A new study suggests nursing, as well as being a healthy weight, could give your baby a smaller chance of developing this obesity-related condition.
You've probably heard that childhood obesity is on the rise, but did you know that a related condition called fatty liver disease is also becoming more widespread? In an effort to find out why, scientists are looking into early causes of the disease in children. A study presented this week at the International Liver Congress found that breastfeeding, as well as moms' pre-pregnancy weight, affected the chances of their children developing fatty liver disease later on.
The connection to childhood obesity
Researchers looked at 1,179 17-year-olds who were given liver ultrasounds, and compared those results to data on their birth and mothers' pregnancy. A whopping 15 percent of the teens in the study were diagnosed with non-alcoholic fatty liver disease (NAFLD). Although that seems like a large percentage, "that figure is no longer surprising, as it tracks with the rising obesity rates in the general population," says lead author Dr. Oyekoya Ayonrinde of the School of Medicine and Pharmacology at the University of Western Australia. But, being exclusively breastfed for at least six months reduced the teens' risk of NAFLD by a third. Plus, a normal pre-pregnancy body mass index (BMI) in their mother lessened the risk by half. "Our study has found a strong association between obesity in pregnant women and subsequent NAFLD in children," Dr. Ayonrinde says. "We also found that NAFLD was 40 percent less common in adolescent children if their mothers restricted nutrition to breast milk intake during the first six months of life."
NAFLD occurs when extra fat ends up in the liver, and is dangerous because it could lead to the liver not functioning properly (a condition called cirrhosis), which may require a transplant. "Risk for NAFLD has been linked to various genes and, more importantly, individual and family risk for metabolic disorders including obesity and diabetes," Dr. Ayonrinde says. "Lifestyle factors such as [too little exercise] or an unhealthy diet are associated with NAFLD." But not much had been known before this study about how pregnancy and breastfeeding are connected to the disease.
The link between moms' BMI and NAFLD in children could be explained through genetics—bigger mothers tend to have bigger babies who are more likely to become obese themselves. In addition, pregnancy complications that are linked with maternal obesity, like gestational diabetes, could also lead to childhood obesity. "NAFLD is strongly associated with childhood obesity as the main risk factor," Dr. Ayonrinde says.
Previous research has suggested that breastfed babies are less likely to be obese or have diabetes later on. "We can at best speculate that the reduction in obesity previously reported, and now a reduction in NAFLD, seen in breastfed individuals may relate to specific properties of breast milk—or early family health habits," including good childhood nutrition and exercise, Dr. Ayonrinde says. Mothers who breastfeed might also be more likely to have a healthier lifestyle themselves. "Normal pre-pregnancy BMI was associated with a longer duration of breastfeeding," she says.
Preventing irreversible damage
If you are obese and pregnant or trying to conceive, a good diet and moderate exercise can help to ensure your baby is as healthy as possible. "The same advice given by obstetricians about better pregnancy outcomes with normal BMI and fitness appears to extend to later health outcomes, including potentially less NAFLD in children," Dr. Ayonrinde says. Breastfeeding is a personal decision, but the chance to reduce your baby's risk of NAFLD should be a consideration.
NAFLD in children is not easy to diagnose, because it often has few symptoms until it progresses further. It might show up in blood work, or your child may have pain in their upper stomach, where the liver is. It's usually found through an ultrasound, MRI or liver biopsy. Treating the disease can be difficult, but first involves including increasing exercise and eating healthier. If you think your child may be at risk for NAFLD, talk to your pediatrician for a plan to put these practices in place now. "Weight gain trajectories from as early as three years old identify paths of risk towards NAFLD in adolescence," Dr. Ayonrinde says. "In the absence of effective simple treatments for NAFLD, the identification of early risk factors and preventive strategies becomes critical."