Childhood obesity : breast-milk vs formula-milk during infancy

Abstract

Topic overview: Childhood obesity is a prevalent disease that diminishes the individual’s quality of life (QOL), increasing morbidity and mortality. Childhood obesity can be the result of different feeding practices during infancy such as formula-feeding and short duration breastfeeding. Research question: Does the consumption of formula milk in infancy increase the risk of obesity in children compared to infants that are breastfed? PICO elements: The population (P) studied was infants/children. The intervention (I) was consumption of formula milk feeding. The comparison (C) was breastfeeding, and the outcome (O) was childhood obesity. Methods: To find the most suitable articles, keywords taken from the PICO elements were used to generate alternative terms. Such terms were inserted into search tools such as EBSCO and PubMed to conduct a systematic literature search. Limiters were set to refine the search and the framework of the PRISMA checklist was used to screen articles. The eligibility criteria for the articles were detailed and included the infant/children population and childhood obesity as the primary outcome. Eligible articles consisted of systematic reviews, meta-analysis, longitudinal and cross-sectional studies. These had to be published within the last ten years and written in English. After this process, eight key studies were selected for critical appraisal using CASP and Cochrane Collaboration’s tools. Results and conclusions: The key studies consisted of five longitudinal studies, one systematic review and meta-analysis and two cross-sectional studies. Several methodological limitations were identified, which could have potentially affected the obtained results. Despite that most of the articles agreed that infants who breastfeed were less likely to develop childhood obesity, there were two studies that did not find a difference between children who were breastfed or formula-fed; therefore, the research question of this review was not answered definitively. Implications and recommendations: An important recommendation is to promote awareness and educate the public, particularly expectant parents, healthcare professionals (HCPs) and educational professionals on the implication of different feeding practices and their effect on childhood obesity. More studies are also needed to confirm the existence of such a link and to create effective interventions for preventing childhood obesity. Implementing trials with less bias is one of the recommendations for future research.