Breastfeeding intention and early post-partum practices among overweight and obese women in Ontario: a selective population-based cohort study

Visram, Hasina; Finkelstein, Sara A.; Feig, Denice S.; Walker, Mark; Yasseen, Abdool S.; Tu, Xin; Keely, Erin

doi:10.3109/14767058.2012.735995

Cited by 24 publications

(27 citation statements)

References 29 publications

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“…The variance in breastfeeding practices explained by constructs in the model (attitudes, subjective norm, perceived behavioural control, and intentions) ranges from 10% (Ismail et al, 2016) to 4% (Wambach, 1997) and is less accurate at predicting breastfeeding behaviour over the postpartum period (McMillan et al, 2008). Intentions for infant feeding in this cohort are consistently measured using dichotomous and categorical scales (Hauff et al, 2014;Jarlenski et al, 2014;Lyons et al, 2018;Newby & Davies, 2016;Visram et al, 2013), which dilutes the wide variability in intentions for infant feeding and subsequently overinflates the Attitudes towards infant feeding were breastfeeding positive across women in this study. No differences in beliefs about breastfeeding have been observed in the wider literature with regard to maternal BMI (Lyons et al, 2018), and little evidence is available to explain why differences in beliefs or attitudes would be dependent on maternal BMI alone.…”

Section: Discussionmentioning

confidence: 76%

“…The variance in breastfeeding practices explained by constructs in the model (attitudes, subjective norm, perceived behavioural control, and intentions) ranges from 10% (Ismail et al, ) to 4% (Wambach, ) and is less accurate at predicting breastfeeding behaviour over the postpartum period (McMillan et al, ). Intentions for infant feeding in this cohort are consistently measured using dichotomous and categorical scales (Hauff et al, ; Jarlenski et al, ; Lyons et al, ; Newby & Davies, ; Visram et al, ), which dilutes the wide variability in intentions for infant feeding and subsequently overinflates the magnitude of differences observed. Using the IFIS (Nommsen‐Rivers & Dewey, ), which is both theoretically informed and psychometrically validated, observed differences in the strength of intentions to breastfeed among healthy weight, overweight, and obese women are negligible.…”

Section: Discussionmentioning

confidence: 91%

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

Davie

Bick

Chilcot

2019

Maternal & Child Nutrition

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Public health guidelines recommend women establish and maintain exclusive breastfeeding to 6 months postpartum. Women with a body mass index (BMI, kg/m2) in the overweight or obese range are less likely to initiate and continue breastfeeding than healthy weight women. Evidence for psychological mechanisms of this association using validated methods of measurement is limited, but factors such as attitudes and intentions for infant feeding are implicated. This study aimed to investigate the associations between maternal BMI, antenatal attitudes and intentions for infant feeding, and subsequent breastfeeding practices. A total of N = 128 women completed an online questionnaire antenatally, and n = 48 were followed‐up in the first month postpartum. Validated measures of intentions (Infant Feeding Intentions Scale) and attitudes (Iowa Infant Feeding Attitude Scale) for infant feeding were used. One‐way analysis of variance and multivariate regression analyses assessed study objectives. Infant feeding attitudes (p = .327) and intentions (p = .254) were similar among healthy weight, overweight, and obese women and did not differ significantly. In adjusted regression models, only intentions significantly predicted early breastfeeding behaviour (p = .036; AR2 = .301). Missing data analysis revealed no significant differences in the profile of completing versus noncompleting women. Evidence suggests postnatal factors contribute significantly to lower breastfeeding rates in cohorts of women with overweight or obese BMIs. Further investigations should consider using theory and methods from behavioural science to longitudinally investigate modifiable mechanisms of action responsible for lower breastfeeding rates among overweight and obese women to inform practices that support prolonged breastfeeding.

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Section: Discussionmentioning

confidence: 76%

“…The variance in breastfeeding practices explained by constructs in the model (attitudes, subjective norm, perceived behavioural control, and intentions) ranges from 10% (Ismail et al, ) to 4% (Wambach, ) and is less accurate at predicting breastfeeding behaviour over the postpartum period (McMillan et al, ). Intentions for infant feeding in this cohort are consistently measured using dichotomous and categorical scales (Hauff et al, ; Jarlenski et al, ; Lyons et al, ; Newby & Davies, ; Visram et al, ), which dilutes the wide variability in intentions for infant feeding and subsequently overinflates the magnitude of differences observed. Using the IFIS (Nommsen‐Rivers & Dewey, ), which is both theoretically informed and psychometrically validated, observed differences in the strength of intentions to breastfeed among healthy weight, overweight, and obese women are negligible.…”

Section: Discussionmentioning

confidence: 91%

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

Davie

Bick

Chilcot

2019

Maternal & Child Nutrition

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“…The characteristics of included studies are summarized in Table . Most were conducted in the USA , with some in Europe , Australia and one in Canada . Sample characteristics were reported infrequently; of 20 included studies, 13 reported participant ethnicity or race , 9 reported mean age and 5 reported mean BMI .…”

Section: Resultsmentioning

confidence: 99%

The association between psychological factors and breastfeeding behaviour in women with a body mass index (BMI) ≥30 kg m⁻²: a systematic review

et al. 2018

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Breastfeeding can play a key role in the reduction of obesity, but initiation and maintenance rates in women with a body mass index (BMI) of ≥30 kg m are low. Psychological factors influence breastfeeding behaviours in the general population, but their role is not yet understood in women with a BMI ≥30 kg m . Therefore, this review aimed to systematically search and synthesize the literature, which has investigated the association between any psychological factor and breastfeeding behaviour in women with a BMI ≥30 kg m . The search identified 20 eligible papers, reporting 16 psychological factors. Five psychological factors were associated with breastfeeding behaviours: intentions to breastfeed, belief in breast milk's nutritional adequacy and sufficiency, belief about other's infant feeding preferences, body image and social knowledge. It is therefore recommended that current care should encourage women to plan to breastfeed, provide corrective information for particular beliefs and address their body image and social knowledge. Recommendations for future research include further exploration of several psychological factors (i.e. expecting that breastfeeding will enhance weight loss, depression, anxiety and stress) and evidence and theory-based intervention development.

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“…Studies concerning intention to breastfeed according to pBMI show mixed findings. Indeed, some authors observed that obese women were less likely to intend to breastfeed than normal‐weight women (Guelinckx et al, ; Visram et al, ). In other studies, no association was found between pBMI and breastfeeding intention (Hauff & Demerath, ; Hauff et al, ).…”

Section: Discussionmentioning

confidence: 99%

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

Boudet-Berquier

Salanave

Desenclos

et al. 2017

Maternal & Child Nutrition

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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.

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Breastfeeding intention and early post-partum practices among overweight and obese women in Ontario: a selective population-based cohort study

Cited by 24 publications

References 29 publications

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

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

The association between psychological factors and breastfeeding behaviour in women with a body mass index (BMI) ≥30 kg m⁻²: a systematic review

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

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Breastfeeding intention and early post-partum practices among overweight and obese women in Ontario: a selective population-based cohort study

Cited by 24 publications

References 29 publications

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

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

The association between psychological factors and breastfeeding behaviour in women with a body mass index (BMI) ≥30 kg m−2: a systematic review

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

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The association between psychological factors and breastfeeding behaviour in women with a body mass index (BMI) ≥30 kg m⁻²: a systematic review