Letters

Childhood obesity

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7246.1401 (Published 20 May 2000) Cite this as: BMJ 2000;320:1401

This article has a correction. Please see:

Breast feeding is important

  1. Carol Campbell, clinical medical officer ([email protected])
  1. Community Paediatric Department, Foyle Health and Social Services Trust, Londonderry BT47 1TG
  2. University College London Medical School, Middlesex Hospital, London W1N 8AA
  3. Great Ormond Street Hospital for Children, London WC1N 3JH
  4. Institute of Child Health, Great Ormond Street Hospital for Children
  5. Middlesex Adolescent Unit, Middlesex Hospital, London W1N 8AA
  6. Glasgow G14 9DW
  7. Liverpool Health Authority, Liverpool L3 6AL
  8. Saratov Medical University, Saratov, 410601 Russia
  9. Department of Endocrinology, Clinica Universitaria de Navarra, University of Navarra, 31008 Pamplona, Spain

    EDITOR—Frühbeck does not consider the role of infant feeding in the aetiology of childhood overweight and obesity.1 Dewey et al found that formula fed infants were heavier than those who received no milk other than breast milk in the first 12 months, although they were of similar length and head circumference.2 The study also found that the energy intake of breastfed infants was lower than that of formula fed infants, even after the introduction of solids, and suggested that relatively low energy intakes are a function of self regulation in breastfed infants.

    Von Kries et al found in children aged 5 and 6 years a substantial, dose dependent, protective effect of breast feeding on obesity and overweight: three to five months of exclusive breast feeding was associated with a 35% reduction in obesity at the age of 5 to 6 years. They discuss the evidence for a programming effect of breast feeding in preventing obesity and overweight in later life.3 Breast feeding mothers lose weight after pregnancy more effectively than those who feed artificially, an advantage seen over at least the first 12 months of breast feeding.4 It seems that promoting and supporting breast feeding should be part of the initiative to tackle the “epidemic of obesity.” 5

    References

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    Aim should be weight maintenance, not loss

    1. Russell Viner, honorary senior lecturer in adolescent medicine ([email protected]),
    2. Rachel Bryant-Waugh, consultant clinical psychologist,
    3. Dasha Nicholls, lecturer in behavioural sciences,
    4. Deborah Christie, consultant clinical psychologist
    1. Community Paediatric Department, Foyle Health and Social Services Trust, Londonderry BT47 1TG
    2. University College London Medical School, Middlesex Hospital, London W1N 8AA
    3. Great Ormond Street Hospital for Children, London WC1N 3JH
    4. Institute of Child Health, Great Ormond Street Hospital for Children
    5. Middlesex Adolescent Unit, Middlesex Hospital, London W1N 8AA
    6. Glasgow G14 9DW
    7. Liverpool Health Authority, Liverpool L3 6AL
    8. Saratov Medical University, Saratov, 410601 Russia
    9. Department of Endocrinology, Clinica Universitaria de Navarra, University of Navarra, 31008 Pamplona, Spain

      EDITOR—Frühbeck's call for action over childhood obesity was heartening.1 However, we have concerns about the focus of the editorial.

      Firstly, we believe that weight maintenance rather than weight loss should be the goal of treatment of obesity in childhood while height growth continues. Weight loss is difficult to achieve, and drop-out rates are up to 90% in large series.2 Additionally, ill-advised intake restriction may compromise nutrition and growth during vulnerable periods. Weight maintenance during the growing years is more easily achieved than weight loss 3 and …

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