Association Between Maternal Overweight and Obesity on Breastfeeding Duration

Background: Addressing barriers to breastfeeding initiation, duration, and exclusivity are important for increasing national and global rates of breastfeeding and improving children's health. One such barrier may be the worldwide rise of obesity among reproductive-aged women, which is associated with several adverse perinatal health outcomes. Purpose: This review aimed to determine the association between Body Mass Index (BMI) on breastfeeding duration. Methods: This systematic review included only empirical epidemiologic studies that (1) examined an association between pre-pregnant BMI and breastfeeding duration, and (2) included some clear differentiation between BMI categories (underweight, normal weight, overweight, obese). Twenty articles published between 1992 and 2009 met the study criteria. Results: Of the 20 included studies, 9 were prospective cohort, 4 were retrospective cohort, 6 were cross-sectional, and 1 was a randomized case-control. The number of participants ranged from 57 to 37,459. The combined results support the hypothesis that there exists a dose-dependent inverse relationship between maternal BMI and duration of breastfeeding among the women studied. This decrease in breastfeeding duration is evident from descriptive statistics, survival analyses and other multivariate analyses such as logistic regression. Even when adjusting for potential confounding variables, BMI remained significant in most studies. Conclusions: The negative association between BMI and breastfeeding duration suggested by this review is evidence of the need to implementing interventions to improve the health of women and infants. The obesity epidemic is a challenge for health professionals attempting to meet national and global health goals to increase breastfeeding initiation and duration.