Prepregnancy Obesity Class Is a Risk Factor for Failure to Exclusively Breastfeed at Hospital Discharge among Latinas

Abstract

Background:

Suboptimal infant feeding practices, including the failure to exclusively breastfeed, are modifiable risk factors that affect multiple maternal and child health outcomes. Women who are overweight or obese prenatally are more likely to fail to exclusively breastfeed. In the United States, Latinas represent a high-risk population with respect to overweight, obesity, and suboptimal infant feeding practices.

Objectives:

Examine whether exclusive breastfeeding status at hospital discharge among overweight and obese Latinas was associated with (1) prepregnancy body mass index (BMI) and gestational weight gain and (2) sociodemographic, psychosocial, and maternal/infant biomedical factors.

Methods:

An electronic medical records review was conducted to determine exclusive breastfeeding status at hospital discharge among Latinas who gave birth at Hartford Hospital, Hartford, Connecticut, USA (N = 480). Eligible participants were ≥ 16 years, Latina, overweight or obese (BMI ≥ 25.0 kg/m²) and delivered a healthy full-term (≥ 37 weeks) singleton.

Results:

In the multivariable model, obese class II (BMI, 35.0-39.9 kg/m²) women had increased odds of failing to exclusively breastfeed at hospital discharge compared with overweight women. Planned formula use/partial breastfeeding was the single strongest predictor of nonexclusive breastfeeding status. Other risk factors included Puerto Rican ethnicity and parity.

Conclusion:

Maternal prepregnancy obesity class is an important predictor of exclusive breastfeeding status at hospital discharge among overweight and obese Latinas. Future research should examine why in-hospital exclusive breastfeeding behaviors differ by obesity class to subsequently inform the design of breastfeeding promotion and support interventions tailored to the needs of Latinas by obesity class. Culturally appropriate prenatal breastfeeding promotion interventions emphasizing action and coping planning should be considered.

Keywords

behaviors breastfeeding exclusive breastfeeding Latina women maternal obesity

Get full access to this article

View all access options for this article.

References

Bartick

Reinhold

. The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis. Pediatrics. 2010;125(5):e1048-e1056.

Bartick

Stuebe

Schwarz

Luongo

Reinhold

Foster

. Cost analysis of maternal disease associated with suboptimal breastfeeding. Obstet Gynecol. 2013;122(1):111-119.

Centers for Disease Control and Prevention (CDC). Breastfeeding Report Card—United States, 2014. http://www.cdc.gov/breastfeeding/pdf/2014breastfeedingreportcard.pdf. Accessed December 1, 2014.

United Nations Children’s Fund (UNICEF). Child Info: Monitoring the Situation of Children and Women. Infant and Young Child Feeding (2000-2007). http://www.childinfo.org/breastfeeding_countrydata.php. Accessed April 12, 2015.

Healthy People 2020. Healthy People 2020 Objectives: Maternal, Infant, and Child Health. https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives. Accessed August 17, 2015.

Centers for Disease Control and Prevention (CDC). Final formula supplementation of breast milk rates by socio-demographic factors, among children born in 2006. http://www.cdc.gov/breastfeeding/data/NIS_data/2006/socio-demographic_formula.htm. Accessed March 26, 2014.

Rasmussen

. Association of maternal obesity before conception with poor lactation performance. Annu Rev Nutr. 2007;27:103-121.

Pan

Blanck

Sherry

Dalenius

Grummer-Strawn

. Trends in the prevalence of extreme obesity among US preschool-aged children living in low-income families, 1998-2010. JAMA. 2012;308(24):2563-2565.

Hauff

Leonard

Rasmussen

. Associations of maternal obesity and psychosocial factors with breastfeeding intention, initiation, and duration. Am J Clin Nutr. 2014;99(3):524-534.

10.

Kronborg

Vaeth

Rasmussen

. Obesity and early cessation of breastfeeding in Denmark. Eur J Public Health. 2013;23(2):316-322.

11.

Scott

Binns

. Factors associated with the initiation and duration of breastfeeding: a review of the literature. Breastfeed Rev. 1999;7(1):5-16.

12.

Ahluwalia

D’Angelo

Morrow

McDonald

. Association between acculturation and breastfeeding among Hispanic women: data from the Pregnancy Risk Assessment and Monitoring System. J Hum Lact. 2012;28(2):167-173.

13.

Chapman

Perez-Escamilla

. Acculturative type is associated with breastfeeding duration among low-income Latinas. Matern Child Nutr. 2013;9(2):188-198.

14.

Centers for Disease Control and Prevention (CDC). Summary Health Statistics for U.S. Adults: National Health Interview Survey. www.cdc.gov/nchs/data/series/sr_10/sr10_252.pdf. Accessed November 8, 2013.

15.

Wojcicki

. Maternal prepregnancy body mass index and initiation and duration of breastfeeding: a review of the literature. J Womens Health. 2011;20(3):341-347.

16.

Amir

Donath

. A systematic review of maternal obesity and breastfeeding intention, initiation and duration. BMC Pregnancy Childbirth. 2007;7:9.

17.

Turcksin

Bel

Galjaard

Devlieger

. Maternal obesity and breastfeeding intention, initiation, intensity and duration: a systematic review. Matern Child Nutr. 2014;10(2):166-183.

18.

Babendure

Reifsnider

Mendias

Moramarco

Davila

. Reduced breastfeeding rates among obese mothers: a review of contributing factors, clinical considerations and future directions. Int Breastfeed. 2015;10(1):21.

19.

Kugyelka

Rasmussen

Frongillo

. Maternal obesity is negatively associated with breastfeeding success among Hispanic but not black women. J Nutr. 2004;134(7):1746-1753.

20.

Thompson

Zhang

Black

. The association of maternal pre-pregnancy body mass index with breastfeeding initiation. Matern Child Healthl. 2013;17(10):1842-1851.

21.

World Health Organization (WHO). Body mass index (BMI) classification. http://apps.who.int/bmi/index.jsp?introPage=intro_3.html. Accessed November 21, 2015.

22.

Liu

Smith

Dobre

Ferguson

. Maternal obesity and breast-feeding practices among white and black women. Obesity. 2010;18(1):175-182.

23.

Baker

Michaelsen

Sorensen

Rasmussen

. High prepregnant body mass index is associated with early termination of full and any breastfeeding in Danish women. Am J Clin Nutr. 2007;86(2):404-411.

24.

Sebire

Jolly

Harris

. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord. 2001;25(8):1175-1182.

25.

World Health Organization (WHO). Exclusive breastfeeding: e-Library of Evidence for Nutrition Actions (eLENA). http://www.who.int/elena/titles/exclusive_breastfeeding/en/. Accessed February 16, 2015.

26.

Viswanathan

Siega-Riz

Moos

. Outcomes of maternal weight gain. Evid Rep Technol Assess. 2008;(168):1-223.

27.

Olsen

Groveman

Lawson

Clark

Zemel

. New intrauterine growth curves based on United States data. Pediatrics. 2010;125(2):e214-e224.

28.

Chapman

Morel

Bermudez-Millan

Young

Damio

Perez-Escamilla

. Breastfeeding education and support trial for overweight and obese women: a randomized trial. Pediatrics. 2013;131(1):e162-e170.

29.

Scott

Binns

Oddy

Graham

. Predictors of breastfeeding duration: evidence from a cohort study. Pediatrics. 2006;117(4):e646-e655.

30.

Linares

Rayens

Gomez

Gokun

Dignan

. Intention to breastfeed as a predictor of initiation of exclusive breastfeeding in Hispanic women. J Immigr Minor Health. 2014;6:6.

31.

Schwarzer

. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Appl Psychol. 2008;57(1):1-29.

32.

Anderson

Damio

Himmelgreen

Peng

Segura-Perez

Perez-Escamilla

. Social capital, acculturation, and breastfeeding initiation among Puerto Rican women in the United States. J Hum Lact. 2004;20(1):39-45.

33.

Rassin

Markides

Baranowski

Richardson

Mikrut

Bee

. Acculturation and the initiation of breastfeeding. J Clin Epidemiol. 1994;47(7):739-746.

34.

Perez-Escamilla

Putnik

. The role of acculturation in nutrition, lifestyle, and incidence of type 2 diabetes among Latinos. J Nutr. 2007;137(4):860-870.

35.

Chapman

Pérez-Escamilla . Breastfeeding among minority women: moving from risk factors to interventions. Adv Nutr. 2012;3(1):95-104.