweight and obesity, breastfeeding remains still well below the global goal of 50% EBF at 2025 [33,34,35]. Our data represent the BF practices and related factors corresponding to the year 2012 but are in agreement with other recent survey analyses indicating less than satisfactory breastfeeding practices in many European countries [36]. In our sample, only 6.3% of children were exclusively breastfed during the 6th month”
“Children who were exclusively BF throughout the first three months of life were less likely to become overweight at preschool age when adjusted for country, age and gender, mother’s pre-pregnancy age and BMI.
The odds to become overweight at preschool age among children who were BF for 4–6 months is 0.87 and 0.31 for the EBF and solids introduction at 4–6 months in comparison to the formula milk feeding, when adjusted for mother’s characteristics (age and BMI before pregnancy, smoking habits during pregnancy, country, SES and gender of children). Thus the effect size for breastfeeding effects on later obesity in our study, although non-significant, is in the same order of magnitude as found in reviews and meta-analyses [15,16,17,18]. Our results also show a protective role of any breastfeeding against obesity and overweight, with 13% less risk at any BF of 4–6 months, and 69% for overweight and 12% for obesity at EBF and solid foods introduction for six months, compared to exclusive formula feeding. These results agree with the reported 26% decrease of the odds of overweight or obesity with any BF in 113 studies [23]. Also, infants fed formula during the first 4–6 months have a higher prevalence of overweight and obesity in preschool age (Table 4). Possible mechanisms for this relationship may include the different macronutrient composition of breast milk and formula, in particular the lower protein supply with breast milk [18], and potentially the presence of bioactive substances like ghrelin, leptin, insulin-like growth factor-1, adiponectin in human milk but not in formula [41]. There is published evidence that feeding formula milk has an accelerating effect on infant weight, height, body fat, apparently mediated through high levels of protein (the “early protein hypothesis”) [18] and lower appetite control of bottle-fed infants [15,20,42,43]. Moreover, a recent study reported that formula feeding in the early life of infants small for their gestational age is related to prospective overweight in preschool age, but only among girls [44]. Breastfeeding also modulates the physiological development of the digestive tract [45] and intestinal colonization [46], which might contribute to risk reduction for obesity in later life [47]. However, our results also show significant confounding of the association of breastfeeding and later overweight by low SES that is linked to both less breastfeeding success and more overweight. A more detailed analysis of the relationship between SES and overweight/obesity prevalence in children participating in the ToyBox study was previously published [32]. In the current analysis, SES is included as a confounder for which the analysis has been adjusted.”
Among the authors’ conclusions:
“The findings of less than desirable breastfeeding rates and duration underline the need for enhanced protection, promotion, and support of breastfeeding throughout Europe. Particularly intensive efforts are necessary for populations with low breastfeeding rates and duration based on geographic region and other risk markers such as lower education and socioeconomic class, tobacco smoking, parental overweight and obesity [5,36]; short duration of maternity leave, psychological factors as maternal perceived stress and postpartum depression [53].”
