Maternal overweight impacts infant feeding patterns—the STEPS Study

Abstract

Our study suggests that women who were overweight or obese before pregnancy breastfed for a shorter time and introduced CFs earlier than normal weight women, which may further impact children's growth.

To what extent does maternal body mass index predict intentions, attitudes, or practices of early infant feeding?

“…Efforts should be made to consider the influence of sociodemographic factors when developing support strategies, as breastfeeding interventions that are socially and culturally tailored have been effective (Dyson, McCormick, & Renfrew, ; Fairbank et al, ). The wider evidence available has identified reduced uptake and duration of breastfeeding across women with overweight and obese BMIs during pregnancy (Amir & Donath, ; Mäkelä et al, ; Turcksin et al, ; Wojcicki, ); however, the extent to which maternal BMI independently predicts lower rates of breastfeeding initiation and duration may still differ among different sociodemographic and clinical subgroups of women.…”

“…Recent evidence suggests that women with a prepregnancy body mass index (BMI; kg/m 2 ) in the overweight (25-29.9 kg/m 2 ) or obese (≥30 kg/m 2 ) range are less likely to initiate and continue breastfeeding to the same extent as women who have a healthy BMI (18.5-24.9 kg/m 2 ; Amir & Donath, 2007;Mäkelä, Vaarno, Kaljonen, Niinikoski, & Lagström, 2014;Turcksin, Bel, Galjaard, & Devlieger, 2014;Wojcicki, 2011). Meta-analytic evidence estimates that women with prepregnancy BMI in the overweight or obese range are up to 60% more likely (95% CI [1.47, 1.74]) to cease exclusive breastfeeding in the first 6 months postpartum than women with BMI in the healthy range (Flores, Mielke, Wendt, Nunes, & Bertoldi, 2018).…”

Changing Societal and Lifestyle Factors and Breastfeeding Patterns Over Time

“…These results support findings of recent studies conducted in other developed countries associating maternal obesity with higher risk of noninitiation and shorter breastfeeding duration. 27,28 Although reasons for this association remain unclear, some evidence suggests links to psychosocial factors including low self-efficacy among obese mothers. 29 Obese mothers may be more prone to delayed lactogenesis, 30 difficulty positioning the child for breastfeeding, and other issues including fatigue and mastitis.…”

Childhood Obesity, Breastfeeding, Intestinal Microbiota, and Early Exposure to Antibiotics

“…3 Another confounding factor is early exposure to antibiotics, which is increasing even for minor infections. Antibiotics were found to induce a growth-promoting effect in prepubertal children, possibly by altering their IM.…”