Influence of breastfeeding in the first months of life on blood pressure levels of preschool children

Nobre, Luciana Neri; Lessa, Angelina do Carmo

doi:10.1016/j.jped.2016.02.011

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Original articles • J. Pediatr. (Rio J.) 92 (6) • Nov-Dec 2016 • https://doi.org/10.1016/j.jped.2016.02.011 copy

Influence of breastfeeding in the first months of life on blood pressure levels of preschool children^☆ ☆ Please cite this article as: Nobre LN, Lessa AC. Influence of breastfeeding in the first months of life on blood pressure levels of preschool children. J Pediatr (Rio J). 2016;92:588-94.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To investigate whether breastfeeding in early life affects blood pressure of preschoolers.

Methods:

Cross-sectional study nested in a cohort from a municipality in the state of Minas Gerais, Brazil. All children in the cohort were invited for this study. Thus, between 2009 and 2010, blood pressure of 230 preschool children and their mothers, in addition to anthropometric variables, previous history, and socioeconomic status were evaluated. Blood pressure measurement was assessed in the morning, using automatic Omron^® HEM-714INT and HEM-781INT devices to measure the blood pressure of preschool children and their mothers, respectively. Logistic regression was used to study the association between breastfeeding and blood pressure. The significance level was set at 5%.

Results:

This study identified 19 (8.26%) preschool children with high blood pressure (values above the 90th percentile). High systolic blood pressure was associated with low birth weight (OR = 5.41; 95% CI = 1.45-20.23) and total breastfeeding duration of less than six months (OR = 4.14; 95% CI = 1.40-11.95). High diastolic blood pressure was not associated with any variable, whereas high systolic blood pressure/diastolic blood pressure ratio was associated with breastfeeding duration of less than six months (OR = 3.48; 95% CI = 1.34-9.1).

Conclusion:

The results of this study indicate that preschoolers breastfed for a period of less than six months were more likely to have high blood pressure when compared to those breastfed for a longer period, suggesting a protective effect of breastfeeding against high blood pressure in this population.

KEYWORDS
Child; Breastfeeding; Blood pressure

Assessed variables	Assessed preschoolers (n = 230)
	n	%
Gender
Female	141	61.3
Male	89	38.7

Birth weight (kg)
≥2.5	213	82.6
<2.5	17	7.4

Maternal breastfeeding (months)
≥6	169	73.5
<6	61	26.5

Current excess weight (BMI)
No	190	82.6
Yes	40	17.4

Waist circumference ^a a Risk category was defined as WC values >75th percentile.
<p75	213	92.6
≥p75	17	73.0

Child's SBP (mmHg)
Normal	215	93.5
Elevated	15	6.5

Child's DBP (mmHg)
Normal	221	96.1
Elevated	9	3.9

Child's SBP/DBP (mmHg)
Normal	211	91.7
Elevated	19	8.3

Maternal SBP/DBP (mmHg)
Normal	191	84.5
Elevated	35	15.5

Monthly per capita income (R$) ^b b Minimum wage at the time of the study: R$ 540.00.
<½ MW	198	85.2
≥½ MW	34	14.8

Variables	SBP^d d Elevated values were those >90th percentile alone (systolic [SBP] or diastolic [DBP] blood pressure) or both (SBP/DBP).			DBP^d d Elevated values were those >90th percentile alone (systolic [SBP] or diastolic [DBP] blood pressure) or both (SBP/DBP).			SBP/DBP^d d Elevated values were those >90th percentile alone (systolic [SBP] or diastolic [DBP] blood pressure) or both (SBP/DBP).
	OR	95% CI	p-Value	Crude OR	95% CI	p-Value	OR	95% CI	p-Value
Gender
Male	1			1			1
Female	0.7	0.2-2.2	0.51	0.8	0.2-2.9	0.72	0.7	0.3-1.7	0.42

Birth weight (kg)
≥2.5	1			1			1
<2.5	5.6	1.6-20.2	0.008	3.9	0.7-20.6	0.10	2.6	0.7-10.1	0.16

Total breastfeeding (months) ^a a Value refers to the total breastfeeding time.
≥6	1			1			1
<6	4.7	1.6-13.8	0.005	2.3	0.6-8.8	0.23	3.5	1.3-9.0	0.001

Excess weight (kg/m ² )
No	1						1
Yes	1.2	0.3-4.5	0.78	-	-	-	0.9	0.2-3.2	0.85

WC (cm) ^b b Refers to waist circumference (WC).
<p75	1						1
≥p75	2.0	0.4-9.9	0.37	-	-	-	1.5	0.3-7.3	0.58

Maternal SBP/DBP (mmHg)
Normal	1			1			1
Elevated	1.4	0.4-5.2	0.62	1.6	0.3-8.0	0.57	1.5	0.5-4.9	0.48

Per capita income (R$)^c c Value refers to a minimum wage (MW) of R$ 540.00.
≥½ MW	1						1
<½ MW	0.7	0.2-2.5	0.55	-	-	-	0.9	0.2-3.3	0.89

Variables	SBP^a a Systolic blood pressure (SBP) - analysis adjusted for time of breastfeeding and birth weight.			SBP/DBP^b b Systolic (SBP) and diastolic (DBP) blood pressure - analysis adjusted for time of breastfeeding and birth weight.
	OR	95% CI	p-Value	OR	95% CI	p-Value
Birth weight (kg)
≥2.5	1			1
<2.5	6.0	1.5-23.3	0.009	2.6	0.6-10.5	0.171

Total breastfeeding (months)
≥6	1			1
<6	4.9	1.6-14.9	0.005	3.5	1.3-9.1	0.011

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E-mail: jped@jped.com.br

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[1] * Corresponding author. E-mail:lunerinobre@yahoo.com.br (L.N. Nobre).

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Influence of breastfeeding in the first months of life on blood pressure levels of preschool children☆ ☆ Please cite this article as: Nobre LN, Lessa AC. Influence of breastfeeding in the first months of life on blood pressure levels of preschool children. J Pediatr (Rio J). 2016;92:588-94.

Abstract

Objective:

Methods:

Results:

Conclusion:

Influence of breastfeeding in the first months of life on blood pressure levels of preschool children^☆ ☆ Please cite this article as: Nobre LN, Lessa AC. Influence of breastfeeding in the first months of life on blood pressure levels of preschool children. J Pediatr (Rio J). 2016;92:588-94.