Pre-pregnancy Obesity and Breastfeeding Practices: Differences by Race/Ethnicity: Findings from the 2007 Los Angeles Mommy and Baby (LAMB) Survey

OBJECTIVE. To evaluate the relationship between pre-pregnancy obesity (BMI >29) and breastfeeding practices in a racially diverse county. METHODS. We analyzed data from the 2007 LAMB Survey. LAMB is a population-based mail survey of Los Angeles County residents who recently gave birth to a live-born infant. Mothers were selected by randomly sampling birth certificates. Our analyses were based on the responses of 6,044 singleton women. The questionnaire asked women to report their height and weight before pregnancy, which was used to calculate pre-pregnancy BMI. LAMB also asked women about their breastfeeding practices. Multiple logistic regression models were performed to assess the association between maternal obesity and breastfeeding practices after controlling for potential confounders. Appropriate sampling weights were used to adjust for design effect and non-response bias. RESULTS. Compared to normal weight women, obese women were less likely to initiate breastfeeding and more likely to stop breastfeeding within the first 3 and 6 months (aOR=2.1,95%CI=1.9-4; aOR=2, 95%CI= 2-4, aOR=1.4,95%CI=1.4-3.1 respectively). There was no racial difference was found in breastfeeding initiation. However, compared to White women, Black and Latino women had higher risks of discontinuing breastfeeding at 3 months (aOR:1.6 and 1.4) and 6 months (aOR:1.2 and 1.5). Asian women had a higher risk of stopping breastfeeding at 6 months, compared to White women(aOR=1.3,95%CI=1.1-4). CONCLUSIONS. Pre-pregnancy obesity and the initiation and duration of breastfeeding were inversely related. Policy initiatives and local interventions should continue to promote breastfeeding and prevent maternal obesity, especially among racial minority.