A prospective study of breastfeeding intentions of healthy weight and overweight women as predictors of breastfeeding outcomes.

Women with a higher BMI are at increased risk of breastfeeding for a shorter duration, however it is unclear if weight status itself or other factors such as feeding intentions are responsible for early breastfeeding cessation. The aim of this study was determine the influence of maternal pre-pregnancy weight status on infant feeding intentions during pregnancy using a validated scale and assess whether high intentions to exclusively breastfeed measured during pregnancy predicted feeding mode at discharge and at 4 months postpartum in both healthy weight (Hwt) (BMI< 25kg/m2) and overweight (Owt)(BMI > 25kg/m2) women. This prospective, observational study commenced when participants were <20 weeks gestation, continuing until four months post partum. Self-administered questionnaires assessed pre-pregnancy weight, infant feeding intentions at 36 weeks gestation, and breastfeeding practices at hospital discharge and 4 months postpartum. Hospital records provided details of delivery mode, gestation and breastfeeding during hospital stay. Binary logistic regression analyses were used to compare weight groups on the breastfeeding beliefs and practices adjusting for selected covariates PARTICIPANTS AND SETTING: A consecutive sample of pregnant women (n = 715) were recruited from an Australian metropolitan hospital between August 2010 and January 2011. All women <20 weeks gestation were eligible unless they had pre-existing Type 1 or 2 diabetes or insufficient English language skills to complete questionnaires. Of 715 women recruited, 402 had complete data at 4 months post-partum. There were no differences in high breastfeeding intentions (66% vs 53%, p = 0.10) or initiation (96% vs. 98%, p = 0.33) between Hwt and Owt women. Owt women were less likely to be exclusively breastfeeding at hospital discharge AOR [95%CI] 0.57 [0.33,0.98] and 4 months post-partum 0.62 [0.40,0.97]. High intention to breastfeed was positively associated with exclusively/fully breastfeeding at hospital discharge in Hwt 3.24 [1.52,6.89] but not Owt women 1.73 [0.75,4.00] and 4 months post partum in both weight groups (Hwt 4.1 [2.4-7.2], Owt 6.5 [2.9-14.3]). Healthy and overweight women appear to have similar antenatal intentions for infant feeding but overweight mothers are less likely to be exclusive breastfeeding at hospital discharge. High antenatal intentions for breastfeeding are related to exclusively/fully breastfeeding at 4 months post partum in both healthy and overweight women. Investigation of early hospital practices that support and hinder the establishment of successful breastfeeding in overweight mothers may help to identify effective strategies to protect breastfeeding relationships between mother-infant dyads, particularly those who have experienced a caesarean delivery.

de Jersey SJ ，Mallan K ，Forster J ，Daniels LA ... -  《-》

To what extent does maternal body mass index predict intentions, attitudes, or practices of early infant feeding?

Public health guidelines recommend women establish and maintain exclusive breastfeeding to 6 months postpartum. Women with a body mass index (BMI, kg/m2 ) in the overweight or obese range are less likely to initiate and continue breastfeeding than healthy weight women. Evidence for psychological mechanisms of this association using validated methods of measurement is limited, but factors such as attitudes and intentions for infant feeding are implicated. This study aimed to investigate the associations between maternal BMI, antenatal attitudes and intentions for infant feeding, and subsequent breastfeeding practices. A total of N = 128 women completed an online questionnaire antenatally, and n = 48 were followed-up in the first month postpartum. Validated measures of intentions (Infant Feeding Intentions Scale) and attitudes (Iowa Infant Feeding Attitude Scale) for infant feeding were used. One-way analysis of variance and multivariate regression analyses assessed study objectives. Infant feeding attitudes (p = .327) and intentions (p = .254) were similar among healthy weight, overweight, and obese women and did not differ significantly. In adjusted regression models, only intentions significantly predicted early breastfeeding behaviour (p = .036; AR2  = .301). Missing data analysis revealed no significant differences in the profile of completing versus noncompleting women. Evidence suggests postnatal factors contribute significantly to lower breastfeeding rates in cohorts of women with overweight or obese BMIs. Further investigations should consider using theory and methods from behavioural science to longitudinally investigate modifiable mechanisms of action responsible for lower breastfeeding rates among overweight and obese women to inform practices that support prolonged breastfeeding.

Davie P ，Bick D ，Chilcot J 《-》

Factors Influencing Exclusive Breastfeeding in Early Infancy: A Prospective Study in North Central Nigeria.

Balogun OO ，Kobayashi S ，Anigo KM ，Ota E ，Asakura K ，Sasaki S ... -  《-》

Breastfeeding intention and early post-partum practices among overweight and obese women in Ontario: a selective population-based cohort study.

Visram H ，Finkelstein SA ，Feig D ，Walker M ，Yasseen A ，Tu X ，Keely E ... -  《-》

Breastfeeding among inner-city women: from intention before delivery to breastfeeding at hospital discharge.

Hundalani SG ，Irigoyen M ，Braitman LE ，Matam R ，Mandakovic-Falconi S ... -  《-》