The Impact of Exclusive Breastfeeding on the Risk of Obesity: A Narrative Review

Abstract

Background: Childhood obesity is a growing global health concern, affecting nearly 18% of children and adolescents worldwide. Exclusive breastfeeding (EBF) has been proposed as an effective strategy to promote optimal growth and prevent obesity in later life. However, evidence remains inconsistent due to methodological and contextual variations. This narrative review aims to synthesize recent evidence on the relationship between EBF and childhood obesity, including biological mechanisms and maternal factors influencing this association.

Methods: A literature search was conducted in PubMed, ScienceDirect, and Google Scholar for English-language articles published between 2020 and 2025 using the keywords “exclusive breastfeeding,” “obesity,” “overweight,” and “BMI.” Original human studies with cross-sectional, cohort, case–control, or interventional designs were included, while non-English, animal, and non-obesity-related studies were excluded. Seven eligible studies were analyzed narratively

Results: Most studies demonstrated that EBF was associated with a 24–44% reduction in obesity risk, with stronger protection observed for breastfeeding durations longer than six months. Biological mechanisms include better appetite regulation, lower protein intake, improved insulin and IGF-1 balance, and healthier gut microbiota. Rapid weight gain during infancy partially mediated this association. Maternal obesity, inflammation, and gestational diabetes were identified as key modifiers of EBF duration and protective effects.

Conclusion: Exclusive breastfeeding provides measurable protection against obesity through nutritional, hormonal, and metabolic pathways. Promoting EBF for the first six months of life should remain a global public health priority, supported by strategies that enhance maternal health, breastfeeding education, and equitable lactation support.

Keywords: Breastfeeding, Childhood Obesity, Exclusive Breastfeeding, Rapid Weight Gain