Providers' Help/ Encouragement, Maternal Body Mass Index, and Breastfeeding Initiation: Findings from the 2007 Los Angeles Mommy and Baby (LAMB) Project

OBJECTIVE. Providers' help/encouragement can influence mothers' initiation of breastfeeding. This study examined associations among pre-pregnancy BMI, provider's help/encouragement during pregnancy, and breastfeeding initiation (BFI). METHODS. We analyzed data from the 2007 LAMB Survey (6,044 singleton mothers). 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. Women were asked if their providers helped or encouraged them to breastfeed during prenatal care (PNC) visits and at the delivery hospital. Women also reported their height and weight before pregnancy, which was used to calculate and category pre-pregnancy BMI (underweight, normal, overweight, and obese). Multiple logistic regression models were performed for each BMI category. Appropriate sampling weights were used to adjust for design effect and non-response bias. RESULTS. The BFI rate was 87%. Sixty percent of providers encouraged breastfeeding during the PNC visit and 85% at the delivery hospital. Except for women who were underweight before pregnancy, providers' help/encouragement at delivery hospitals was significantly associated with BFI. For normal weight mothers, those who had been encouraged or helped to breastfeed were almost 4 times more likely as others to have done so (aOR=3.9, 95%CI=2.7-5.8). Similar association was found in women who were obese or overweight before pregnancy (aOR=2.4, 95%=1.5-4; aOR=2.1 95% CI=1.2-3.6). Providers' help/encouragement at PNC was not associated with BFI. CONCLUSIONS. There was an association between providers' help/encouragement at the delivery hospital and BFI, highlighting the need to continue developing effective strategies to encourage breastfeeding.