Online Program

Pre-pregnancy obesity and the initiation/duration of breastfeeding in los angeles county

Tuesday, November 5, 2013 : 1:10 p.m. - 1:30 p.m.

Diana E. Ramos, MD, MPH, Reproductive Health, Maternal, Child & Adoloescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Shin Margaret Chao, PhD, MPH, Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Stacy Sun, MS, Tulane Medical School
Suzanne Bostwick, Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
BACKGROUND: Obesity is a national epidemic with wide consequences and cost to America's health. In Los Angeles County 1 in 3 women of reproductive age are overweight or obese, with a disproportionately higher number of Hispanic and African American women being affected. Maternal overweight and obesity are linked to poor birth outcomes and lower breastfeeding rates. METHODS:A 2007 population-based mail survey of 6,044 Los Angeles County residents who recently gave birth to a live-born infant. Mothers were selected by randomly sampling birth certificates. Women reported their pre-pregnancy height and weight before pregnancy, BMI was calculated, and 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 (OR=2.1,95%CI=1.9-4; a OR=2, 95%CI= 2-4, a OR=1.4,95%CI=1.4-3.1 respectively). 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 (OR:1.6 and 1.4) and 6 months (OR:1.2 and 1.5). Asian women had a higher risk of stopping breastfeeding at 6 months, compared to White women (OR=1.3,95%CI=1.1-4). CONCLUSIONS: Pre-pregnancy obesity and the initiation/duration of breastfeeding were inversely related. Policy initiatives and local interventions should continue to promote breastfeeding and prevent maternal obesity, especially among racial minority.

Learning Areas:

Chronic disease management and prevention
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related education

Learning Objectives:
Describe the pregnancy complications associated with obesity. Describe the differences in breastfeeding duration in postpartum obese women. Describe the ethnic breastfeeding differences in postpartum obese women.

Keyword(s): Breastfeeding, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: OB/Gyn area of expertise in obesity, breastfeeding and reproductive health.I am also the director for reproductive health ofr the L.A. County Public Health Department.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.