Abstract
An association between high pre-pregnancy body mass index (BMI) and early breastfeeding cessation has been previously observed, but studies examining the effect of underweight are still scant and remain inconclusive. This study analyzed data from a nationally representative cohort of 18,312 women (mean age 28.3 years; underweight 20.1%; overweight 8.2%; obesity 1.9%) who delivered singleton live births in 2005 in Taiwan. Comprehensive face-to-face interviews and surveys were completed at 6 and 18 months postpartum. BMI status and breastfeeding duration were calculated from the self-reported data in the questionnaires. In the adjusted ordinal logistic regression model, maternal obesity and underweight had a higher odds of shorter breastfeeding duration compared with normal-weight women. The risk of breastfeeding cessation was significantly higher in underweight women than in normal-weight women after adjustments in the logistic regression model (2 m: aOR = 1.11, 95% CI = 1.03–1.2; 4 m: aOR = 1.32, 95% CI = 1.21–1.43; 6 m: aOR = 1.3, 95% CI = 1.18–1.42). Our findings indicated that maternal underweight and obesity are associated with earlier breastfeeding cessation in Taiwan. Optimizing maternal BMI during the pre-conception period is essential, and future interventions to promote and support breastfeeding in underweight mothers are necessary to improve maternal and child health.
Highlights
Breastfeeding is a key strategy to improve maternal and child health
Considering that parity might be another important contributor to maternal obesity [16,23], we further examined the association by subgroup analysis stratified by parity
Women with excessive Gestational weight gain (GWG) had a higher odds ratio of early breastfeeding cessation at 2 months postpartum. Another logistic regression model analysis was done after excluding women who never breastfed (Table S2), and the findings showed similar results, as in the original analysis model
Summary
Breastfeeding is a key strategy to improve maternal and child health. The benefits for infants include the reduction of risk of infectious disorders, obesity, allergic disorders, and developmental delays [1,2].For mothers, breastfeeding could protect against postpartum weight retention, cardiovascular diseases, and malignancy, including breast, ovarian and endometrial cancers [3]. the World Health Organization (WHO) and the American Academy of Pediatrics (AAP) have recommended exclusive breastfeeding for the first six months of life [4,5], recent data suggest that less than 37% of women could fulfill this goal worldwide [2]. Breastfeeding is a key strategy to improve maternal and child health. The benefits for infants include the reduction of risk of infectious disorders, obesity, allergic disorders, and developmental delays [1,2]. The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) have recommended exclusive breastfeeding for the first six months of life [4,5], recent data suggest that less than 37% of women could fulfill this goal worldwide [2]. Factors associated with the low breastfeeding rate are multifaceted. Potential risk factors for breastfeeding cessation are maternal smoking behavior, delivery mode, parity, dyad separation, maternal educational status [6], paternal support [7], maternal perception of lacking sufficient milk supply, mastitis, infants’ failure to thrive [8], predelivery breastfeeding education [9], and maternal obesity [10]
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