0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Childhood Obesity, Breastfeeding, Intestinal Microbiota, and Early Exposure to Antibiotics What Is the Link?

Giulia Paolella, MD1; Pietro Vajro, MD2
[+] Author Affiliations
1Pediatric Residency Program, School of Medicine, University of Milan, Milano, Italy
2Department of Medicine and Surgery, University of Salerno, Baronissi-Salerno, Italy
JAMA Pediatr. 2016;170(8):735-737. doi:10.1001/jamapediatrics.2016.0964.
Text Size: A A A
Published online

Extract

Prevention of obesity is among the well-recognized beneficial effects that breastfeeding exerts on a variety of organs and systems. This effect seems to occur via various mechanisms: (1) a low content of proteins in human milk as opposed to the high content found in formula and cow’s milk that leads to obesogenic concentrations of insulin and insulin-like growth factor 1 in blood; (2) a good balance of other hormonal molecules that regulate the fat to lean body mass ratio or favor better recognition of satiety; (3) an optimal intestinal microbiota (IM) composition; and (4) food preferences later in life. However, the breastfeeding-obesity link has been questioned because of several confounding factors,1 including maternal habits during gestation and breastfeeding as well as the mother’s metabolic health status (obesity and diabetes), race, and ethnicity. The duration of breastfeeding is also an issue that should be considered in studies of breastfeeding and obesity. Indeed, a long duration of breastfeeding (>7 months) has been associated with a reduced risk of overweight and obesity,2 while a short duration (≤4 months) may not be sufficient to obtain the beneficial effects of breastfeeding.3 Another confounding factor is early exposure to antibiotics, which is increasing even for minor infections. Antibiotics were found to induce a growth-promoting effect in prepubertal children, possibly by altering their IM.4 The neonatal IM composition is influenced by prenatal and postnatal antibiotic exposure5 and other age-specific modifiers such as mode of delivery (natural birth vs cesarean delivery) and mother-to-infant transfer of bacterial strains and human milk oligosaccharides via breastfeeding. The latter are structurally diverse unconjugated glycans that are highly abundant in and unique to human milk; they can stimulate the growth and/or activity of healthy intestinal bacteria.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

4,152 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
Jobs
JAMAevidence.com

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence to Support the Update

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence Summary and Review 1

brightcove.createExperiences();