High Prepregnant Body Mass Index is Associated With Poor Lactation Outcomes Among White,Rural Women Independent of Psychosocial and Demographic Correlates
Restricted accessOtherFirst published online February, 2004
High Prepregnant Body Mass Index is Associated With Poor Lactation Outcomes Among White,Rural Women Independent of Psychosocial and Demographic Correlates
To determine whether high prepregnant body mass index (BMI) is associated with later onset of lactogenesis II (LGII) and shorter duration of breastfeeding, we questioned 151 women about their demographic and psychosocial characteristics during pregnancy and about the onset of LGII during days 1 to 5 postpartum. Compared towomen with earlier (< 72 hours) onset of LGII, those with later onset had a higher BMI (P < .05), a higher proportion of primiparity (P < .01), and a lower infant score on the Mother-Baby Assessment (P < .05). Prepregnant BMI (P < .04) and primiparity (P < .005) were each associated with later onset of LGII, but only primiparity remained significant when both factors were considered simultaneously. These results suggest that, in addition to those who have just delivered their first infant, those with higher prepregnant BMI values also warrant extra support to decrease their risk of early discontinuation of breastfeeding. J Hum Lact. 20(1):18-29.
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References
1.
1. Rolls BJ, Rowe EA, Fahrbach SE, Agius L, Williamson DF. Obesity and high energy diets reduce survival and growth of rat pups [abstract]. Proc Nutr Soc. 1980;39: 51A .
2.
2. Rolls BA, Edwards-Webb JD, Gurr MI. The influence of dietary obesity on milk composition in the rat [abstract]. Proc Nutr Soc. 1981;40: 60A .
3.
3. Shaw MA, Rasmussen KM, Myers TR. Consumption of a high-fat diet impairs reproductive performance in Sprague-Dawley rats . J Nutr. 1997;127: 64-69 .
4.
4. Rolls BA, Gurr MI, van Duijenvoorde PM, Rolls BJ, Rowe EA. Lactation in lean and obese rats: effects of cafeteria feeding and of dietary obesity on milk composition . Physiol Behav. 1986;38: 185-190 .
5.
5. Rolls BJ, Rowe EA. Pregnancy and lactation in the obese rat: effects on maternal and pup weights . Physiol Behav. 1982;28: 393-400 .
6.
6. Rutishauser IHE, Carlin JB. Body mass index and duration of breastfeeding: a survival analysis during the first six months of life . J Epidemiol Comm Health. 1992;46: 559-565 .
7.
7. Hilson JA, Rasmussen KM, Kjolhede CL. Maternal obesity and breastfeeding success in a local population of Caucasian women . Am J Clin Nutr. 1997;66: 1371-1378 .
8.
8. Chapman D, Perez-Escamilla R. Lactogenesis stage II: hormonal regulation, determinants and public health consequences . Recent Res Dev Nutr. 2000;3: 43-63 .
9.
9. Neville MC, Morton J. Physiology and endocrine changes underlying human lactogenesis II . J Nutr. 2001;131: 3005S-3008S .
10.
10. Kulski JK, Hartmann PE. Changes in human milk composition during the initiation of lactation . Aust J Exp Biol Med Sci. 1981;59: 101-114 .
11.
11. Lawrence RA. Breastfeeding: A Guide for the Medical Profession. 4th ed. St. Louis, MO: Mosby ; 1994.
12.
12. Neifert MR. Routine management of breast-feeding. In: Neville MC, Neifert MR, eds. Lactation: Physiology, Nutrition, and Breast-Feeding. New York, NY: Plenum ; 1983:273-301.
13.
13. Mulford C. The mother-baby assessment (MBA): an “Apgar Score” for breastfeeding . J Hum Lact. 1992;8: 79-82 .
14.
14. Manstead ASR, Proffitt C, Smart JL. Predicting and understanding mothers’ infant-feeding intentions and behavior: testing the theory of reasoned action . J Personal Soc Psychol. 1983;44: 657-671 .
15.
15. Matheny RJ, Picciano MF, Birch L. Attitudinal and social influences on infant-feeding preference . J Nutr Educ. 1987;19: 21-31 .
16.
16. Gielen AC, Faden RR, O’Campo P, Paige DM. Determinants of breastfeeding in a rural WIC population . J Hum Lact. 1992;8: 11-15 .
17.
17. O’Campo P, Faden RR, Gielen AC, Wang MC. Prenatal factors associated with breastfeeding duration: recommendations from prenatal interventions . Birth. 1992;19: 195-201 .
18.
18. Matich JR, Sims LS. A comparison of social support variables between women who intend to breast or bottle feed . Soc Sci Med. 1992;34: 919-927 .
19.
19. Fishbein M, Azjen I. Belief, Attitude, Intention and Behavior: An Introduction to Theory and Research. Reading, MA: Addison-Wesley ; 1975.
20.
20. Azjen I, Fishbein M. Understanding Attitudes and Predicting Social Behaviors. Englewood Cliffs, NJ: Prentice-Hall ; 1980.
21.
21. Bandura A. Social Learning Theory. Englewood Cliffs, NJ: Prentice-Hall ; 1977.
22.
22. Bandura A. Self-efficacy: toward a unifying theory of behavior change . Psych Rev. 1977;84: 191-215 .
23.
23. Institute of Medicine, Subcommittee on Nutritional Status and Weight Gain During Pregnancy and Dietary Intake and Nutrient Supplements During Pregnancy, Committee on Nutritional Status During Pregnancy and Lactation, Food and Nutrition Board. Nutrition During Pregnancy: Part 1, Weight Gain; Part II, Nutrient Supplements. Washington, DC: National Academy Press ; 1990.
24.
24. Chapman D, Perez-Escamilla R. Identification of risk factors for delayed onset of lactation . J Am Dietet Assoc. 1999;99: 450-454 .
25.
25. Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999-2000 . JAMA. 2002;288: 1723-1727 .
26.
26. Chapman D, Perez-Escamilla R. Maternal perception of delayed onset of lactogenesis (OL): a useful marker of delayed onset of lactogenesis stage II (OLII) . Paper presented at: 9th International Conference of the International Society of Research in Human Milk and Lactation; October 1999; Irsee, Germany.
27.
27. Gortmaker SL, Must A, Perrin JM, Sobol AM, Dietz WH. Social and economic consequences of being overweight in adolescence and young adulthood . N Engl J Med. 1993;329: 1008-1012 .
28.
28. Rogers J, Mitchell GW. The relation of obesity to menstrual disturbances . N Engl J Med. 1952;247: 53-55 .
29.
29. Hytten FE. Differences in yield and composition between first and second lactations . Proc Nutr Soc. 1959;18: xxi-xxii .
30.
30. Hill P, Humenick SS, Argubright TM, Aldag JC. Effects of parity and weaning practices on breastfeeding duration . Public Health Nurs. 1997;14: 227-234 .
31.
31. Rasmussen KM, Kjolhede CL. Prepregnant overweight and obesity diminish the prolactin (PRL) response to suckling in the first week postpartum [abstract]. FASEB J. 2003;17: A697 .
32.
32. National Center for Health Statistics. Update: prevalence of overweight among children, adolescents, and adults—United States, 1988-1994 . MMWR. 1997;46: 199-202 .
