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A prospective study of breastfeeding intentions of healthy weight and overweight women as predictors of breastfeeding outcomes.
Midwifery 2017; 53:20-27M

Abstract

OBJECTIVE

Women with a higher BMI are at increased risk of breastfeeding for a shorter duration, however it is unclear if weight status itself or other factors such as feeding intentions are responsible for early breastfeeding cessation. The aim of this study was determine the influence of maternal pre-pregnancy weight status on infant feeding intentions during pregnancy using a validated scale and assess whether high intentions to exclusively breastfeed measured during pregnancy predicted feeding mode at discharge and at 4 months postpartum in both healthy weight (Hwt) (BMI< 25kg/m2) and overweight (Owt)(BMI > 25kg/m2) women.

DESIGN

This prospective, observational study commenced when participants were <20 weeks gestation, continuing until four months post partum. Self-administered questionnaires assessed pre-pregnancy weight, infant feeding intentions at 36 weeks gestation, and breastfeeding practices at hospital discharge and 4 months postpartum. Hospital records provided details of delivery mode, gestation and breastfeeding during hospital stay. Binary logistic regression analyses were used to compare weight groups on the breastfeeding beliefs and practices adjusting for selected covariates PARTICIPANTS AND SETTING: A consecutive sample of pregnant women (n = 715) were recruited from an Australian metropolitan hospital between August 2010 and January 2011. All women <20 weeks gestation were eligible unless they had pre-existing Type 1 or 2 diabetes or insufficient English language skills to complete questionnaires.

MEASUREMENTS AND FINDINGS

Of 715 women recruited, 402 had complete data at 4 months post-partum. There were no differences in high breastfeeding intentions (66% vs 53%, p = 0.10) or initiation (96% vs. 98%, p = 0.33) between Hwt and Owt women. Owt women were less likely to be exclusively breastfeeding at hospital discharge AOR [95%CI] 0.57 [0.33,0.98] and 4 months post-partum 0.62 [0.40,0.97]. High intention to breastfeed was positively associated with exclusively/fully breastfeeding at hospital discharge in Hwt 3.24 [1.52,6.89] but not Owt women 1.73 [0.75,4.00] and 4 months post partum in both weight groups (Hwt 4.1 [2.4-7.2], Owt 6.5 [2.9-14.3]).

KEY CONCLUSIONS

Healthy and overweight women appear to have similar antenatal intentions for infant feeding but overweight mothers are less likely to be exclusive breastfeeding at hospital discharge. High antenatal intentions for breastfeeding are related to exclusively/fully breastfeeding at 4 months post partum in both healthy and overweight women.

IMPLICATIONS FOR PRACTICE

Investigation of early hospital practices that support and hinder the establishment of successful breastfeeding in overweight mothers may help to identify effective strategies to protect breastfeeding relationships between mother-infant dyads, particularly those who have experienced a caesarean delivery.

Authors+Show Affiliations

Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia; School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia. Electronic address: susie.dejersey@qut.edu.au.School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia; School of Psychology (Brisbane Campus), Australian Catholic University, 1100 Nudgee Road, Banyo, QLD 4014, Australia. Electronic address: kimberley.mallan@acu.edu.au.School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia. Electronic address: justine.a.forster@gmail.com.School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia. Electronic address: l2.daniels@qut.edu.au.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

28735032

Citation

de Jersey, Susan J., et al. "A Prospective Study of Breastfeeding Intentions of Healthy Weight and Overweight Women as Predictors of Breastfeeding Outcomes." Midwifery, vol. 53, 2017, pp. 20-27.
de Jersey SJ, Mallan K, Forster J, et al. A prospective study of breastfeeding intentions of healthy weight and overweight women as predictors of breastfeeding outcomes. Midwifery. 2017;53:20-27.
de Jersey, S. J., Mallan, K., Forster, J., & Daniels, L. A. (2017). A prospective study of breastfeeding intentions of healthy weight and overweight women as predictors of breastfeeding outcomes. Midwifery, 53, pp. 20-27. doi:10.1016/j.midw.2017.07.002.
de Jersey SJ, et al. A Prospective Study of Breastfeeding Intentions of Healthy Weight and Overweight Women as Predictors of Breastfeeding Outcomes. Midwifery. 2017;53:20-27. PubMed PMID: 28735032.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of breastfeeding intentions of healthy weight and overweight women as predictors of breastfeeding outcomes. AU - de Jersey,Susan J, AU - Mallan,Kimberley, AU - Forster,Justine, AU - Daniels,Lynne A, Y1 - 2017/07/05/ PY - 2017/03/27/received PY - 2017/06/26/revised PY - 2017/07/03/accepted PY - 2017/7/25/pubmed PY - 2018/6/5/medline PY - 2017/7/24/entrez KW - Breastfeeding intentions KW - Exclusive breastfeeding KW - Healthy weight KW - Infant Feeding Intentions Scale KW - Initiation KW - Obese KW - Overweight KW - Pregnancy SP - 20 EP - 27 JF - Midwifery JO - Midwifery VL - 53 N2 - OBJECTIVE: Women with a higher BMI are at increased risk of breastfeeding for a shorter duration, however it is unclear if weight status itself or other factors such as feeding intentions are responsible for early breastfeeding cessation. The aim of this study was determine the influence of maternal pre-pregnancy weight status on infant feeding intentions during pregnancy using a validated scale and assess whether high intentions to exclusively breastfeed measured during pregnancy predicted feeding mode at discharge and at 4 months postpartum in both healthy weight (Hwt) (BMI< 25kg/m2) and overweight (Owt)(BMI > 25kg/m2) women. DESIGN: This prospective, observational study commenced when participants were <20 weeks gestation, continuing until four months post partum. Self-administered questionnaires assessed pre-pregnancy weight, infant feeding intentions at 36 weeks gestation, and breastfeeding practices at hospital discharge and 4 months postpartum. Hospital records provided details of delivery mode, gestation and breastfeeding during hospital stay. Binary logistic regression analyses were used to compare weight groups on the breastfeeding beliefs and practices adjusting for selected covariates PARTICIPANTS AND SETTING: A consecutive sample of pregnant women (n = 715) were recruited from an Australian metropolitan hospital between August 2010 and January 2011. All women <20 weeks gestation were eligible unless they had pre-existing Type 1 or 2 diabetes or insufficient English language skills to complete questionnaires. MEASUREMENTS AND FINDINGS: Of 715 women recruited, 402 had complete data at 4 months post-partum. There were no differences in high breastfeeding intentions (66% vs 53%, p = 0.10) or initiation (96% vs. 98%, p = 0.33) between Hwt and Owt women. Owt women were less likely to be exclusively breastfeeding at hospital discharge AOR [95%CI] 0.57 [0.33,0.98] and 4 months post-partum 0.62 [0.40,0.97]. High intention to breastfeed was positively associated with exclusively/fully breastfeeding at hospital discharge in Hwt 3.24 [1.52,6.89] but not Owt women 1.73 [0.75,4.00] and 4 months post partum in both weight groups (Hwt 4.1 [2.4-7.2], Owt 6.5 [2.9-14.3]). KEY CONCLUSIONS: Healthy and overweight women appear to have similar antenatal intentions for infant feeding but overweight mothers are less likely to be exclusive breastfeeding at hospital discharge. High antenatal intentions for breastfeeding are related to exclusively/fully breastfeeding at 4 months post partum in both healthy and overweight women. IMPLICATIONS FOR PRACTICE: Investigation of early hospital practices that support and hinder the establishment of successful breastfeeding in overweight mothers may help to identify effective strategies to protect breastfeeding relationships between mother-infant dyads, particularly those who have experienced a caesarean delivery. SN - 1532-3099 UR - https://www.unboundmedicine.com/medline/citation/28735032/A_prospective_study_of_breastfeeding_intentions_of_healthy_weight_and_overweight_women_as_predictors_of_breastfeeding_outcomes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0266-6138(17)30230-9 DB - PRIME DP - Unbound Medicine ER -