Breastfeeding in children born small for gestational age and future nutritional and metabolic outcomes: a systematic review

• Published in: Jornal de pediatria 2019-05, Vol.95 (3), p.264-274
• Main Authors: Santiago, Ana Cecília Travassos, Cunha, Louise Perna Martins da, Vieira, Nayara Silva Argollo, Oliveira Moreira, Lícia Maria, Oliveira, Patrícia Ribeiro de, Lyra, Priscila Pinheiro Ribeiro, Alves, Crésio de Aragão Dantas
• Format: Article
• Language: English
• Subjects: Aleitamento materno; Breast Feeding; Breastfeeding; Child; Child Development; Feeding Behavior; Humans; Infant; Infant, Newborn; Infant, Small for Gestational Age; Insulin resistance; Metabolic Syndrome; Obesity; Overweight; PEDIATRICS; Pequeno para idade gestacional; Resistência insulínica; Small for gestational age; Sobrepeso; Síndrome metabólica; Time Factors
• ISSN: 0021-7557; 1678-4782; 1678-4782
• DOI: 10.1016/j.jped.2018.06.013

To systematically review evidence related to nutritional and cardiometabolic outcomes in children born at term and small for gestational age and the association with breastfeeding. Two independent reviewers searched the MEDLINE, LILACS, SciELO, and Embase databases without time or language restrictions. The PRISMA tool was used, and studies that evaluated infants born at term and small for gestational age, breastfed, and with an evaluation of cardiometabolic outcomes were included. Studies with preterm infants, those that did not have information on breastfeeding, and those with lack of evaluation of the outcome variables were excluded. Also excluded were review articles, editorials, and series of cases. Only seven articles were found that met the abovementioned criteria. There was a great variability in the type of evaluation, as well as in the age of these children. It was demonstrated that breastfeeding promoted growth without body composition alteration and without increased insulin resistance in children with exclusive breastfeeding, when compared to children receiving a higher calorie formula, except for one article that observed an increase in fat mass in exclusively breastfed children. Breastfeeding seems to be a safe feeding practice for infants born at term and small for gestational age, showing no association with deleterious short-term outcomes. Breastfeeding stimulation in these populations seems to be a way of preventing the health problems associated with the high risk of chronic noncommunicable diseases and obesity. Revisar sistematicamente as evidências relacionadas aos desfechos nutricionais e cardiometabólicos em crianças nascidas a termo e pequenas para idade gestacional e a relação com o aleitamento materno. Dois revisores independentes fizeram buscas nas bases de dados MEDLINE, LILACS, SciELO, EMBASE sem restrições de tempo ou idioma. Foi usada a ferramenta PRISMA sendo incluídos estudos que avaliaram crianças nascidas a termo e pequenas para idade gestacional, amamentadas e com avaliação dos desfechos cardiometabólicos. Foram excluídos estudos com prematuros, aqueles que não trouxessem informação do aleitamento materno, ausência de avaliação das variáveis de desfecho. Também não foram incluídos artigos de revisão, editorial e série de casos. Foram encontrados apenas sete artigos que preencheram os critérios citados acima. Houve uma grande variabilidade na forma de avaliação, assim como na idade dessas crianças. Foi evidenciado que o