Relationship between maternal body mass index with the onset of breastfeeding and its associated problems: an online survey

Abstract

Background: Obesity is a worldwide public health problem that demands significant attention. Several studies have found that maternal obesity has a negative effect on the duration of breastfeeding and delayed lactogenesis. The World Health Organization has classified Body Max Index (BMI) as normal weight (normoweight) (BMI:18.5-24.9), overweight (BMI:25-29.9), obesity grade I (30.0-34.9), obesity grade II (BMI: 35.0-39.9) and obesity grade III (BMI ≥ 40.0). The objective of this study is to describe the relationship between maternal BMI and breastfeeding rates, as well as breastfeeding-associated problems and discomfort in women assisted by the Spanish Health System. Methods: To this end, a cross-sectional observational study aimed at women who have been mothers between 2013 and 2018 in Spain was developed. The data was collected through an online survey of 54 items that was distributed through lactation associations and postpartum support groups between March and June 2019. Five thousand eight hundred seventy one women answered the survey. In the data analysis, Crude Odds Ratios (OR) and Adjusted Odds Ratios (AOR) were calculated through a multivariate analysis through binary and multinomial regression. Results: A linear relationship was observed between the highest BMI figures and the reduction of the probability of starting skin-to-skin contact (AOR for obesity type III of 0.51 [95% CI 0.32, 0.83]), breastfeeding in the first hour (AOR for obesity type III of 0.58 [95% CI 0.36, 0.94]), and exclusive breastfeeding to hospital discharge (AOR for obesity type III of 0.57 [95% CI 0.35, 0.94]), as compared to women with normoweight. Conclusions: Women with higher BMI are less likely to develop successful breastfeeding than women with normoweight.

Lactation as a programming window for metabolic syndrome

“…The concentration of specific micronutrients and/or hormonal factors may have a critical impact on infant growth and development, for example affecting the newborn's gut development, which may account for future immune, inflammatory and metabolic diseases. Importantly, besides the impact of maternal metabolic status and diet, increased BMI and gestational weight gain were identified as risk factors for delayed lactogenesis and early termination of breastfeeding 136,137 . Such data reinforce the need for proper body weight control during gestation and lactation periods for infant health.…”

“…Importantly, besides the impact of maternal metabolic status and diet, increased BMI and gestational weight gain were identified as risk factors for delayed lactogenesis and early termination of breastfeeding. 136,137 Such data reinforce the need for proper body weight control during gestation and lactation periods for infant health.…”

Maintenance of Maternal Breastfeeding up to 6 Months: Predictive Models

“…In the search for information explaining this phenomenon, we spent several years studying the most influential reasons and variables. Most studies independently analyze the impact of the reasons or causes of cessation and/or sociodemographic factors that influence the onset, maintenance, or cessation of BF [ 17 , 18 , 19 , 20 , 21 ]. The results show that the most influential variables are the perception that the child is hungry, hypogalactia, use of accessories, such as a pacifier, and return to work [ 17 , 18 , 22 , 23 , 24 ].…”

Mechanisms of Maternal Diet-Induced Obesity Affecting the Offspring Brain and Development of Affective Disorders

“…Moreover, an elevated BMI has been suggested to modify the immunological composition of breast milk, with high levels of IL-6 [ 211 ], leptin [ 213 , 214 ], and other pro-inflammatory mediators [ 215 ] reported. Lastly, the maternal BMI shows a positive association with Caesarian delivery as opposed to natural birth [ 216 ], a negative association with the rate and time to onset of breastfeeding [ 217 , 218 ], and a reduction in the manual expression of milk compared to the use of a breast pump [ 218 ]. These factors likely also contribute to changes in the infant microbiome.…”