Association between Maternal Pre-pregnancy Body Mass Index and Breastfeeding Duration in Taiwan: A Population-Based Cohort Study

Abstract

An association between high pre-pregnancy body mass index (BMI) and early breastfeeding cessation has been previously observed, but studies examining the effect of underweight are still scant and remain inconclusive. This study analyzed data from a nationally representative cohort of 18,312 women (mean age 28.3 years; underweight 20.1%; overweight 8.2%; obesity 1.9%) who delivered singleton live births in 2005 in Taiwan. Comprehensive face-to-face interviews and surveys were completed at 6 and 18 months postpartum. BMI status and breastfeeding duration were calculated from the self-reported data in the questionnaires. In the adjusted ordinal logistic regression model, maternal obesity and underweight had a higher odds of shorter breastfeeding duration compared with normal-weight women. The risk of breastfeeding cessation was significantly higher in underweight women than in normal-weight women after adjustments in the logistic regression model (2 m: aOR = 1.11, 95% CI = 1.03–1.2; 4 m: aOR = 1.32, 95% CI = 1.21–1.43; 6 m: aOR = 1.3, 95% CI = 1.18–1.42). Our findings indicated that maternal underweight and obesity are associated with earlier breastfeeding cessation in Taiwan. Optimizing maternal BMI during the pre-conception period is essential, and future interventions to promote and support breastfeeding in underweight mothers are necessary to improve maternal and child health.

Analysis of the Influence of Pre-Pregnancy BMI and Weight Gain during Pregnancy on the Weight of Healthy Children during the First 2 Years of Life: A Prospective Study

“…Additionally, the percentage of 6-month breastfeeding women was similar among underweight, overweight and obese mothers before pregnancy. Contrary to our results, Chen et al, have shown maternal underweight and obesity to be associated with earlier breastfeeding cessation in Taiwan [ 43 ]. Moreover, other authors have demonstrated maternal obesity to have an inverse association with breastfeeding duration [ 44 , 45 ].…”

Identifying Patterns of Symptom Distress in Pregnant Women: A Pilot Study

“…This pilot study had a relatively small number ( n = 95) of participants who were older and had a higher education level compared to Chen’s studies of 18,312 Taiwanese women [ 43 ]; therefore, we must be cautious in generalizing or extending our present results to a wider population. Taiwan is a moderate-to-high income country [ 44 ].…”

Pregnant Women’s Knowledge and Beliefs regarding the Affect of Obesity on the Continuation of Breast Feeding

“…(7) Furthermore, maternal obesity often results in physical discomfort and di culties in adopting comfortable breastfeeding positions, further impeding the successful establishment of breastfeeding. (10) Moreover, maternal obesity exerts a discernible in uence on infant feeding intentions, with research indicating that higher maternal BMI correlates with an increased likelihood of prematurely discontinuing breastfeeding. (17,9,8) This underscores the pivotal role of addressing obesity among women of reproductive age not only in safeguarding maternal health but also in fostering optimal infant feeding practices and enhancing child health outcomes.…”

“…(9) Additionally, studies in Taiwan have revealed associations between maternal obesity or underweight and premature breastfeeding cessation. (10) Furthermore, obese women exhibit signi cantly elevated risks of early breastfeeding cessation, with hazard ratios ranging from 1.24 to 2.54. (11) While several studies in Saudi Arabia have explored pregnant women's awareness of obesity's role in cardio-metabolic diseases and its impact on pregnancy and delivery outcomes, scant attention has been devoted to examining obesity-related knowledge and beliefs concerning breastfeeding continuation.…”