Background: Human milk is considered the gold standard for infant nutrition, but more data are needed that examine the
constellation of weight-related concerns as barriers to exclusive breastfeeding.
Research Aims: The aim of this study was to examine how mothers’ concerns regarding their own and their infants’
weight, as well as disordered eating behaviors, were associated with breastfeeding self-efficacy and exclusive breastfeeding
at 6 months.
Methods: A prospective, quantitative, and self-report online survey design was used. Participants included 206 women
(88.30% White, 59.20% with graduate degrees), with a mean age of 33.04 years (SD = 4.31 years) and a mean prepregnancy
body mass index (BMI) of 24.80 kg/m2 (SD = 5.50 kg/m2), who had given birth within the past 6 months.
Results: Participants who reported not exclusively breastfeeding at 6 months had significantly higher prepregnancy BMI
(p < .001), higher body dissatisfaction (p = .003), more disordered eating (p = .036), higher child weight concerns (p <
.001), and lower breastfeeding self-efficacy (p < .001). Mediation modeling revealed a direct negative relationship between
prepregnancy BMI and exclusive breastfeeding at 6 months (p < .001). Indirect negative relationships between prepregnancy
BMI and exclusive breastfeeding at six months via (a) body dissatisfaction, (b) disordered eating, and (c) child weight concern,
as well as breastfeeding self-efficacy (entered as concurrent mediators), were all significant.
Conclusions: Mothers’ weight, body image and eating concerns, concern regarding their children’s weight, and breastfeeding
self-efficacy may constitute critical barriers to exclusive breastfeeding at 6 months. Interventions to improve breastfeeding
duration and confidence should target maternal body image and eating concerns.