Impact of breastfeeding during infancy on functional constipation at 3 years of age: the Japan Environment and Children's Study

Noriko Motoki; Yuji Inaba; Hirokazu Toubou; Kohei Hasegawa; Takumi Shibazaki; Teruomi Tsukahara; Tetsuo Nomiyama; Japan Environment and Children’s Study (JECS) Group

doi:10.1186/s13006-023-00592-y

Impact of breastfeeding during infancy on functional constipation at 3 years of age: the Japan Environment and Children's Study

Int Breastfeed J. 2023 Nov 6;18(1):57. doi: 10.1186/s13006-023-00592-y.

Authors

Noriko Motoki¹, Yuji Inaba^{2

3

4}, Hirokazu Toubou⁵, Kohei Hasegawa⁵, Takumi Shibazaki⁶, Teruomi Tsukahara^{2

5}, Tetsuo Nomiyama^{2

5}; Japan Environment and Children’s Study (JECS) Group

Collaborators

Japan Environment and Children’s Study (JECS) Group:
Michihiro Kamijima, Shin Yamazaki, Yukihiro Ohya, Reiko Kishi, Nobuo Yaegashi, Koichi Hashimoto, Chisato Mori, Shuichi Ito, Zentaro Yamagata, Hidekuni Inadera, Takeo Nakayama, Tomotaka Sobue, Masayuki Shima, Hiroshige Nakamura, Narufumi Suganuma, Koichi Kusuhara, Takahiko Katoh

Affiliations

¹ Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan. nmotoki@shinshu-u.ac.jp.
² Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
³ Department of Neurology, Nagano Children's Hospital, Azumino, Nagano, Japan.
⁴ Life Science Research Center, Nagano Children's Hospital, Azumino, Nagano, Japan.
⁵ Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
⁶ Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.

Abstract

Background: There is a lack of large, nationwide, birth cohort studies in Japan that examine the relationships of initial feeding habits and breastfeeding period duration with offspring functional constipation at 3 years of age. This study assessed the impact of breastfeeding during infancy on early childhood functional constipation.

Methods: The fixed data of 70,078 singleton births from the ongoing Japan Environment and Children's Study cohort study that commenced in 2011 were used to identify functional constipation as estimated by Rome III at 3 years of age. The exposure variables were breastfeeding period duration until 12 months of age (never, up to 6 months, or ≥ 7 months) as well as breastfeeding status at 1 month and 6 months of age (breastfeeding exclusively, partial breastfeeding, or infant formula feeding only). Multiple logistic regression analysis was employed to search for correlations for functional constipation development with breastfeeding period duration until 12 months of age and breastfeeding status during infancy.

Results: We identified 8,118 toddlers (11.6%) who met the Rome III criteria at 3 years of age. After controlling for potential covariates, a breastfeeding period duration of 7 months or more was inversely related to functional constipation development (≥ 7 months: adjusted odds ratio [OR] [95% confidence interval (CI)] 0.76 [0.65, 0.88] versus never breastfed, P for trend < 0.001). Other initial feeding methods were significantly related to an increased risk of functional constipation as compared with breastfeeding exclusively at 1 month of age (partial breastfeeding: adjusted OR [95% CI] 1.17 [1.11, 1.23], formula feeding only: 1.23 [1.07, 1.40]) and 6 months of age (partial breastfeeding: adjusted OR [95% CI] 1.18 [1.12, 1.24], formula feeding only: adjusted OR [95% CI] 1.42 [1.20, 1.68]).

Conclusion: This large nationwide survey revealed a possible protective effect of a prolonged breastfeeding period duration and early exclusive breastfeeding in infancy on functional constipation at 3 years.

Keywords: Breastfeeding period duration; Exclusive breastfeeding; Functional constipation; Infant; Japan; Toddler.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Breast Feeding*
Child, Preschool
Cohort Studies
Female
Humans
Infant
Infant Formula*
Japan / epidemiology
Longitudinal Studies