Weight-Related Concerns as Barriers to Exclusive Breastfeeding at 6 Months

Zimmerman, Emily; Rodgers, Rachel F.; O’Flynn, Jennifer L.; Bourdeau, Althea

doi:10.1177/0890334418797312

Cited by 23 publications

(23 citation statements)

References 40 publications

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“…Indeed, few studies in which mothers continued breastfeeding up to six months (as recommended by the WHO and UNICEF) remained for analyses. Second, we excluded 10 studies [21][22][23][24][25][26][27][28][29][30] that provided continuous risk estimates because risk with a one unit increase in BMI is exponential, and thus difficult to interpret by combining the different sources of populations. Indeed, the 10 studies [21][22][23][24][25][26][27][28][29][30] vary across countries, BF types, and the length of the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

“…Second, we excluded 10 studies [21][22][23][24][25][26][27][28][29][30] that provided continuous risk estimates because risk with a one unit increase in BMI is exponential, and thus difficult to interpret by combining the different sources of populations. Indeed, the 10 studies [21][22][23][24][25][26][27][28][29][30] vary across countries, BF types, and the length of the follow-up period. Nine studies [21][22][23][24][25][26][27][28][29] were reported from Western countries and three investigated initiation [23,25,27].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, the 10 studies [21][22][23][24][25][26][27][28][29][30] vary across countries, BF types, and the length of the follow-up period. Nine studies [21][22][23][24][25][26][27][28][29] were reported from Western countries and three investigated initiation [23,25,27]. Among the seven studies [21][22][23][24]26,29,30] that assessed the risk of timing at six months after delivery, only two [27,30] reported that the BF significantly decreased by a unit increase of BMI.…”

Section: Discussionmentioning

confidence: 99%

“…Nine studies [21][22][23][24][25][26][27][28][29] were reported from Western countries and three investigated initiation [23,25,27]. Among the seven studies [21][22][23][24]26,29,30] that assessed the risk of timing at six months after delivery, only two [27,30] reported that the BF significantly decreased by a unit increase of BMI. Furthermore, we also attempted to collect mean BMI according to BF status in order to perform a quantitative assessment, but only two studies [25,29] provided such data.…”

Section: Discussionmentioning

confidence: 99%

“…Among the seven studies [21][22][23][24]26,29,30] that assessed the risk of timing at six months after delivery, only two [27,30] reported that the BF significantly decreased by a unit increase of BMI. Furthermore, we also attempted to collect mean BMI according to BF status in order to perform a quantitative assessment, but only two studies [25,29] provided such data. These two studies also reported the risks at different points in time (i.e., 18 months [25] and six months [29]) and thus we did not include these.…”

Section: Discussionmentioning

confidence: 99%

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Maternal Body Mass Index and Breastfeeding Non-Initiation and Cessation: A Quantitative Review of the Literature

et al. 2020

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This study aims to investigate which maternal body mass index (BMI) categories are associated with the non-initiation or cessation of breastfeeding (BF) based on a quantitative review of the literature. We searched Ovid MEDLINE and EBSCO CINAHL for peer-reviewed articles published between 1946 (MEDLINE) or 1981 (CINAHL), and 2019. Selected studies were either cross-sectional or cohort studies, of healthy mothers and infants, that reported nutrition method (exclusive/full or any) and period (initiation/duration/cessation) of breastfeeding according to maternal BMI levels. Pairwise meta-analyses of 57 studies demonstrated that the pooled odds risks (OR) of not initiating BF among overweight and obese mothers compared to normal weight mothers were significant across 29 (OR 1.33, 95% confidence interval (CI), 1.15–1.54, I2 = 98%) and 26 studies (OR 1.61, 95% CI, 1.33–1.95, I2 = 99%), respectively; the pooled risks for BF cessation were inconsistent in overweight and obese mothers with substantial heterogeneity. However, we found that overweight mothers (n = 10, hazard ratio (HR) 1.16, 95% CI, 1.07–1.25; I2 = 23%) and obese mothers (n = 7, HR 1.45, 95% CI: 1.27–1.65; I2 = 44%) were both associated with an increased risk of not continuing any BF and exclusive BF, respectively. Overweight and obese mothers may be at increased risk of not initiating or the cessation of breastfeeding.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Maternal Body Mass Index and Breastfeeding Non-Initiation and Cessation: A Quantitative Review of the Literature

et al. 2020

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The Relationship Between Internalized Weight Stigma During Pregnancy and Breastfeeding: A Prospective Longitudinal Study

Dieterich

Chang

Danford

et al. 2021

Obesity

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Objective This study aimed to examine the relationship between internalized weight stigma during pregnancy and breastfeeding outcomes at 1 month post partum among individuals with prepregnancy overweight or obesity. Secondarily, the study explored the temporal stability of internalized weight stigma from the third trimester to 1 month post partum via the Weight Bias Internalization Scale (WBIS). Methods A total of 103 pregnant individuals with overweight or obesity were recruited for this study. Participants completed the WBIS during the third trimester and self‐reported breastfeeding initiation, continuation, and exclusivity outcomes at 1 month post partum. A paired t test and binomial logistic regression were conducted with covariates hierarchically added to the model. Results The average prepregnancy BMI was 33.53 (SD 7.17) kg/m2 (range = 25.4‐62), and average prenatal WBIS scores were 25.95 (SD 11.83). No difference was found in mean prenatal and postpartum scores (25.95 [SD 11.83]; 26.86 [SD 13.03], respectively; t94 = −0.83, P = 0.41), evidencing temporal stability in WBIS scores from pre to post partum. Prenatal WBIS scores did not predict breastfeeding initiation, continuation, or exclusivity at 1 month post partum in either unadjusted or adjusted models. Conclusions Collectively, this sample displayed low weight bias internalization, which was not predictive of breastfeeding initiation, continuation, or exclusivity at 1 month post partum. Future research is needed to develop a pregnancy‐specific weight stigma measure.

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Pregorexia: a systematic review and meta-analysis on the constructs of body image dissatisfaction and eating disturbances by gestational age in the peripartum

Tarchi,

Merola,

Selvi

et al. 2023

Eat Weight Disord

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Purpose Pregorexia is a phenomenon posited to occur in the peripartum, characterized by an attempt to counter pregnancy’s physiological changes in body shape through reduced calorie intake or increased physical activity. Methods In this pre-registered systematic review and meta-analysis, body image dissatisfaction and eating psychopathology in the peripartum according to gestational age were formally assessed. PubMed was searched up to May 2023. Selection criteria were represented by studies on body image concerns or eating psychopathology in the peripartum (up to 1 year after delivery). The population needed to include women from the general population or among patients with a history of (or current) eating disorder. For the meta-analysis, 17 studies were included: 10 for body image dissatisfaction (2625 individuals overall), 7 for eating behaviors (2551 individuals overall). The interplay between body image and the following themes was examined in depth: the adoption of breastfeeding, peripartum depression, sociocultural influences on body image, sexual disturbances, experiencing or reporting an altered food intake. Results Progressive dissatisfaction with body image during pregnancy by gestational age was observed, stably elevated for at least 12 months postpartum. Eating psychopathology was observed as elevated only at 12 months in the postpartum, but not during pregnancy. Discussion The current work offers normative values of body image satisfaction and eating psychopathology in the peripartum by gestational age. The relevance of current results was discussed, in order to inform both current clinical practice and future public policies. Level of Evidence Level I—Evidence obtained from: systematic reviews and meta-analyses.

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Weight-Related Concerns as Barriers to Exclusive Breastfeeding at 6 Months

Cited by 23 publications

References 40 publications

Maternal Body Mass Index and Breastfeeding Non-Initiation and Cessation: A Quantitative Review of the Literature

Maternal Body Mass Index and Breastfeeding Non-Initiation and Cessation: A Quantitative Review of the Literature

The Relationship Between Internalized Weight Stigma During Pregnancy and Breastfeeding: A Prospective Longitudinal Study

Pregorexia: a systematic review and meta-analysis on the constructs of body image dissatisfaction and eating disturbances by gestational age in the peripartum

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