Breastfeeding and Maternal and Child Cardiometabolic Outcomes 10–14 Years after Delivery

Abstract

Background:

Breastfeeding can improve long-term maternal and child cardiometabolic outcomes, but many of the cardiometabolic outcomes remain understudied.

Objective:

To examine the association between breastfeeding and maternal and child cardiometabolic outcomes 10–14 years after delivery.

Study Design:

A secondary analysis of the prospective Hyperglycemia and Adverse Pregnancy Outcome Follow-Up Study (2013–2016). The exposure was any breastfeeding. The primary outcomes were maternal and child disorders of glucose metabolism assessed separately and defined as one of the following: prediabetes (impaired fasting glucose [100–125 mg/dL] or impaired glucose tolerance [2-hour plasma glucose of 140–199 mg/dL]) or type 2 diabetes mellitus. Secondary outcomes included maternal and child hypertension and dyslipidemia (low-density lipoprotein ≥103 mg/dL, total cholesterol ≥200 mg/dL, or triglycerides ≥200 mg/dL), and child adiposity (body fat percentage >85th). Multivariate logistic regression was used to examine the association between breastfeeding and maternal and child cardiometabolic outcomes.

Results:

Of 4,685 assessed maternal–child dyads, 79.7% reported breastfeeding. The risk of maternal disorders of glucose metabolism did not differ by breastfeeding status (24.1% versus 24.5% with versus without breastfeeding, adjusted relative risk [aRR] 1.00, 95% confidence interval [CI] 0.88–1.14). The risk of childhood disorders of glucose metabolism was lower with breastfeeding (10.7% versus 13.7%, aRR: 0.76, 95% CI: 0.63–0.92). With regard to secondary outcomes, mothers who breastfed had a lower rate of dyslipidemia (29.4% versus 32.8%, aRR: 0.88, 95% CI: 0.80–0.98). Offspring that were breastfed had lower rates of child adiposity (13.6% versus 17.5%, aRR: 0.82, 95% CI: 0.70–0.96). There was no difference in the rate of maternal hypertension by breastfeeding status. In the subgroup of mothers with gestational diabetes, breastfeeding was associated with a lower risk of child hypertension (aRR: 0.66, 95% CI: 0.45–0.99) and a lower risk of child adiposity measured by skinfold sum > 85th percentile (aRR: 0.67, 95% CI: 0.49–0.92).

Conclusions:

In an international prospective cohort, breastfeeding was associated with a reduced risk of maternal hypercholesterolemia and disorders of glucose metabolism and adiposity in the offspring.

Community Brief

A. Why was this study conducted?

Cardiometabolic risk factors, such as hypertension, obesity, diabetes, and dyslipidemia, are leading contributors to morbidity and mortality. Breastfeeding can prevent cardiometabolic risk factors in the postpartum period. However, more prospective data are needed about the association between breastfeeding and long-term maternal and child cardiometabolic outcomes.

B. What are the key findings?

In an international prospective cohort of 4,832 mother–child pairs, breastfeeding was associated with lower odds of maternal dyslipidemia and child dysglycemia and adiposity 10–14 years after delivery.

C. What does this study add to what is already known?

These results from a large prospective international cohort emphasize the benefits of breastfeeding toward improving multiple measures of maternal and child cardiovascular health.