Article

High prepregnant body mass index is associated with early termination of full and any breastfeeding in Danish women

Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 08/2007; 86(2):404-11.
Source: PubMed

ABSTRACT

An association between high prepregnant body mass index (BMI) and early termination of breastfeeding has been observed, but this finding may have depended on the sociocultural context.
The objective was to determine whether this association was stronger with increasing maternal obesity, was modified by gestational weight gain, and still existed when there was greater social support for breastfeeding.
Study participants (37 459 women) were drawn from the Danish National Birth Cohort. The association of prepregnant BMI and gestational weight gain with the termination of full or any breastfeeding by 1, 16, or 20 wk postpartum was assessed with logistic regression analyses, and the risk of early termination of full and any breastfeeding during the first 18 mo postpartum was assessed with Poisson regression analyses.
The risk of early termination of any (with similar results for full) breastfeeding rose progressively with increasing prepregnant BMI values (in kg/m(2)), from 1.12 (95% CI: 1.09, 1.16) for overweight (BMI = 25.0-29.9) women to 1.39 (95% CI: 1.19, 1.63) for obese class III women (BMI >or= 40) compared with normal-BMI women. Gestational weight gain did not add to or modify the association between prepregnant BMI and breastfeeding.
These findings extend the observation to a broader range of BMIs that the greater the prepregnant BMI, the earlier the termination of breastfeeding. Together with the fact that this association was evident in a more supportive social context for breastfeeding, these findings suggest a biological basis for the association.

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    • "4 Overweight: 25-29.9 kg/m 2 Normal weight: Ob: > 30 kg/m 2 91.8 ± 2.8/80.1 ± 4.1/65.2 ± 4.9/49.0 ± 5.2/20.7 ± 4.2 Overweight: 89.3 ± 5.9/82.4 ± 7.2/65.5 ± 9.0/48.3 ± 9.5/18.7 ± 7.4 Ob: 85.9 ± 7.4/72.7 ± 9.4/49.4 ± 10.6/35.7 ± 10.1/15.6 ± 7.7 Baker et al. Denmark. 2007 37,459 18-45 12 Underweight: < 18.5 kg/m 2 ;"
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    ABSTRACT: The short duration or lack of breastfeeding has been associated with maternal obesity. The purpose of this study was to systematically review prospective studies that assessed the effect of maternal obesity on lactation. A search of studies was conducted in Pubmed, these included prospective studies on maternal obesity and initiation, intention and duration of breastfeeding: 653 articles were found, only seven were prospective studies. After adding other studies found by hand, a total of nine studies were analyzed. Three out of four papers observed a higher risk for delay lactogenesis among obese mothers, odds ratio ranging from 1.02 to 1.10. The study assessing the initiation of lactation showed that non-obese mothers initiated lactation sooner, OR: 0.39 (95% CI: 0.25-0.62). The overall risk for cessation of breastfeeding showed that obese mothers had higher risks of early cessation, HR: 1.50 (CI 95% 1.11-2.04). In one study it was observed that obese mothers were not more likely to never breastfeed, OR = 1.56 (95% CI: 0.97-1.50). This review shows that in prospective studies, obese mothers are more likely to have delayed lactogenesis and reduced lactation. Therefore, weight control and breastfeeding promotion should be reinforced before and during pregnancy. In overweight and obese mothers, breastfeeding should be closely monitored after birth.
    Full-text · Article · Dec 2011 · Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral
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    • "ations could reflect shared genes and / or shared environments , diet and activity patterns post - natally ( Figure 9 ) . It could also reflect infant feeding practices ; breast - feeding is thought to protect children from later obesity ( Owen et al . 2005 ) and in some populations overweight women are less likely to breast - feed their infants ( Baker et al . 2007 ) ."
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    ABSTRACT: AIM: Research in animals has shown that altering foetal nutrition by under-nourishing or over-nourishing the mother or rendering her diabetic or foetal exposure to glucocorticoids and toxins can programme obesity in later life. The increased adiposity is mediated by permanent changes in appetite, food choices, physical activity and energy metabolism. In humans, increased adiposity has been shown in people who experienced foetal under-nutrition due to maternal famine or over-nutrition due to maternal diabetes. Lower birth weight (a proxy for foetal under-nutrition) is associated with a reduced adult lean mass and increased intra-abdominal fat. Higher birth-weight caused by maternal diabetes is associated with increased total fat mass and obesity in later life. There is growing evidence that maternal obesity, without diabetes, is also a risk factor for obesity in the child, due to foetal over-nutrition effects. Maternal smoking is associated with an increased risk of obesity in the children, although a causal link has not been proven. Other foetal exposures associated with increased adiposity in animals include glucocorticoids and endocrine disruptors. CONCLUSIONS: Reversing the current obesity epidemic will require greater attention to, and better understanding of, these inter-generational (mother-offspring) factors that programme body composition during early development.
    Preview · Article · Jul 2011 · Annals of Human Biology
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    • "4 Overweight: 25-29.9 kg/m 2 Normal weight: Ob: > 30 kg/m 2 91.8 ± 2.8/80.1 ± 4.1/65.2 ± 4.9/49.0 ± 5.2/20.7 ± 4.2 Overweight: 89.3 ± 5.9/82.4 ± 7.2/65.5 ± 9.0/48.3 ± 9.5/18.7 ± 7.4 Ob: 85.9 ± 7.4/72.7 ± 9.4/49.4 ± 10.6/35.7 ± 10.1/15.6 ± 7.7 Baker et al. Denmark. 2007 37,459 18-45 12 Underweight: < 18.5 kg/m 2 ;"
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The short duration or lack of breastfeeding has been associated with maternal obesity. The purpose of this study was to systematically review prospective studies that assessed the effect of maternal obesity on lactation. Methods: A search of studies was conducted in Pubmed, these included prospective studies on maternal obesity and initiation, intention and duration of breastfeeding: 653 articles were found, only seven were prospective studies. After adding other studies found by hand, a total of nine studies were analyzed. Results: Three out of four papers observed a higher risk for delay lactogenesis among obese mothers, odds ratio ranging from 1.02 to 1.10. The study assessing the initiation of lactation showed that non-obese mothers initiated lactation sooner, OR: 0.39 (95% CI: 0.25-0.62). The overall risk for cessation of breastfeeding showed that obese mothers had higher risks of early cessation, HR: 1.50 (CI 95% 1.11-2.04). In one study it was observed that obese mothers were not more likely to never breastfeed, OR = 1.56 (95% CI: 0.97-1.50). Conclusions: This review shows that in prospective studies, obese mothers are more likely to have delayed lactogenesis and reduced lactation. Therefore, weight control and breastfeeding promotion should be reinforced before and during pregnancy. In overweight and obese mothers, breastfeeding should be closely monitored after birth.
    Full-text · Article · Jan 2011 · Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral
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