Maternal obesity, health status during pregnancy and breastfeeding initiation and duration

Although a number of studies have found that overweight and obese women are less likely to initiate breastfeeding and typically breastfeed for a shorter duration compared to women of normal weight, limited research exists on how the impact of overweight/obesity on breastfeeding differs according to mothers' health status during pregnancy. Using data from the Early Childhood Longitudinal Study-Birth Cohort, the purpose of this study is to determine whether maternal prepregnancy overweight and obesity has independent effects on breastfeeding initiation and duration and whether these effects are different for women who experience medical problems during pregnancy or labor/delivery complications in comparison to those who have no medical or labor/delivery complications. Kaplan-Meier survival functions, logistic and Cox regression modeling were used in the analyses. Findings indicate that overweight/obese women with medical or labor/delivery complications are less likely to initiate breastfeeding in comparison to their counterparts of normal weight. Although we find no independent effect of prepregnancy overweight/obesity on breastfeeding initiation among women with no medical problems, this group of women had an 11% increased risk of stopping breastfeeding with each additional month of breastfeeding duration in comparison to those of normal weight. Being Black, younger than 20 years of age and unmarried, belonging to lower SES status and smoking increase the risk of early breastfeeding cessation in both groups of women. This study provides evidence that public health care providers should develop interventions that target overweight/obese women in conjunction with their health status during pregnancy for successful initiation and duration of breastfeeding.