Impact of maternal obesity and breastfeeding intention on lactation intensity and duration

Marshall, Nicole; Lau, Bernard; Purnell, Jonathan Q.; Thornburg, Kent L.

doi:10.1111/mcn.12732

Cited by 62 publications

(50 citation statements)

References 44 publications

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“…When antenatal intentions were comparable between obese and non‐obese women, rates of breastfeeding initiation and duration were previously observed to be significantly lower among women with a prepregnancy BMI ≥30 kg/m 2 (Babendure et al, ; Lyons et al, ; Marshall, Lau, Purnell, & Thornburg, ). In this study, no differences in feeding practices were recorded in the early postnatal period, suggesting that variation in practices may only emerge over time.…”

Section: Discussionmentioning

confidence: 98%

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: 98%

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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“…Twenty-nine studies [16,60,[65][66][67]70,73,74,[76][77][78][79]83,86,88,89,[96][97][98][99][104][105][106][107][110][111][112]114,118]…”

Section: Study Characterisicsmentioning

confidence: 99%

“…T overall OR of being obese was significant (OR 1.47, 95% CI: 1.16-1.86) among 18 studies [7 73,75,80,85,91-93,96,97,101,103,109-111,113,117] but heterogeneity was substantial (I 2 = 93%, p for < 0.001,Tau 2 = 0.20). The subgroup analyses showed that the pooled risk among seven studies with higher quality score [71,73,96,97,[101][102][103][104][105][106][107][108][109][110][111] Table 3 shows the pooled risk for ABF cessation with 95% CI, heterogeneity, and publication bias and Figure 3 shows a forest plot for ABF cessation according to BMI categories. For studies that investigated underweight mothers, both the overall HR of four studies [70,76,102,115] (1.28, 95% CI: 0.71-2.31; I 2 = 95%, p for Q = 0.024, Tau 2 = 0.32) and the OR of 10 studies [69,71,73,92,96,97,101,103,109,116] (0.91, 95% CI: 0.64-1.28; I 2 = 86%, p for Q = 0.002, Tau 2 = 0.19) were insignificant.…”

Section: Study Characterisicsmentioning

confidence: 99%

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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“…Despite the associated health benefits, only 43% of infants are exclusively breastfed during the first 6 months worldwide, and in 2015 this percentage was 36% in Colombia [22]. Breastfeeding initiation and duration are even lower in overweight women; those with pre-pregnancy BMI ≥ 30 kg/m 2 are less likely to intend to exclusively breastfeed compared with normal weight and overweight women (78.8% vs 95.5 and 96.2%, respectively) [23]; whilst overweight women have significantly lower initiation and duration of breastfeeding than women in the normal range [24].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a new approach for exclusive breastfeeding counselling on breastfeeding prevalence, infant growth velocity and postpartum weight loss in overweight or obese women: protocol for a randomized controlled trial

2020

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Background: Maternal overweight, infant feeding and early growth velocity are risk factors for obesity later in life. The first one thousand days are a window of opportunity to program health and disease. Exclusive breastfeeding may protect against obesity; however, it is not consistently practiced. Obesity rates have been increasing worldwide. Overweight or obese women have lower rates of breastfeeding and face mechanical, psychological and biological difficulties. Breastfeeding counselling is a successful strategy to support breastfeeding in normal weight women; but there is a lack of evidence on its effectiveness in overweight women. Our purpose is to evaluate a new approach to exclusive breastfeeding counselling based on Carl Rogers' Centred-Client Theory in overweight women, and to examine effects on breastfeeding prevalence, infant growth velocity and maternal postpartum weight loss. Methods: A two-arm simple randomized controlled trial will be conducted in overweight and obese women recruited in a Baby Friendly Hospital in Bogotá, Colombia. The intervention is exclusive breastfeeding counselling based on Rogers' theory but adapted for overweight women; it will be performed during the last month of pregnancy, 24 h after delivery and during early infancy (1 and 3 months postpartum). The primary outcomes will be exclusive breastfeeding prevalence, infant growth velocity and maternal weight loss from birth up to 4 months after delivery; and the secondary outcomes will be prolactin and macronutrient levels in breast milk and serum prolactin levels. Intention to treat analysis will be performed to estimate the effect of the new counselling approach compared to standard management on the prevalence of exclusive breastfeeding, infant growth velocity and maternal weight loss. Discussion: We hypothesize that the intervention will result in an increase in the initiation and maintenance of exclusive breastfeeding, allowing adequate infant growth velocity and maternal weight loss after delivery. It is hoped that the results of this trial will provide evidence to support public health policy on supporting breastfeeding in this vulnerable group of women.

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Impact of maternal obesity and breastfeeding intention on lactation intensity and duration

Cited by 62 publications

References 44 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?

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

Effectiveness of a new approach for exclusive breastfeeding counselling on breastfeeding prevalence, infant growth velocity and postpartum weight loss in overweight or obese women: protocol for a randomized controlled trial

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