Despite their intentions to breastfeed, women with high prepregnancy BMI had psychosocial characteristics associated with poor breastfeeding outcomes. However, these characteristics did not fully explain the association between maternal obesity and breastfeeding outcomes.
Women with high prepregnant BMI have reduced lactation duration that is mediated by lack of comfort/confidence with one's body. Further research into the interplay between body image, weight status, and breastfeeding outcomes may point to behavioral targets amenable to intervention and modification that may in turn improve breastfeeding outcomes for overweight/obese women and their infants.
Little is known about how psychosocial factors (PSF) influence breastfeeding (BF) behavior of obese women. Our objectives were to determine a) whether maternal prepregnancy body mass index (BMI) is associated with social knowledge of, social influence towards, maternal confidence in, and behavioral beliefs about BF; b) whether these PSF predict BF outcomes; and c) whether prepregnancy BMI is associated with these outcomes, independent of the PSF. Longitudinal data from the Infant Feeding Practices Study II (n=2890) were analyzed using logistic and proportional hazards regression models. Prepregnancy BMI was associated with confidence in (P<0.0001), social influence towards (P=0.04), and social knowledge of BF (P<0.0001), but not with behavioral beliefs in BF (P=0.48). Overweight and obese women did not differ from normal‐BMI women in intention to breastfeed (P=0.06), but they had lower odds of ever BF (P=0.03), and were at greater risk of ceasing exclusive (P=0.0008) and any BF (P=0.02) earlier. Only the association with exclusive BF remained significant (P=0.01) after controlling for PSF. All the PSF were positively associated with each BF outcome. We conclude that women with high prepregnancy BMI have psychosocial characteristics associated with poor BF outcomes, despite having strong intentions to breastfeed. Funded by NIH (5T32HD007331) and USDA (Hatch 399307).Grant Funding Source: NIH (5T32HD007331) and USDA (Hatch 399307)
High prepregnant maternal body mass index (BMI) is associated with reduced breastfeeding duration. The objective of this research was to examine how maternal obesity might impact early cessation of exclusive breastfeeding (EBF) by exploring key aspects of early breastfeeding success: prolactin values, milk output, and mother‐infant positioning during the first week postpartum. In this prospective study, data were collected from 51 primiparous women from Minnesota. Multivariate models were used to determine relationships between maternal obesity and early cessation of EBF via a variety of breastfeeding outcome variables. Among overweight and obese women, 35% stopped breastfeeding exclusively by 2 weeks postpartum compared to 4% of normal BMI women (P < 0.05). Greater milk output at 1 week postpartum reduced the risk of early cessation of EBF (OR 0.41, P < 0.05). Milk output was significantly associated with the predictor variables of basal prolactin concentration within 48 hours postpartum (P < 0.05) and Mother‐Baby Assessment (MBA) score (a measure of efficient positioning) at 1 week postpartum (P < 0.0001). Prolactin levels (P < 0.05) and MBA scores (P < 0.05) were in turn negatively associated with maternal obesity. These findings suggest that low milk output, influenced by decreased prolactin levels and especially poor positioning, may play a role in early cessation of EBF among obese women. Funded by NSF.
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