ECHO Study Suggests Early Breastfeeding May Be Linked to Lower Risk of Childhood Obesity

Authors: Gayle Shipp, Adaeze Wosu, et al.

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

Why was this study needed?

Obesity in kids is becoming more common around the world. When children have obesity, they often carry it into adulthood, affecting their long-term health outcomes. While previous studies have shown that breastfeeding may protect children against obesity and other chronic conditions, this relationship has not been studied much in women with obesity. ECHO Cohort researchers wanted to explore the possible link between breastfeeding practices in women with obesity and overweight prior to pregnancy and a child’s BMIz score. Researchers use BMIz scores to compare children’s height and weight to those of their peers while the more familiar BMI assesses body weight in relation to height.

What were the study results?

This study found that consistently breastfeeding infants in any amount during their first three months was associated with lower BMIz scores during early childhood (between the ages of 2 and 6) and a lower risk of childhood obesity, regardless of the mother’s pre-pregnancy BMI. This protective association appeared stronger for children with mothers who had obesity before pregnancy (BMI of 30 or higher) compared to those categorized as overweight (BMI between 25 and 29.9) during the same time.

Exclusive breastfeeding at three months was associated with a lower child BMIz score only among women with a pre-pregnancy BMI in the normal range. Each additional month of any or exclusive breastfeeding correlated with a significantly lower child BMIz, particularly for mothers categorized as overweight (in the case of any breastfeeding) or as having obesity (for any or exclusive breastfeeding) prior to pregnancy.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was this study's impact?

The results of this study highlight that each additional month of breastfeeding, whether a consistent amount or exclusive, may contribute to a lower weight later in childhood, especially for mothers who had obesity before pregnancy. Health professionals can use this study’s findings as an opportunity to encourage and promote breastfeeding among all women, especially those who have obesity.

Who was involved?

The study looked at BMI measurements from 8,134 pairs of mothers and kids at 21 study sites in 16 states and Puerto Rico.

What happened during the study?

The researchers calculated BMI and BMIz scores from measurements taken at study visits, medical records, or self-reported data for the mother and child. Additionally, the study examined two breastfeeding situations: whether the mother ever breastfed or whether the mother was exclusively breastfeeding the infant at 3 months old. This continuous breastfeeding measure included the duration of any breastfeeding allowing for formula or other food and the duration of exclusive breastfeeding with no formula feeding or other food.

What happens next?

Future research and public health prevention efforts could continue to focus on addressing disparities in breastfeeding duration and obesity among mothers that can affect child health outcomes.

Where can I learn more?

Access the full journal article titled “Maternal Pre-pregnancy BMI, Breastfeeding, and Child BMI” in Pediatrics.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published December 19, 2023

Access the associated press release.

Download this summary

ECHO Study Suggests Early Breastfeeding May Be Linked to Lower Risk of Childhood Obesity

ECHO Researchers Find Connection Between Mothers’ Food Quality During Pregnancy and their Duration of Breastfeeding

Posted on November 28, 2022March 31, 2025 by Jodi Snare

Collaborative ECHO research led by Emily Zimmerman, PhD of Northeastern University investigates the relationship between mothers’ food sources and preparation during pregnancy and the length of time they breastfed. Pregnant participants who reported eating the least processed food and take-out, tended to breastfeed for an average of 41 weeks (10 months), while pregnant participants who reported eating the most processed food and take-out breastfed for an average of 16 weeks. This research, titled “Association Between Quality of Maternal Prenatal Food Source and Preparation and Breastfeeding Duration in The Environmental influences on Child Health Outcome (ECHO) Program,” is published in Nutrients.

This study included 751 mothers who were at least 18 years old and their infants from 12 ECHO cohorts located across the United States. Mothers reported on their food source and preparation during pregnancy and were placed in one of three groups: high, moderate, or low food source quality. Mothers also reported on their breastfeeding duration.

“This is the first time that maternal food source during pregnancy has been examined and linked to breastfeeding duration in such a large and diverse cohort,” said Dr. Zimmerman. “Our findings are in line with our hypothesis that mothers who reported eating more processed and fast foods and less food prepared at home breastfed for a shorter duration.”

Future studies are needed to understand the relation between breastfeeding duration and maternal food quality over time. These studies can also provide more specific information on maternal diet, food source, and preparation during pregnancy while considering other important factors, like socioeconomic status, that may affect the types of foods mothers have access to.

Read the research summary.

ECHO Study Suggests Eating Processed Foods May Affect How Long Mothers Breastfeed Their Babies

<< Back to Research Summaries

ECHO Study Suggests Eating Processed Foods May Affect How Long Mothers Breastfeed Their Babies

Authors: Emily Zimmerman, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health.

What were the study results?

The results from this study suggested that pregnant women who reported eating the most processed food and take-out tended to breastfeed for an average of 16 weeks (4 months), while pregnant women who reported eating the least amount of processed food and take-out breastfed for an average of 41 weeks (10 months).

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This is the first large and diverse cohort study examining the potential link between maternal food quality during pregnancy and breastfeeding duration. The results from this study suggest that pregnant women who eat a lot of processed food or take-out during pregnancy, tend to breastfeed for a shorter period of time.

Why was this study needed?

Breastfeeding promotes positive health outcomes for infants, but few studies have looked at the connection between the quality of mothers’ food during pregnancy and the length of time they breastfed. This study examined the relationship between self-reported food quality and preparation (e.g., organic foods, processed foods, take out) during pregnancy and breastfeeding duration.

Who was involved?

This study included 751 mothers who were at least 18 years old and their infants from 12 ECHO cohorts located across the United States.

What happened during the study?

Mothers reported on their food source and preparation during pregnancy and were placed in one of three groups: high, moderate, or low food source quality. Mothers also reported on their breastfeeding duration. Researchers investigated whether there was a relationship between the mothers’ food quality during pregnancy and the length of time they breastfed.

What happens next?

Future studies are needed to understand the relation between breastfeeding duration and maternal food quality over time. These studies can also provide more specific information on maternal diet, food source, and preparation during pregnancy while considering other important factors, like socioeconomic status, that may affect the types of foods mothers have access too.

Where can I learn more?

Access the full journal article, titled “Association Between Quality of Maternal Prenatal Food Source and Preparation and Breastfeeding Duration in The Environmental influences on Child Health Outcome (ECHO) Program,” in Nutrients.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published November 21, 2022

Access the associated article.

Download this summary

ECHO Study Suggests Eating Processed Foods May Affect How Long Mothers Breastfeed Their Babies

ECHO

Environmental Influences on Child Health Outcomes

breastfeeding

ECHO Study Suggests Early Breastfeeding May Be Linked to Lower Risk of Childhood Obesity