Breastfeeding and childhood obesity in the Azores

Background
The hypothesis that breastfeeding has a protective effect in childhood obesity is not new; however, controversial results have been published. Since the Azores reported the lowest rate of breastfeeding in Portugal and a high prevalence of childhood obesity, it becomes important to understand whether these facts are related or not.

Objectives
To investigate the relationship between breastfeeding and childhood obesity in a population of Azorean children.

Material and methods
A cross-sectional study was carried out on 183 Azorean children between 5–10 years of age between September and December 2016. The weight and height of the children were measured at the consultation and other variables were investigated through a questionnaire. The association between breastfeeding and childhood obesity was tested using logistic regression models.

Results
18.6% of the children were obese and 74.3% were breastfed. The exclusive breastfeeding rate at 6 months was 3.3%. Complementary breastfeeding was present in 39.3% at 6 months and 7.1% at 2 years. Obese children were breastfed less time than non-obese children, suggesting a dose-effect relationship (p = 0.025). We found a significant and independent relationship between infant obesity and total time of breastfeeding (RR = 0.906; 95% CI [0.842, 0.974]; p = 0.008), physical activity (RR = 0.883; 95% CI [0.801, 0.972]; p = 0.012) and maternal nutritional status (RR = 3.452; 95% CI [1.361, 8.755]; p = 0.009).

Conclusions
Breastfeeding and physical activity behaved as protective factors for childhood obesity, while the nutritional status of the mother acted as a risk factor. Childhood obesity is a current problem in the Azores, and breastfeeding can be an effective, simple and affordable tool to reduce this.