Association between maternal prepregnancy obesity and breastfeeding duration: Data from a nationwide prospective birth cohort

Abstract

Association of maternal obesity with shorter breastfeeding duration may involve different factors and might be modified by parity. In a national birth cohort, we aimed to estimate the association between prepregnancy body mass index (pBMI) and breastfeeding duration after adjustment for sociodemographic, pregnancy, and other characteristics and assess the effect modification of parity in such associations. In 2012, 3,368 mother-infant dyads were randomly included at birth in the French Epifane cohort. Breastfeeding information was collected in maternity wards and by phone interview at 1, 4, 8, and 12 months postpartum. Poisson regression analyses estimated the association of pBMI with the number of days of "any breastfeeding" (ABF) and "exclusive breastfeeding" (EBF) in unadjusted and adjusted models. Interactions between parity and pBMI were tested. Obesity before pregnancy was independently associated with shorter ABF duration (incidence rate ratio [IRR] = 0.86, 95%CI [0.74, 0.99]) compared to normal-weight status. Parity showed an effect modification only with EBF duration. Among primiparae, no association was found for obesity, but overweight was significantly associated with shorter EBF duration independently of all covariates (IRR = 0.74 [0.58, 0.95]). Among multiparas, obesity was associated with shorter EBF duration after controlling for sociodemographic factors (IRR = 0.71 [0.53, 0.95]). This association was no longer statistically significant after controlling for other covariates. Obesity appears to be a strong risk factor in shorter ABF duration. Furthermore, parity is a key factor in the relationship of pBMI to shorter EBF duration. Overweight primiparous and obese multiparous women need additional support to prolong breastfeeding duration.

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

“…Overweight and obese women may not only have a greater risk of adverse perinatal outcomes [13], but may also have more difficulty in continuing to breastfeed after delivery, due to a decreased prolactin secretion response to suckling [14] and delayed lactogenesis II [15]. However, observational studies have been conducted, to determine the possible associations between pre-pregnancy body mass index (pBMI) and breastfeeding practices, and the evidence remains inconclusive [16][17][18][19][20][21]. Less is known about the effects of maternal pre-pregnancy underweight status on breastfeeding behavior.…”

Postpartum Comfort and Breastfeeding Behavior of Primipara Obese and Non-Obese Mothers

“…They mentioned in their study that maternal obesity caused certain problems, such as a decrease in the prolactin level, responding, and delay. Failure in the breastfeeding results in formula feeding, and this increases the future obesity risk (16,17,21). In the study by Mehta et al (28), in which the effect of the maternal obesity on the beginning of breastfeeding and psychological factors was analyzed, it was found that obese and overweight women have four times higher risk of unsuccessful breastfeeding.…”

“…), (f) having no complications in the post-partum period, (g) having no operative vaginal deliveries, (h) having deliveries with elective cesarean because of cephalopelvic disproportion, (i) having no diagnosed psychological problems, (j) being together with the newborn in the postpartum period, and (k) acceptance to participate in the study. As mentioned in the literature, because the birth type, parity, and maternal age might affect the postpartum comfort and breastfeeding, groups were homogenized by their ages and the birth type, and the study was conducted with only primipara mothers (11,(17)(18)(19). During the study conducted between July and December 2014, 337 (22 underweight, 144 normal, 89 overweight, and 82 obese mothers) births took place at the hospital.…”

“…In the same study, it was found that delayed breastfeeding was correlated with maternal obesity. In the prospective cohort study by Boudet Berquier et al, (17) it was declared that maternal obesity was one of the important factors affecting the breastfeeding period, and it was found that it was a key factor in the exclusive breastfeeding period for primipara obese mothers. The failure at breastfeeding leads to an increase in the rate of formula-fed infants.…”

Agreement between Future Parents on Infant Feeding Intentions and Its Association with Breastfeeding Duration: Results from the Growing Up in New Zealand Cohort Study

“…Mothers reporting they had very good or excellent health and partners reporting they had excellent health were more likely to intend to breastfeed and to breastfeed for longer than 6 months. Most research that has looked at predictors of breastfeeding and maternal health have focussed on specific health indicators such as maternal obesity (i.e., [ 35 ] or pregnancy health related conditions such as diabetes (i.e., [ 36 ]). We have shown self-reported maternal and paternal health status also to be a useful indicator of intended breastfeeding behaviours.…”