The effect of breastfeeding in body composition of young children


  • Ligiana Pires Corona Faculty of Public Health - University of Sao Paulo
  • Wolney Lisboa Conde Faculty of Public Health - University of Sao Paulo



breastfeeding, nutritional status, child growth, child nourishment, nutrition


Introduction: the effect of breastfeeding over the body mass components still demands analyses aiming to further investigate the body composition evolution in the after-breastfeeding childhood. Objective: analyze the influence of breastfeeding (BF) over the body composition of children under 3 years old. Methods: 760 children between zero and 3 years old were selected from the data of the longitudinal, home-based study “Saúde das Crianças de São Paulo II” [“São Paulo’s Children Health II”] (1995-1997). The outcome variables used were the anthropometric indexes BMI-for-age (ZBI) and triceps skinfold-for-age (ZDI) expressed in Z-scores based on the WHO reference curve. Panel regression models were used in the analyses, with data from the 3 visits, adjusted by: birth weight, mother’s educational level and mother’s age. Results: there was no association between breastfeeding and ZBI after multiple adjustments. There was inverse association between BF duration and the ZDI index. The interaction between the mother educational level and the BF duration revealed the protective effect of higher educational level over ZDI , when isolated. The mean nutritional indexes showed dose-response effect inversely proportional to the BF duration. Conclusion: breastfeeding
showed protective effect against the mean body fat increase in children younger than 3 years. 

Biografia do Autor

Ligiana Pires Corona, Faculty of Public Health - University of Sao Paulo

Faculty of Public Health - University of Sao Paulo - Departament of Epidemiology.

Wolney Lisboa Conde, Faculty of Public Health - University of Sao Paulo

Faculty of Public Health - University of Sao Paulo - Departament of Nutrition.


Singhal A, Lanigan J. Breastfeeding, early growth and later obesity. Obes Rev. 2007, 8 Suppl 1: 51-54.

O’Tierney PF, Barker DJ, Osmond C, Kajantie E, Eriksson JG. Duration of breast-feeding and adiposity in adult life. J Nutr. 2009, 139: 422S-425S.

Grummer-Strawn LM, Mei Z, System CfDCaPPNS. Does breastfeeding protect against pediatric overweight? Analysis of longitudinal data from the Centers for Disease Control and Prevention Pediatric Nutrition Surveillance System. Pediatrics. 2004, 113: e81-86.

Harder T, Bergmann R, Kallischnigg G, Plagemann A. Duration of breastfeeding and risk of overweight: a meta-analysis. Am J Epidemiol. 2005, 162: 397-403.

Von Kries R, Koletzko B, Sauerwald T, et al. Breast feeding and obesity: cross sectional study. BMJ. 1999, 319: 147-150.

Horta BL, Bahl R, Martines JC, Victora CG. Evidence on the long-term effects of breastfeeding :systematic review and metaanalyses. Geneva: WHO, 2007.

Baird J, Fisher D, Lucas P, Kleijnen J, Roberts H, Law C. Being big or growing fast: systematic review of size and growth in infancy and later obesity. BMJ. 2005, 331: 929.

Monteiro PO, Victora CG. Rapid growth in infancy and childhood and obesity in later life - a systematic review. Obes Rev. 2005, 6: 143-154.

Longo GZ, Souza JMP, Souza SB, Szarfarc SC. Crescimento de crianças até seis meses de idade, segundo categorias de aleitamento. Rev Bras Saúde Matern Infant. 2005, 5: 109-118.

Spyrides MH, Struchiner CJ, Barbosa MT, Kac G. Amamentação e crescimento infantil: um estudo longitudinal em crianças do Rio de Janeiro, Brasil, 1999/2001. Cad Saude Publica. 2005, 21: 756-766.

Araújo CL, Victora CG, Hallal PC, Gigante DP. Breastfeeding and overweight in childhood: evidence from the Pelotas 1993 birth cohort study. Int J Obes (Lond). 2006, 30: 500-506.

Monteiro CA, Conde WL. Tendência secular da desnutrição e da obesidade na infância na cidade de São Paulo (1974-1996). Rev Saúde Pública. 2000, 34: 52-61.

WHO. The WHO Multicentre Growth Reference Study (MGRS). WHO, 2006. Disponível em:

De Onis M, Cutberto G, Victora CG, Bhan MK, Norum KR. The WHO Multicentre Growth Reference Study (MGRS): Rationale, planning, and implementation. Food and Nutrition Bulletin. 2004, 25 (suppl 1): S3-S84.

Lindsey JK. Models for repeated measurements. 2. ed ed. Oxford: Oxford University Press, 1993. p. 3-16.

WHO. The Optimal Duration of Exclusive Breastfeeding: Report Of An Expert Consultation. Geneva: WHO, 2001. p. 1-2.

Butte NF, Wong WW, Hopkinson JM, Heinz CJ, Mehta NR, Smith EO. Energy requirements derived from total energy expenditure and energy deposition during the first 2 y of life. Am J Clin Nutr. 2000, 72: 1558-1569.

Agostoni C, Grandi F, Giannì ML, et al. Growth patterns of breast fed and formula fed infants in the first 12 months of life: an Italian study. Arch Dis Child. 1999, 81: 395-399.

Dewey KG. Growth characteristics of breastfed compared to formula-fed infants. Biol Neonate. 1998, 74: 94-105.

Innis SM, Auestad N, Siegman JS. Blood lipid docosahexaenoic and arachidonic acid in term gestation infants fed formulas with high docosahexaenoic acid, low eicosapentaenoic acid fish oil. Lipids. 1996, 31: 617-625.

Giovannini M, Agostoni C, Fiocchi A, Bellú R, Trojan S, Riva E. Antigen-reduced infant formulas versus human milk: growth and metabolic parameters in the first 6 months of life. J Am Coll Nutr. 1994, 13: 357-363.

Owen G, Garry P, Hooper E. Feeding and growth of infants. Nutr Res. 1984, 4: 727–731.

Czajka-Narins D, Jung E. Physical growth of breast-fed and formula- fed infants from birth to age two years. Nutr Res. 1986, 6: 753–762.

Fisher JO, Birch LL, Smiciklas-Wright H, Picciano MF. Breast-Feeding Through the First Year Predicts Maternal Control in Feeding and Subsequent Toddler Energy Intakes. Journal of the American Dietetic Association. 2000, 100:641-646.

Lucas A, Boyes S, Bloom SR, Aynsley-Green A. Metabolic and endocrine responses to a milk feed in six-day-old term infants: differences between breast and cow’s milk formula feeding. Acta Pædiatrica. 1981, 70: 195-200.

Dewey KG, Heinig MJ, Nommsen LA, Peerson JM, Lönnerdal B. Breast-fed infants are leaner than formula-fed infants at 1 y of age: the DARLING study. Am J Clin Nutr. 1993, 57:140-145.

De Bruin NC, Degenhart HJ, Gàl S, Westerterp KR, Stijnen T, Visser HK. Energy utilization and growth in breast-fed and formula-fed infants measured prospectively during the first year of life. Am J Clin Nutr. 1998,67: 885-896.

Haisma H, Wells JC, Coward WA, et al. Complementary feeding with cow’s milk alters sleeping metabolic rate in breast-fed infants. J Nutr. 2005,135: 1889-1895.

Heinig MJ, Nommsen LA, Peerson JM, Lonnerdal B, Dewey KG. Energy and protein intakes of breast-fed and formula-fed infants during the first year of life and their association with growth velocity: the DARLING Study. The American Journal of Clinical Nutrition. 1993, 58:152-161.

Singhal A, Farooqi IS, O’Rahilly S, Cole TJ, Fewtrell M, Lucas A. Early nutrition and leptin concentrations in later life. The American Journal of Clinical Nutrition. 2002,75: 993-999.

Mook-Kanamori DO, Steegers EA, Uitterlinden AG, et al. Breast-feeding modifies the association of PPARgamma2 polymorphism Pro12Ala with growth in early life: the Generation R Study. Diabetes. 2009, 58:992-998.

Auwerx J. PPARgamma, the ultimate thrifty gene. Diabetologia. 1999,42: 1033-1049.

Valve R, Sivenius K, Miettinen R, et al. Two polymorphisms in the peroxisome proliferatoractivated receptor-gamma gene are associated with severe overweight among obese women. J Clin Endocrinol Metab. 1999,84: 3708-3712.

Pihlajamäki J, Vanhala M, Vanhala P, Laakso M. The Pro12Ala polymorphism of the PPAR gamma 2 gene regulates weight from birth to adulthood. Obes Res. 2004,12: 187-190.

Lagou V, Scott RA, Manios Y, et al. Impact of peroxisome proliferator-activated receptors gamma and delta on adiposity in toddlers and preschoolers in the GENESIS Study. Obesity (Silver Spring). 2008,16: 913-918.

Escobar AMdU, Ogawa AR, Hiratsuka M, et al. Aleitamento materno e condições socioeconômico-culturais: fatores que levam ao desmame precoce. Rev Bras Saude Mater Infant. 2002, 2: 253-261.

Damião JdJ. Influência da escolaridade e do trabalho maternos no aleitamento materno exclusivo. Rev bras epidemiol. 2008, 11:442-452.

Simon VGN, Souza JMP, Leone C, Souza SB. Practice and duration of breastfeeding of children registered in private schools in São Paulo, SP. Rev Bras Crescimento Desenvolvimento Hum. 2009,19: 403-411.

Mascarenhas ML, Albernaz EP, Silva MB, Silveira RB. Prevalence of exclusive breastfeeding and its determiners in the first 3 months of life in the South of Brazil. J Pediatr (Rio J). 2006, 82:289-294.

Wenzel D, Souza SB. Prevalence of breastfeeding in Brazil according to socioeconomic and demographics conditions. Rev Bras Crescimento Desenvolvimento Hum. 2011, 21: 251-258.

Dietz WH. Critical periods in childhood for the development of obesity. Am J Clin Nutr. 1994, 59: 955-959.

Dietz WH. Periods of risk in childhood for the development of adult obesity—what do we need to learn? J Nutr. 1997, 127: 1884S-1886S.

Roche A. Anthropometry and ultrasound. In: Roche A, Heymsûeld S, Lohman T, eds. Human Body Composition Champaign, IL: Human Kinetics Books, 1996, pp. 167–189.





Artigos Originais