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Cited by 458Breastfeeding Practices and InfluencesInfant Nutrition and HealthObesity, Physical Activity, Diet

Effects of prolonged and exclusive breastfeeding on child height, weight, adiposity, and blood pressure at age 6.5 y: evidence from a large randomized trial

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Kramer, Michael S, Matush, Lidia, Vanilovich, Irina, Platt, Robert W, Bogdanovich, Natalia, Sevkovskaya, Zinaida, Dzikovich, Irina, Shishko, Gyorgy +7 more·2007·The American Journal of Clinical Nutrition
DOI 10.1093/ajcn/86.5.1717
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Abstract

Background The evidence that breastfeeding protects against obesity and a variety of chronic diseases comes almost entirely from observational studies, which have a potential for bias due to confounding, selection bias, and selective publication.Objective We assessed whether an intervention designed to promote exclusive and prolonged breastfeeding affects children's height, weight, adiposity, and blood pressure at age 6.5 y.Design The Promotion of Breastfeeding Intervention Trial (PROBIT) is a cluster-randomized trial of a breastfeeding promotion intervention based on the WHO/UNICEF Baby-Friendly Hospital Initiative. A total of 17,046 healthy breastfed infants were enrolled from 31 Belarussian maternity hospitals and their affiliated clinics; of those infants, 13,889 (81.5%) were followed up at 6.5 y with duplicate measurements of anthropometric variables and blood pressure. Analysis was based on intention to treat, with statistical adjustment for clustering within hospitals or clinics to permit inferences at the individual level.Results The experimental intervention led to a much greater prevalence of exclusive breastfeeding at 3 mo in the experimental than in the control group (43.3% and 6.4%, respectively; P < 0.001) and a higher prevalence of any breastfeeding throughout infancy. No significant intervention effects were observed on height, body mass index, waist or hip circumference, triceps or subscapular skinfold thickness, or systolic or diastolic blood pressure.Conclusions The breastfeeding promotion intervention resulted in substantial increases in the duration and exclusivity of breastfeeding, yet it did not reduce the measures of adiposity, increase stature, or reduce blood pressure at age 6.5 y in the experimental group. Previously reported beneficial effects on these outcomes may be the result of uncontrolled confounding and selection bias.

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Crossref · 10.1093/ajcn/86.5.1717

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  • An intention-to-treat analysis was used to assess the impact of these differences on BMI at age 6.5 (n = 13,879) and on BMI and fat mass index (FMI) at age 11.5 (n = 13,866).

    “An intention- to-treat analysis was used to assess the impact of these differences on BMI at age 6.5 (n = 13 879) and on BMI and fat mass index (FMI) at age 11.5 (n = 13 866).”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [65]

  • 17,046 Belarusian women with healthy singleton births were randomized to a breastfeeding promotion intervention or usual care.

    “17 046 Belarusian women with healthy singleton births were randomized to a breastfeeding promotion intervention or usual care.”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [65]

  • The intervention resulted in marked differences in ever breastfeeding, duration of breastfeeding and whether breastfeeding was exclusive.

    “The intervention resulted in marked differences in ever breastfeeding, duration of breastfeeding and whether breastfeeding was exclusive.”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [65]

  • The large RCT of a breastfeeding intervention that resulted in marked differences in breastfeeding practice showed no effect of randomization on BMI at mean age 6.5 years.

    “The large RCT of a breastfeeding intervention that resulted in marked differences in breastfeeding practice showed no effect of randomization on BMI at mean age 6.5 years”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [65]

  • The large RCT showed no effect of randomization on BMI or fat mass index at age 11.5 years.

    “or on BMI or fat mass index at age 11.5 years.65,66”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [65]

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Authors
Kramer, M. S., Matush, L., Vanilovich, I., Platt, R. W., Bogdanovich, N., Sevkovskaya, Z., Dzikovich, I., Shishko, G., Collet, J.-P., Martin, R. M., Davey Smith, G., Gillman, M. W., Chalmers, B., Hodnett, E., & Shapiro, S.
Affiliations
Harvard University (US)
Corresponding author
Kramer, Michael S
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2007-12
Volume
86
Issue
6
Pages
1717-1721
ISSN
0002-9165 (ISSN-L)
DOI
10.1093/ajcn/86.5.1717
OpenAlex
W2161341552
Cited by
458
References
28
Citations by year
2026: 3 · 2025: 9 · 2024: 9 · 2023: 21 · 2022: 16 · 2021: 18 · 2020: 26 · 2019: 32 · 2018: 20 · 2017: 26 · 2016: 31 · 2015: 28 · 2014: 36 · 2013: 39 · 2012: 40
FWCI
18.11
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • European Commission
  • Canadian Institutes of Health Research
Topics
  • Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
  • Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
exclusive breastfeeding, prolonged breastfeeding, breastfeeding promotion interventions, Baby-Friendly Hospital Initiative, childhood adiposity, childhood obesity, child height, child weight, blood pressure, anthropometry, skinfold thickness, confounding, selection bias
MeSH terms
Adult, Blood Pressure, Body Constitution, Body Height, Body Weight, Breast Feeding, Republic of Belarus, Child, Child Development, Female, Follow-Up Studies, Humans, Male, Adiposity

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