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Public Health Nutr. 2013 Feb;16(2):219-27. doi: 10.1017/S1368980012003850. Epub 2012 Aug 24.

Infant feeding practices and prevalence of obesity in eight European countries - the IDEFICS study.

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  • 1Public Health Epidemiology Unit, Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 454 SE-405 30, Gothenburg, Sweden.



To assess the association between exclusive breast-feeding and childhood overweight.


Cross-sectional data are from the baseline survey of the longitudinal cohort study IDEFICS. Exclusive rather than partial breast-feeding is the focus of the study due to the theoretical relationship between exclusive breast-feeding and development of dietary self-regulation. Children's measured heights and weights were used to calculate weight status, while waist-to-height ratio (WtHR) and skinfold measures were examined as alternative indicators of adiposity and fat patterning.


Examination centres in eight European countries (Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain).


The analysis included 14 726 children aged 2-9 years for whom early feeding practices were reported by parents in standardized questionnaires.


After controlling for education, income and other potential confounders, breast-feeding exclusively for 4-6 months was protective of overweight (including obesity) when compared with children never exclusively breast-fed (OR = 0·73; 95 % CI 0·63, 0·85) across all measures of overweight. Exclusively breast-feeding for 6 months offered slightly more protection than for 4 and 5 months combined (OR = 0·71; 95 % CI 0·58, 0·85). The associations could not be explained by socio-economic characteristics or maternal overweight.


This multi-country investigation indicated that exclusive breast-feeding for 4-6 months may confer protection against overweight in addition to other known benefits. There was no demonstrated benefit of exclusive breast-feeding for more than 6 months or combination feeding for any duration across all measures of overweight examined.

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