The U.S. Agency for Healthcare Research and Quality (AHRQ) and the World Health Organization (WHO) agree that breastfeeding protects against childhood obesity. And the Centers for Disease Control and Prevention (CDC) recognizes breastfeeding as a key component in its “Strategies to Prevent Obesity and Other Chronic Diseases: the CDC Guide to Strategies to Support Breastfeeding Mothers and Babies."
But establishing a clear link between breastfeeding and a reduced risk of childhood obesity has been difficult, since much of the data are derived from observational studies. Breastfeeding also tends to be associated with other factors that are linked to lower risk of childhood obesity, including higher maternal education, higher socioeconomic status, healthier maternal weight, and older maternal age, making it hard to separate the effect of breastfeeding alone from these potential confounders.
Nevertheless, science shows breastfeeding does seem to offer protection against childhood obesity, with a dose-response relationship; meaning, the longer you breastfeed, the lower your baby’s risk for childhood obesity.
Ways to reduce the risk of childhood obesity
In addition to breastfeeding for as long as both mother and baby choose, the following tips will help you reduce your baby’s risk of childhood obesity:
- Maintain a healthy weight before pregnancy.
- Gain a healthy amount of weight during pregnancy. The American College of Obstetricians and Gynecologists (ACOG) recommends women who are underweight (BMI < 18.5) gain 28–40 pounds; women who are normal weight (BMI 18.5–24.9) gain 25–35 pounds; women who are overweight (BMI 25–29.9) gain 15–25 pounds, and women who are obese (BMI >30) gain 11–20 pounds. A growing body of evidence suggests that children of women who gain excess weight during pregnancy are more likely to be obese.
- Exercise during pregnancy. The CDC recommends that healthy pregnant women should get at least 150 minutes of moderate-intensity aerobic activity (e.g., brisk walking, swimming) during pregnancy, spreading the activity throughout the week, perhaps in 20-30 minute sessions. Healthy pregnant women who already engage in vigorous-intensity aerobic activity (e.g., running) can continue to do so unless their health changes. An added bonus: Moderate exercise can help relieve common pregnancy ailments like backache, constipation, bloating, swelling, and mood changes. Just be careful not to get overheated or dehydrated, and avoid doing any exercise that requires lying on your back after the first trimester.
- Breastfeed as long as possible. The AAP and WHO recommend exclusive breastfeeding for the first six months of a child’s life and continued breastfeeding for at least 1–2 years or as long as the mother and her baby wish to do so.
- Introduce healthy solid foods at the right time. The AAP recommends waiting until your baby is about 6 months old to introduce solids. Watch for signs of readiness and offer foods that include iron-rich lean meats, vegetables, fruits, and whole grains. Avoid sweets and other empty calorie foods. (For more on introducing solids, including which foods to offer first, read this.)
- If using a bottle for some feedings, choose the right size. Using an oversized bottle may contribute to overfeeding. A large study published in Pediatrics found that using a large bottle (6 ounces or larger) in early infancy contributed to rapid infant weight gain, which may increase the risk of obesity in formula-fed infants.
- Use paced bottle-feeding. For bottle-fed babies, parents and caregivers are urged to mimic the act of breastfeeding. Stimulate the baby’s rooting reflex, wait for the baby to draw the bottle nipple into his mouth, and encourage frequent pauses while feeding (suck-suck-suck-pause). Stop when the baby shows signs of satiety; don’t focus on emptying the bottle. For more bottle-feeding tips, read this.