Embargo 0001H UK time Tuesday 30 April
New research from WHO published at this month’s European Congress on Obesity shows that babies who are never or only partially breast fed have an increased risk of becoming obese as children compared to babies who are exclusively breastfed. This WHO Europe research study was led Dr Ana Rito and Dr Ricardo of the National Institute of Health, Lisbon, Portugal, and colleagues.
The research paper is part of the WHO Childhood Obesity Surveillance Initiative (COSI) led by Dr João Breda, Head of the WHO European Office for Prevention and Control of Noncommunicable Diseases and his team and is being presented at the European Congress on Obesity (ECO) in Glasgow, UK (28 April – 1 May).
In the WHO European Region, despite childhood obesity rates in some regions apparently plateauing, progress on tackling this important public health issue remains slow and inconsistent. In the scientific literature breastfeeding has been described as a protective factor for obesity in childhood. The more exclusively and the longer a child is breastfed, the greater their protection from obesity. Higher birthweight has also been shown to be associated with later risk for obesity.
This new research investigated the association between early-life factors, namely breastfeeding, exclusive breastfeeding and birth weight, and obesity among children. The analysis included 22 participant countries from the 4th round (2015/2017) of the WHO COSI initiate. Data was collected using cross-sectional nationally representative samples of 6 to 9-year-olds, including 100 583 children.
At the country level, statistical significance was found in 6 individual countries confirming this relationship with increased risks for obesity for never-breastfed children, compared to having been breast-fed for 6 months: Montenegro (90%), Malta (69%), Croatia (62%), Georgia (53%), Spain (25%) and Italy (21%).
Regarding the association between obesity and characteristics at birth, the analysis revealed a 50% higher risk of being obese in case of preterm birth. Low birthweight was associated with a lower risk of future obesity by 35%, while high birthweight increased it by 9%.
Despite the consistent flow of research evidence showing the health benefits from breastfeeding, along with numerous policy initiatives aimed to promote optimal breastfeeding practices, adoption of exclusive breastfeeding in Europe remains below global recommendation. This study showed that, while in nearly all countries, more than 77% of children were breastfed, there were exceptions — in Ireland, France and Malta, 46%, 38% and 35% of children, respectively, were never breastfed. Only 4 out of 12 countries had a 25% or higher prevalence of exclusive breastfeeding (for 6 months or more), namely Georgia (35%); Kazakhstan (51%); Turkmenistan (57%) and Tajikistan (73%).
The authors say: “Considering that promoting breastfeeding presents a ‘window of opportunity’ for obesity policy prevention to respond to the problem of childhood obesity in Europe, the existence of national policies to promote breastfeeding practices and how these policies are developed, can lead some countries to be more or less successful. In general, breastfeeding practices in Europe fall short of WHO recommendations, due to inefficient policies to encourage breastfeeding; lack of preparation of health professionals to support breastfeeding, intensive marketing of breast milk substitutes, and problems in legislation on maternity protection, among others.”
They conclude: “This study confirms the beneficial effect of breastfeeding with regard to the odds of becoming obese, which was statistically significant increased if children were never breastfed or breastfed for less than 6 months. Nevertheless, adoption of exclusive breastfeeding is below the global recommendations and far from the target to increase the prevalence of exclusive breastfeeding in the first 6 months up to at least 50% by 2025, a goal endorsed by the WHO’s Member States at the World Health Assembly Global Targets for Nutrition”.
Dr Breda adds: “WHO is working to promote, protect and support breastfeeding by strengthening monitoring systems that track progress of policies, programmes and funding towards achieving global targets, providing training and recommendations to healthcare workers (including measures in the ‘Ten Steps to Successful Breastfeeding’ recommendations), improving breastfeeding mothers’ access to skilled breastfeeding counselling, and supporting countries in efforts to implement strong legal measures related to ‘The International Code of Marketing of Breastmilk Substitutes’, which aims to stop aggressive, inappropriate marketing practices.”
Note to editors:
The authors declare no conflicts of interest
Although this study does not include UK data, according to preliminary WHO data (which still requires validation from countries), the UK has some of the lowest levels of exclusive breastfeeding at six months (the WHO recommendation) in Europe (around 1%) according to data from 2010 (published in a 2015 paper: Bosi, Ayse Tulay Bagci, et al. “Breastfeeding practices and policies in WHO European region member states.” Public health nutrition 19.4 (2016): 753-764.
For full pdf of this paper, click here
This press release is based on the WHO research ‘Association between characteristics at birth, breastfeeding and obesity, in 22 countries. The WHO European Childhood Obesity Surveillance Initiative – COSI 2015/2017’ being presented at this year’s European Congress on Obesity in Glasgow. A copy of the full paper is available, it is due to be published in the journal Obesity Facts, the journal of the European Association for the Study of Obesity (EASO).
For full embargoed paper click here
For extra fact sheet on this data prepared by WHO, click here
For details of the Ten Steps to Successful Breastfeeding, see: https://www.who.int/nutrition/bfhi/ten-steps/en/
To link to details of the COSI initiative in your stories, please use this link:
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