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Law S, Wan K, Yang W. Effects of bariatric surgery on sexual function and fertility: A narrative review. Obes Rev 2024; 25:e13757. [PMID: 38689132 DOI: 10.1111/obr.13757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 05/02/2024]
Abstract
Obesity has emerged as a prevalent global health concern, with its detrimental effects on the reproductive system and sexual function garnering increasing attention. Both men and women affected by obesity face a heightened risk of fertility challenges and sexual dysfunction. Although fertility and sexual function are distinct topics, they are intricately linked and mutually influential in both medical and societal contexts. Bariatric surgery (BS) has generated promising results in alleviating sexual dysfunction and enhancing fertility, results which are often gender specific. In men, improvements in sexual function can often be attributed to weight loss and subsequent optimizations in sex hormone levels. However, improving female sexual function may be related to a range of factors beyond weight loss. Bariatric procedures have shown limited benefits for male fertility; in fact, in some situations it can even be detrimental, leading to a decrease in sperm count and quality. Conversely, BS may positively impact female fertility, improving pregnancy and neonatal outcomes. Nevertheless, it is essential to consider the potential risks related to the adverse effects of malnutrition and rapid weight loss following BS, making it advisable to wait for 12-18 months before attempting pregnancy.
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Affiliation(s)
- Saikam Law
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- School of Medicine, Jinan University, Guangzhou, China
| | - Kating Wan
- School of Medicine, Jinan University, Guangzhou, China
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
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2
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Call CC, Hawkins MS, Shah VK, Frank D, Niemi S, Jouppi RJ, Ferguson E, Conlon RPK, Levine MD. A longitudinal investigation of breastfeeding planning, initiation, and duration among individuals with pre-pregnancy overweight or obesity. Appetite 2024; 197:107333. [PMID: 38570117 PMCID: PMC11104448 DOI: 10.1016/j.appet.2024.107333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/21/2024] [Accepted: 03/29/2024] [Indexed: 04/05/2024]
Abstract
Individuals with a body mass index (BMI)≥25 kg/m2 are less likely to initiate and continue breastfeeding than are those with BMIs<25. Given the intergenerational health benefits of breastfeeding, it is important to understand breastfeeding behaviors and their correlates among individuals with BMIs≥25. Thus, in an observational cohort with BMI≥25 (N = 237), we aimed to characterize longitudinal relationships among breastfeeding planning, initiation, and duration and their sociodemographic/clinical correlates and determine if pre-pregnancy BMI predicts breastfeeding planning, initiation, and duration. Breastfeeding behaviors, weight/BMI, and sociodemographic/clinical characteristics were assessed in early, mid, and late pregnancy, and at six-months postpartum. Most participants planned to (84%) and initiated (81%) breastfeeding, of which 37% breastfed for ≥6 months. Participants who were married, first-time parents, higher in education/income, and had never smoked tobacco were more likely to plan, initiate, and achieve ≥6 months of breastfeeding. Higher pre-pregnancy BMI was not associated with breastfeeding planning or initiation but was associated with lower adjusted odds of breastfeeding for ≥6 months relative to <6 months. Findings suggest that support aimed at extending breastfeeding among those with elevated pre-pregnancy BMI may be warranted. Future interventions should also address sociodemographic and clinical inequities in breastfeeding.
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Affiliation(s)
- Christine C Call
- University of Pittsburgh, Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
| | - Marquis S Hawkins
- University of Pittsburgh, Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Vrusha K Shah
- University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA, 15261, USA
| | - David Frank
- University of Pittsburgh, Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Sarah Niemi
- University of Pittsburgh, Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Riley J Jouppi
- University of Pittsburgh, Department of Psychology, 210 South Bouquet Street, Pittsburgh, PA, 15260, USA
| | - Emma Ferguson
- University of Pittsburgh, Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Rachel P K Conlon
- University of Pittsburgh, Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Michele D Levine
- University of Pittsburgh, Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA; University of Pittsburgh, Department of Psychology, 210 South Bouquet Street, Pittsburgh, PA, 15260, USA
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3
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Boyd M, Brown CC, Goudie A. Association Between Prepregnancy Body Mass Index and Newborn Breastfeeding Initiation. Breastfeed Med 2024; 19:275-283. [PMID: 38535874 PMCID: PMC11238845 DOI: 10.1089/bfm.2023.0262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Background: The benefits of breastfeeding a newborn are well documented. Identification of mothers who do not initiate breastfeeding is essential for developing initiatives to improve breastfeeding initiation. Methods: The study used data from the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) birth certificate data (2014-2021) to identifying 15,599,930 in-hospital deliveries. We used multivariable logistic regression to assess the association between seven body mass index (BMI) categories and initiation of breastfeeding before hospital discharge. Prepregnancy BMI (weight in kilograms/height in meters2) included underweight (<18.5), healthy weight (18.5-24.9), overweight (25.0-29.9), Obesity Class I (30-34.9), Obesity Class II (35-39.9), and Obesity Class III (40-49.9) classes, in addition to a class newly identified in the literature as super obese (≥50), hereafter "Obesity Class IV." "This project was deemed non-human subjects research." Results: Approximately, 83% of mothers initiated breastfeeding before hospital discharge. Compared to mothers with a healthy prepregnancy BMI, the likelihood of breastfeeding initiation before hospital discharge decreased with increasing prepregnancy BMI. Specifically, we found reduced likelihood of initiation for mothers who were overweight (adjusted odds ratio [aOR]: 0.952, 95% confidence interval [CI]: [0.948-0.955]), Obesity Class I (aOR: 0.884, 95% CI: [0.880-0.888]), Obesity Class II (aOR: 0.816, 95% CI: [0.811-0.820]), Obesity Class III (aOR: 0.750, 95% CI: [0.745-0.755]), and Obesity Class IV (aOR 0.672: 95% CI: [0.662-0.683]). Conclusions: Mothers with prepregnancy BMI above the healthy range had reduced likelihood of initiating breastfeeding prior hospital discharge. This information should be used to develop and initiate interventions for mothers who wish to breastfeed but may need additional lactation assistance support.
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Affiliation(s)
- Melanie Boyd
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Science, Little Rock, Arkansas, USA
| | - Clare C. Brown
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Science, Little Rock, Arkansas, USA
| | - Anthony Goudie
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Science, Little Rock, Arkansas, USA
- Arkansas Center for Health Improvement, Little Rock, Arkansas, USA
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Hernández-Cordero S, Vilar-Compte M, Tomori C, Lara-Mejía V, Rovelo-Velázquez N, Hayes K, Pérez-Escamilla R. Healthcare professionals and commercial milk formula recommendations in the urban Mexican context. Front Public Health 2023; 11:1260222. [PMID: 38045970 PMCID: PMC10693414 DOI: 10.3389/fpubh.2023.1260222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/16/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Breastfeeding (BF) is considered an essential component of optimal care for child health and development. In the past two decades, global data have shown improvements in some, but not all, BF indicators. Despite these positive changes sales and per capita intake of commercial milk formula (CMF) have increased globally. The CMF industry invests millions of dollars in marketing, which targets families and healthcare professionals (HCP). In Mexico, more than half of the mothers (53%) who feed their infants with CMF chose their Brand on the recommendation of HCP. Understanding the reasons behind the current recommendations for the use of CMF by HCP is important for the design of BF interventions. The primary objective of this study was to explore Mexican HCP' beliefs, attitudes, perceptions, and practices about early infant feeding practices, and reasons for recommending CMF. The secondary objective was to explore pregnant women and mother's perceptions of the infant feeding recommendations they received from HCP, and of the factors that influenced their infant feeding decisions. Methods The study was based on a secondary qualitative data analysis of a WHO/UNICEF multi-country study. We analyzed focus group discussions (FGDs) and in-depth interviews (IDIs) from Mexico. Data were collected through convenience sampling in Mexico City and Guadalajara. HCP (n = 34) analysis was based on IDIs, and pregnant women or mothers of children 0-18 months (n = 74) on FGDs and IDIs. Results Through a thematic analysis, we identified the socioecology of BF and triangulated HCP and women's accounts. HCP, pregnant women, and mothers recognized that several factors might have influenced their infant feeding decisions including healthcare facilities' policies and maternal work conditions. Although HCP believed that BF is the best way to feed newborns and young children, they routinely recommended CMF. On the other hand, pregnant women and mothers had a strong belief that BF is the best way to feed their babies. However, when women sought support from HCP, the latter often recommended switching to CMF. Discussion This study highlights the discordance between HCP perceptions and mothers' experiences of HCP recommendations about infant feeding. Our findings support a national call for policy actions.
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Affiliation(s)
- Sonia Hernández-Cordero
- Research Center for Equitable Development EQUIDE, Universidad Iberoamericana, Mexico City, Mexico
| | - Mireya Vilar-Compte
- Department of Public Health, Montclair State University, Montclair, NJ, United States
| | - Cecília Tomori
- Johns Hopkins School of Nursing and Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Vania Lara-Mejía
- Research Center for Equitable Development EQUIDE, Universidad Iberoamericana, Mexico City, Mexico
| | - Natalia Rovelo-Velázquez
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, United States
| | - Keily Hayes
- Department of Public Health, Montclair State University, Montclair, NJ, United States
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
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The importance of sleep and parity in understanding changes in weight and breastfeeding behavior among postpartum women. Appetite 2021; 170:105889. [PMID: 34954303 DOI: 10.1016/j.appet.2021.105889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Breastfeeding duration has been linked with the health of both women and their children, but research that considers women's weight change postpartum and practical factors that may impact their quality of life (i.e., sleep quantity, number of children) is limited. METHOD A survey was administered to 568 women (M age = 31.32 years; SD = 4.21) who had given birth within the past year. The survey included assessments of pre- and post-pregnancy weight and height, breastfeeding practices, current sleep quantity, presence of breastfeeding-specific support, and other demographics including their total number of children. RESULTS Greater pre-pregnancy to postpartum weight increase was related to shorter duration of breastfeeding. Mothers who exclusively breastfed for the first six months had less postpartum weight increase (i.e., the discrepancy between their pre-pregnancy and post-pregnancy weight was smaller) than those who did not. Fewer children and greater hours of sleep were significantly associated with longer duration of breastfeeding. Sleep partially accounted for the relationship between body mass index change and breastfeeding duration. Breastfeeding-specific support did not impact the effect of low sleep on shorter breastfeeding duration. CONCLUSIONS Duration of breastfeeding may suffer due to fatigue. Sleep plays a key role in understanding the ways in which weight change impact breastfeeding behavior. Greater holistic support for mothers in the postpartum period is needed to foster an environment that encourages breastfeeding.
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Incollingo Rodriguez AC, Nagpal TS. The WOMBS Framework: A review and new theoretical model for investigating pregnancy-related weight stigma and its intergenerational implications. Obes Rev 2021; 22:e13322. [PMID: 34288364 DOI: 10.1111/obr.13322] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/30/2021] [Indexed: 11/30/2022]
Abstract
As the growing weight stigma literature has developed, one critically relevant and vulnerable population has received little consideration-pregnant and postpartum women. Because weight fluctuations are inherent to this life phase, and rates of prepregnancy overweight and obesity are already high, this gap is problematic. More recently, however, there has been a rising interest in pregnancy-related weight stigma and its consequences. This paper therefore sought to (a) review the emerging research on pregnancy-related weight stigma phenomenology and (b) integrate this existing evidence to present a novel theoretical framework for studying pregnancy-related weight stigma. The Weight gain, Obesity, Maternal-child Biobehavioral pathways, and Stigma (WOMBS) Framework proposes psychophysiological mechanisms linking pregnancy-related weight stigmatization to increased risk of weight gain and, in turn, downstream childhood obesity risk. This WOMBS Framework highlights pregnant and postpartum women as a theoretically unique at-risk population for whom this social stigma engages maternal physiology and transfers obesity risk to the child via social and physiological mechanisms. The WOMBS Framework provides a novel and useful tool to guide the emerging pregnancy-related weight stigma research and, ultimately, support stigma-reduction efforts in this critical context.
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Affiliation(s)
- Angela C Incollingo Rodriguez
- Psychological & Cognitive Sciences, Department of Social Science & Policy Studies, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
| | - Taniya S Nagpal
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
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' [The pediatrician] said that maybe my milk, instead of doing good, no longer helped': the ecology of infant formula in rural communities in Central Mexico. Public Health Nutr 2021; 24:3879-3891. [PMID: 34187610 DOI: 10.1017/s1368980021002433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE As Mexico continues to develop, an epidemiological and nutritional transition has led to an increase in infant formula use in its rural and indigenous communities. Our objective was to determine the social and cultural factors that influence the use of formula in such populations in Central Mexico. DESIGN Qualitative study using a data collection instrument based on the socio-ecological framework. SETTING Two rural and indigenous communities in Central Mexico. PARTICIPANTS Mothers, fathers, grandparents and healthcare providers. RESULTS Breast-feeding was favoured in both communities; however, several cultural traditions hindered exclusive breast-feeding. As these communities became more developed, emerging ideas of modernity led to negative connotations about breast-feeding and many mothers began to view formula as a complement for breast-feeding. Formula was seen as a convenient solution for breast pain, insufficient milk and body image. Healthcare providers promoted the use of formula through their own beliefs, information, communication and conflicts of interest with formula industry representatives. The recent social and economic changes in these communities combined with the increased advertising and availability of breast milk substitutes have facilitated the preference for formula. CONCLUSIONS Women in rural, indigenous communities in Central Mexico are increasingly using formula. Efforts at the policy and institutional levels are needed to protect mothers and their children from the detrimental consequences of unregulated formula promotion and the formula culture that it brings with it.
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Mother's Own Milk Feeding in Preterm Newborns Admitted to the Neonatal Intensive Care Unit or Special-Care Nursery: Obstacles, Interventions, Risk Calculation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084140. [PMID: 33919856 PMCID: PMC8070824 DOI: 10.3390/ijerph18084140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 01/24/2023]
Abstract
Early nutrition of newborns significantly influences their long-term health. Mother's own milk (MOM) feeding lowers the incidence of complications in preterm infants and improves long-term health. Unfortunately, prematurity raises barriers for the initiation of MOM feeding and its continuation. Mother and child are separated in most institutions, sucking and swallowing is immature, and respiratory support hinders breastfeeding. As part of a quality-improvement project, we review the published evidence on risk factors of sustained MOM feeding in preterm neonates. Modifiable factors such as timing of skin-to-skin contact, strategies of milk expression, and infant feeding or mode of delivery have been described. Other factors such as gestational age or neonatal complications are unmodifiable, but their recognition allows targeted interventions to improve MOM feeding. All preterm newborns below 34 weeks gestational age discharged over a two-year period from our large German level III neonatal center were reviewed to compare institutional data with the published evidence regarding MOM feeding at discharge from hospital. Based on local data, a risk score for non-MOM feeding can be calculated that helps to identify mother-baby dyads at risk of non-MOM feeding.
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9
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Nomura K, Minamizono S, Nagashima K, Ono M, Kitano N. Maternal Body Mass Index and Breastfeeding Non-Initiation and Cessation: A Quantitative Review of the Literature. Nutrients 2020; 12:nu12092684. [PMID: 32887461 PMCID: PMC7551008 DOI: 10.3390/nu12092684] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/23/2020] [Accepted: 08/31/2020] [Indexed: 12/29/2022] Open
Abstract
This study aims to investigate which maternal body mass index (BMI) categories are associated with the non-initiation or cessation of breastfeeding (BF) based on a quantitative review of the literature. We searched Ovid MEDLINE and EBSCO CINAHL for peer-reviewed articles published between 1946 (MEDLINE) or 1981 (CINAHL), and 2019. Selected studies were either cross-sectional or cohort studies, of healthy mothers and infants, that reported nutrition method (exclusive/full or any) and period (initiation/duration/cessation) of breastfeeding according to maternal BMI levels. Pairwise meta-analyses of 57 studies demonstrated that the pooled odds risks (OR) of not initiating BF among overweight and obese mothers compared to normal weight mothers were significant across 29 (OR 1.33, 95% confidence interval (CI), 1.15–1.54, I2 = 98%) and 26 studies (OR 1.61, 95% CI, 1.33–1.95, I2 = 99%), respectively; the pooled risks for BF cessation were inconsistent in overweight and obese mothers with substantial heterogeneity. However, we found that overweight mothers (n = 10, hazard ratio (HR) 1.16, 95% CI, 1.07–1.25; I2 = 23%) and obese mothers (n = 7, HR 1.45, 95% CI: 1.27–1.65; I2 = 44%) were both associated with an increased risk of not continuing any BF and exclusive BF, respectively. Overweight and obese mothers may be at increased risk of not initiating or the cessation of breastfeeding.
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Affiliation(s)
- Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita 010-8543, Japan;
- Correspondence: ; Tel.: +81-018-884-6087
| | - Sachiko Minamizono
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita 010-8543, Japan;
| | - Kengo Nagashima
- Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tokyo 190-8562, Japan;
| | - Mariko Ono
- Teikyo University School of Medicine, Tokyo 173-8605, Japan;
| | - Naomi Kitano
- Research Center for Community Medicine and Department of Public Health, Wakayama Medical University School of Medicine, Wakayama 641-8509, Japan;
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Khalsa AS, Copeland KA, Misik L, Brown CL, Kharofa RY, Ollberding NJ. Maternal Body Dissatisfaction and Accuracy of Infant Weight Perception in Families From Low-Income Backgrounds. Acad Pediatr 2020; 20:793-800. [PMID: 32247669 DOI: 10.1016/j.acap.2020.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/22/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the association between maternal body dissatisfaction and mother's (mis)perception of their infant's weight classification among families from low-income households. METHODS Mother-infant dyads were recruited during well-child visits from 2 urban primary care clinics. Maternal body dissatisfaction was measured using the Stunkard Figure Rating Scale. Perception of infant weight was assessed using a 5-point Likert scale. Infant weight-for-length percentiles were calculated using World Health Organization growth charts. Associations between maternal body dissatisfaction score and mother's (mis)perception of their infant's weight classification were examined using logistic regression allowing for nonlinear associations via restricted cubic splines. RESULTS Mothers (n = 180) were 26.6 ± 5.1 years old and 72% Black; infants were 8.8 ± 2.1 months old. Mean infant weight-for-length percentile was 64 ± 26. On average, mothers wanted to be one body figure smaller than their perceived current body size. Most mothers (82%) accurately perceived their infant's weight classification while few overestimated (7%) or underestimated (11%) their child's weight category. The probability of mothers misperceiving their infant's weight classification increased as maternal body dissatisfaction increased in either extreme in unadjusted (P < .05) and adjusted analysis (P = .06). CONCLUSIONS Increased maternal body dissatisfaction may be associated with mother's misperception of infant weight classification. Future studies should examine this relationship in a heterogeneous population.
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Affiliation(s)
- Amrik Singh Khalsa
- Division of Primary Care Pediatrics, Nationwide Children's Hospital (AS Khalsa), Columbus, Ohio; Department of Pediatrics, The Ohio State University College of Medicine (AS Khalsa), Columbus, Ohio.
| | - Kristen A Copeland
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center (KA Copeland), Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine (KA Copeland, RY Kharofa, and NJ Ollberding), Cincinnati, Ohio
| | - Lauren Misik
- Northeast Ohio Medical University, College of Medicine (L Misik), Rootstown, Ohio
| | - Callie L Brown
- Department of Pediatrics, Wake Forest University School of Medicine (CL Brown), Winston-Salem, NC
| | - Roohi Y Kharofa
- Department of Pediatrics, University of Cincinnati College of Medicine (KA Copeland, RY Kharofa, and NJ Ollberding), Cincinnati, Ohio; The Heart Institute, Cincinnati Children's Hospital Medical Center (RY Kharofa), Cincinnati, Ohio
| | - Nicholas J Ollberding
- Department of Pediatrics, University of Cincinnati College of Medicine (KA Copeland, RY Kharofa, and NJ Ollberding), Cincinnati, Ohio; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center (NJ Ollberding), Cincinnati, Ohio
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11
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Bick D, Taylor C, Bhavnani V, Healey A, Seed P, Roberts S, Zasada M, Avery A, Craig V, Khazaezadah N, McMullen S, O’Connor S, Oki B, Oteng-Ntim E, Poston L, Ussher M. Lifestyle information and access to a commercial weight management group to promote maternal postnatal weight management and positive lifestyle behaviour: the SWAN feasibility RCT. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Increasing numbers of UK women have overweight or obese body mass index scores when they become pregnant, or gain excessive weight in pregnancy, increasing their risk of adverse outcomes. Failure to manage postnatal weight is linked to smoking, non-healthy dietary choices, lack of regular exercise and poorer longer-term health. Women living in areas of higher social deprivation are more likely to experience weight management problems postnatally.
Objectives
The objectives were to assess the feasibility of conducting a definitive randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of lifestyle information and access to a commercial weight management group focusing on self-monitoring, goal-setting and motivation to achieve dietary change commencing 8–16 weeks postnatally to achieve and maintain weight management and positive lifestyle behaviour.
Design
The design was a randomised two-arm feasibility trial with a nested mixed-methods process evaluation.
Setting
The setting was a single centre in an inner city setting in the south of England.
Participants
Participants were women with body mass index scores of > 25 kg/m2 at antenatal ‘booking’ and women with normal body mass index scores (18.0–24.9 kg/m2) at antenatal booking who developed excessive gestational weight gain as assessed at 36 weeks’ gestation.
Main outcome measures
Recruitment, retention, acceptability of trial processes and identification of relevant economic data were the feasibility objectives. The proposed primary outcome was difference between groups in weight at 12 months postnatally, expressed as percentage weight change and weight loss from antenatal booking. Other proposed outcomes included assessment of diet, physical activity, smoking, alcohol consumption, body image, maternal esteem, mental health, infant feeding and NHS costs.
Results
Most objectives were achieved. A total of 193 women were recruited, 98 allocated to the intervention arm and 95 to the control arm. High follow-up rates (> 80%) were achieved to 12 months. There was an 8.8% difference in weight loss at 12 months between women allocated to the intervention arm and women allocated to the control arm (13.0% vs. 4.2%, respectively; p = 0.062); 47% of women in the intervention arm attended at least one weight management session, with low risk of contamination between arms. The greatest benefit was among women who attended ≥ 10 sessions. Barriers to attending sessions included capability, opportunity and motivation issues. Data collection tools were appropriate to support economic evaluation in a definitive trial, and economic modelling is feasible to quantify resource impacts and outcomes not directly measurable within a trial.
Limitations
The trial recruited from only one site. It was not possible to recruit women with normal body mass index scores who developed excessive pregnancy weight gain.
Conclusions
It was feasible to recruit and retain women with overweight or obese body mass index scores at antenatal booking to a trial comparing postnatal weight management plus standard care with standard care only and collect relevant data to assess outcomes. Approaches to recruit women with normal body mass index scores who gain excessive gestational weight need to be considered. Commercial weight management groups could support women’s weight management as assessed at 12 months postnatally, with probable greater benefit from attending ≥ 10 sessions. Process evaluation findings highlighted the importance of providing more information about the intervention on trial allocation, extended duration of time to commence sessions following birth and extended number of sessions offered to enhance uptake and retention. Results support the conduct of a future randomised controlled trial.
Trial registration
Current Controlled Trials ISRCTN39186148.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 9. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Debra Bick
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London, UK
| | - Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, UK
| | | | - Andy Healey
- King’s Health Economics, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Paul Seed
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London, UK
| | - Sarah Roberts
- King’s Health Economics, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | | | - Amanda Avery
- Faculty of Science, University of Nottingham, Nottingham, UK
| | | | | | | | | | - Bimpe Oki
- Public Health, London Borough of Lambeth, London, UK
| | | | - Lucilla Poston
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London, UK
| | - Michael Ussher
- Population Health Research Institute, St George’s, University of London, London, UK
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
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12
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Aldana-Parra F, Olaya G, Fewtrell M. Effectiveness of a new approach for exclusive breastfeeding counselling on breastfeeding prevalence, infant growth velocity and postpartum weight loss in overweight or obese women: protocol for a randomized controlled trial. Int Breastfeed J 2020; 15:2. [PMID: 31921328 PMCID: PMC6945425 DOI: 10.1186/s13006-019-0249-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 12/18/2019] [Indexed: 12/12/2022] Open
Abstract
Background Maternal overweight, infant feeding and early growth velocity are risk factors for obesity later in life. The first one thousand days are a window of opportunity to program health and disease. Exclusive breastfeeding may protect against obesity; however, it is not consistently practiced. Obesity rates have been increasing worldwide. Overweight or obese women have lower rates of breastfeeding and face mechanical, psychological and biological difficulties. Breastfeeding counselling is a successful strategy to support breastfeeding in normal weight women; but there is a lack of evidence on its effectiveness in overweight women. Our purpose is to evaluate a new approach to exclusive breastfeeding counselling based on Carl Rogers’ Centred-Client Theory in overweight women, and to examine effects on breastfeeding prevalence, infant growth velocity and maternal postpartum weight loss. Methods A two-arm simple randomized controlled trial will be conducted in overweight and obese women recruited in a Baby Friendly Hospital in Bogotá, Colombia. The intervention is exclusive breastfeeding counselling based on Rogers’ theory but adapted for overweight women; it will be performed during the last month of pregnancy, 24 h after delivery and during early infancy (1 and 3 months postpartum). The primary outcomes will be exclusive breastfeeding prevalence, infant growth velocity and maternal weight loss from birth up to 4 months after delivery; and the secondary outcomes will be prolactin and macronutrient levels in breast milk and serum prolactin levels. Intention to treat analysis will be performed to estimate the effect of the new counselling approach compared to standard management on the prevalence of exclusive breastfeeding, infant growth velocity and maternal weight loss. Discussion We hypothesize that the intervention will result in an increase in the initiation and maintenance of exclusive breastfeeding, allowing adequate infant growth velocity and maternal weight loss after delivery. It is hoped that the results of this trial will provide evidence to support public health policy on supporting breastfeeding in this vulnerable group of women. Trial registration (UTN) U1111–1228-9913 February 20th 2019; ISRCTN15922904 February 27th 2019, retrospectively registered.
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Affiliation(s)
- Fanny Aldana-Parra
- 1Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Gilma Olaya
- 1Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Mary Fewtrell
- 2UCL Great Ormond Street Institute of Child Health, London, UK
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Chang Y, Glaria AA, Davie P, Beake S, Bick D. Breastfeeding experiences and support for women who are overweight or obese: A mixed-methods systematic review. MATERNAL & CHILD NUTRITION 2020; 16:e12865. [PMID: 31240826 PMCID: PMC7038894 DOI: 10.1111/mcn.12865] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 12/21/2022]
Abstract
Women who are overweight or obese have increased health risks during and beyond pregnancy, with consequences for their infants' shorter and longer term health. Exclusive breastfeeding to 6 months has many benefits for women and their infants. However, women who are overweight or obese have lower rates of breastfeeding intention, initiation, and duration compared with women with normal weight. This systematic review aimed to examine evidence of (a) breastfeeding barriers and support experienced and perceived by women who are overweight or obese, (b) support shown to be effective in increasing breastfeeding initiation and duration among these women, and (c) perceptions of health care professionals, peer supporters, partners, and family members regarding providing breastfeeding support to these women. Sixteen quantitative and qualitative papers were included and critically appraised. Thematic synthesis was undertaken to obtain findings. Maternal physical barriers such as larger breasts, difficulties of positioning to breastfeed, delayed onset of lactation, perceived insufficient supply of breast milk, and impact of caesarean birth were evident. Maternal psychological barriers including low confidence in ability to breastfeed, negative body image, embarrassment at breastfeeding in public, and experiencing stigma of obesity were also described. Support from health care professionals and family members influenced breastfeeding outcomes. Education for maternity care professionals is needed to enable them to provide tailored, evidence-based support to women who are overweight or obese who want to breastfeed. Research on health care professionals, partners, and family members' experiences and views on supporting this group of women to breastfeed is needed to support development of appropriate interventions.
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Affiliation(s)
- Yan‐Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
| | | | - Philippa Davie
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Sarah Beake
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
| | - Debra Bick
- Warwick Clinical Trials UnitUniversity of WarwickCoventryUK
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Anindya IG, Salimo H, Retno Dewi YL. Hubungan Pemberian Asi Eksklusif Dan Status Gizi Ibu Dengan Pertumbuhan Lingkar Kepala Bayi Usia 6 Bulan. AMERTA NUTRITION 2019. [DOI: 10.20473/amnt.v3i4.2019.263-268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Measurement of head circumference is highly crucial during the early years of life which considered as an anthropometric parameter substantially correlated with brain size. The emergence of head circumference aberration functions to warn of abnormal brain development. Breast milk is the ideal nutritional provider that babies need for optimal healthy growth. Nursing mothers with good nutrition will affect their nutritional status. The nutritional status will determine the quantity and quality of dairy products that indirectly play a role in determining children’s nutritional status.Objective: Analyzing the relationship between exclusive breastfeeding and maternal nutritional status with the growth of the head circumference of 6 months old infants.Method: Using a cross-sectional design in the Kaliwates, Jember. Subjects were 6 months old infants in which 128 babies were selected by purposive sampling. Data on maternal nutritional status were based on Body Mass Index (BMI). Data on exclusive breastfeeding were based on interviews and KMS data. The baby’s head circumference data were based on direct measurements and those were interpreted using WHO growth charts. Then, the data were analyzed using Chi-Square test.Results: The results showed that there was a significant relationship between exclusive breastfeeding (p<0.001) and maternal nutritional status (p=0.028) with the growth of the baby’s head circumference.Conclusion: Exclusive breastfeeding and maternal nutritional status are associated with the growth of the baby’s head circumference. ABSTRAKLatar Belakang : Pengukuran lingkar kepala sangat penting selama tahun awal kehidupan, hal ini merupakan parameter antropometri yang sangat berkorelasi dengan ukuran otak. Terjadi penyimpangan pada lingkar kepala, maka memperingatkan perkembangan otak yang tidak normal. Air susu ibu merupakan penyedia nutrisi ideal yang dibutuhkan bayi untuk pertumbuhan yang sehat secara optimal. Ibu menyusui dengan pemenuhan gizi yang baik akan mempengaruhi status gizinya. Status gizi tersebut akan menentukan kuantitas dan kualitas produk susu yang secara tidak langsung berperan dalam menentukan status gizi anak.Tujuan : Menganalisis hubungan pemberian ASI eksklusif dan status gizi ibu dengan pertumbuhan lingkar kepala bayi usia 6 bulan.Metode : Menggunakan desain cross-sectional di wilayah Kecamatan Kaliwates, Kabupaten Jember. Subjek penelitian adalah bayi usia 6 bulan, 128 bayi dipilih dengan purposive sampling. Data status gizi ibu berdasarkan IMT. Data pemberian ASI eksklusif berdasarkan wawancara dan data KMS. Data lingkar kepala bayi berdasarkan pengukuran langsung dan diinterprestasikan menggunakan grafik pertumbuhan WHO. Analisis data menggunakan uji Chi-Square.Hasil : Hasil penelitian menunjukkan bahwa ada hubungan yang bermakna antara pemberian ASI eksklusif (ρ = <0,001 dan OR 9,58) dan status gizi ibu (ρ = 0,028 dan OR 0,28) dengan pertumbuhan lingkar kepala bayi usia 6 bulan.Kesimpulan : Pemberian ASI eksklusif pada bayi akan memberikan pertumbuhan lingkar kepala yang normal dibandingkan bayi yang tidak diberikan ASI eksklusif dan pada ibu yang memiliki status gizi baik juga akan memberikan pertumbuhan lingkar kepala bayi yang normal dibandingkan dengan ibu berstatus gizi kurang dan gemuk. Kata kunci : status gizi, ASI eksklusif, lingkar kepala
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Maternal body dissatisfaction in pregnancy, postpartum and early parenting: An overlooked factor implicated in maternal and childhood obesity risk. Appetite 2019; 147:104525. [PMID: 31756411 DOI: 10.1016/j.appet.2019.104525] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/18/2019] [Accepted: 11/18/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Current evidence indicates that to prevent the intergenerational transfer of overweight and obesity from parent to child, interventions are needed across the early life stages, from preconception to early childhood. Maternal body image is an important but often overlooked factor that is potentially implicated in both short- and long-term maternal and child health outcomes, including maternal gestational weight gain, postpartum weight retention, obesity, child feeding practices and early parenting. AIM The aim of this paper is to propose a conceptual model of the relationship between maternal body image (with a specific focus on body dissatisfaction) and maternal and child excess body weight risk across the pregnancy, postpartum and early childhood periods, as well as to highlight opportunities for intervention. CONCLUSION Our conceptual model proposes factors that mediate the associations between antenatal and postpartum maternal body dissatisfaction and maternal and childhood obesity risk. Pregnancy and postpartum present key risk periods for excess weight gain/retention and body dissatisfaction. Psychosocial factors associated with maternal body dissatisfaction, including psychopathology and disordered eating behaviours, may increase maternal and child obesity risk as well as compromise the quality of mother-child interactions underpinning child development outcomes, including physical weight gain. Our conceptual model may be useful for understanding modifiable psychosocial factors for preventing the intergenerational transfer of obesity risk from mothers to their children, from as early as pregnancy, and highlights next steps for multidisciplinary research focused on combatting maternal and child obesity during critical risk periods.
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Morley-Hewitt AG, Owen AL. A systematic review examining the association between female body image and the intention, initiation and duration of post-partum infant feeding methods (breastfeeding vs bottle-feeding). J Health Psychol 2019; 25:207-226. [DOI: 10.1177/1359105319833744] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A systematic review was conducted to examine female body image in relation to the intention, initiation and duration of post-partum infant feeding methods. A search of 10 databases was conducted to identify studies. A total of nine studies were included in the systematic review. All studies were of a non-randomised control design with a total of 13,046 participants. Findings suggest that exclusive breastfeeding is more likely in pregnant women with a higher body image, while those with body concerns had less intention to breastfeed or initiate, with those who start having a shorter duration.
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Association between gestational weight gain and exclusive breast-feeding for the first 6 months postpartum in Chinese women. Public Health Nutr 2019; 22:2092-2098. [PMID: 30859927 DOI: 10.1017/s1368980019000387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The association between gestational weight gain (GWG) and exclusive breast-feeding (EBF) practices remains unclear. The present study evaluated the association between GWG and EBF in the first 6 months postpartum among primiparas in rural China. DESIGN The study population was drawn from a previous randomized controlled trial, and the relevant data were obtained from an electronic, population-based perinatal system and a monitoring system for child health care. GWG was categorized according to the guidelines of the Institute of Medicine. SETTING Five rural counties in Hebei Province, China.ParticipantsA total of 8449 primiparas. RESULTS Of the women, 58·7 % breast-fed exclusively for the first 6 months postpartum. Overweight women who gained either more or less weight than the recommended GWG tended to experience failure of EBF (OR=0·49; 95 % CI 0·34, 0·70; P<0·001 and OR=0·79; 95 % CI 0·63, 0·99; P=0·048, respectively). The same results were also observed among obese women; the OR for lower and greater weight gain were 0·28 (95 % CI 0·08, 0·94; P=0·04) and 0·55 (95 % CI 0·32, 0·95; P=0·03), respectively. CONCLUSIONS GWG that is below or above the Institute of Medicine recommendations is associated with EBF behaviour for the first 6 months postpartum in overweight and obese primiparas in rural China.
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Huang Y, Ouyang YQ, Redding SR. Maternal Prepregnancy Body Mass Index, Gestational Weight Gain, and Cessation of Breastfeeding: A Systematic Review and Meta-Analysis. Breastfeed Med 2019; 14:366-374. [PMID: 31081684 DOI: 10.1089/bfm.2018.0138] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: Suboptimal breastfeeding, a major factor of maternal and child morbidity and mortality, has been reported around the world. Maternal weight status, as a significant variable influencing breastfeeding outcomes, needs to be studied sufficiently. Objective: This review is to explore the effect of different prepregnancy BMI and gestational weight gain (GWG) categories on breastfeeding initiation and cessation. Materials and Methods: Cohort studies were systematically searched in Embase, Web of Science, PubMed, and CINAHL databases from database establishment to February 2019. Summary risk ratio (RR) on breastfeeding initiation and cessation was estimated with the use of a random-effects model. Results: Thirty cohort studies were included in meta-analysis. Prepregnancy obesity was a risk factor for breastfeeding initiation (RR 1.49, 95% CI [1.33-1.67]), exclusive and any breastfeeding (ABF) duration (RR 1.26, 95% CI [1.17-1.36]; RR 1.34 95% CI [1.16-1.56]). Inadequate GWG was a risk factor for breastfeeding initiation (RR 1.27, 95% CI [1.08-1.49]). Excessive GWG was a risk factor for ABF duration when women were prepregnancy overweight and obese (RR 1.42 95% CI [1.32-1.53]; RR 1.89 95% CI [1.13-3.17]). Conclusion: If women are obese before pregnancy or gain excessive/inadequate weight during pregnancy, they are less likely to initiate and continue breastfeeding according to recommendation time. Hence, guidance about proper weight management to reproductive age women and consultation about recommended GWG to pregnant women should be fully implemented to improve breastfeeding practices. Besides, future research needs to find out the association between prepregnancy underweight status and breastfeeding outcomes.
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Affiliation(s)
- Yi Huang
- School of Health Sciences, Wuhan University, Wuhan, China
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19
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McKenzie SA, Rasmussen KM, Garner CD. Experiences and Perspectives About Breastfeeding in "Public": A Qualitative Exploration Among Normal-Weight and Obese Mothers. J Hum Lact 2018; 34:760-767. [PMID: 29438633 DOI: 10.1177/0890334417751881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Women face societal and cultural barriers to breastfeeding. These challenges have been investigated in international studies and U.S. public opinion polls; however, mothers' experiences with breastfeeding in public in the United States remain unexplored. Research aim: The aim of this study was to describe the experiences of obese and normal-weight women with breastfeeding in public in central New York. METHODS Pregnant women ( N = 26) in central New York who intended to breastfeed and were either normal weight or obese were enrolled during their third trimester. A longitudinal, qualitative study was conducted to obtain information about women's experiences from birth through 3 to 6 months postpartum. Interviews were audio recorded, transcribed, and verified for accuracy. Transcripts were analyzed iteratively using conventional content analysis. RESULTS The concept of "public" was situational rather than a set of physical places; women experienced challenges while breastfeeding around others in private locations that were indistinguishable from those they encountered in places typically considered public. Women experienced social and physical awkwardness including perceived lack of acceptability, fear of confrontation, exposure, and positioning difficulties. They used strategies to reduce awkwardness, for example, being "discreet" and minimizing breastfeeding around other people. Obese women experienced similar challenges but to a greater degree than normal-weight women. CONCLUSION "Breastfeeding around others" described mother's experiences more accurately than "breastfeeding in public" and was experienced as awkward both socially and physically, particularly by obese women. Strategies are needed to normalize breastfeeding in the United States and to prepare mothers for the challenges of breastfeeding around others.
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Affiliation(s)
| | | | - Christine D Garner
- 1 Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.,2 Department of Pediatrics, Texas Tech University School of Medicine, Amarillo, TX, USA
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Mrosková S, Schlosserová A, Reľovská M. Analysis of selected determinants of intention to breastfeed. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2018. [DOI: 10.15452/cejnm.2018.09.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Bigman G, Wilkinson AV, Homedes N, Pérez A. Body Image Dissatisfaction, Obesity and Their Associations with Breastfeeding in Mexican Women, a Cross-Sectional Study. Matern Child Health J 2018; 22:1815-1825. [DOI: 10.1007/s10995-018-2583-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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22
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Pinheiro TV, Goldani MZ. Maternal pre-pregnancy overweight/obesity and gestational diabetes interaction on delayed breastfeeding initiation. PLoS One 2018; 13:e0194879. [PMID: 29912885 PMCID: PMC6005508 DOI: 10.1371/journal.pone.0194879] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/12/2018] [Indexed: 12/16/2022] Open
Abstract
Background Cumulative evidence indicates an association between maternal overweight and gestational diabetes with delayed breastfeeding initiation; however, the presence of both conditions simultaneously has been little explored. This study aims to investigate the interaction between maternal overweight/obesity and gestational diabetes on breastfeeding initiation. Methods This study comprises data from the IVAPSA Birth Cohort, a prospective follow-up of mothers and their newborns. Two of the five groups from IVAPSA were evaluated, considering women with and without gestational diabetes. These women were further categorized according to their pre-pregnancy body mass index as normal weight or overweight/obese. Results 219 women were evaluated, 53.4% of them had pre-pregnancy overweight/obesity and 32% had gestational diabetes. Most women were able to initiate breastfeeding within 12 hours from delivery (92.7%) and only eight (3.7%) women had not breastfed in the first 24 hours postpartum. Of these, seven were overweight/obese (77.8%) and five had gestational diabetes (66.7%), with four of them having overweight/obesity and gestational diabetes concomitantly. Women with both adverse conditions had an adjusted relative risk of delayed breastfeeding initiation of 1.072 (95% CI 1.006; 1.141), p = 0.032. Conclusions The results indicate an additive interaction between maternal pre-pregnancy overweight/obesity and gestational diabetes on delayed breastfeeding initiation.
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Affiliation(s)
- Tanara Vogel Pinheiro
- Department of pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
| | - Marcelo Zubaran Goldani
- Department of pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of pediatrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - IVAPSA group
- Department of pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of pediatrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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GÜNEY E, UÇAR T. Gebelikteki beden imajının emzirme tutumu ve doğum sonu emzirme sürecine etkisi. ACTA ACUST UNITED AC 2018. [DOI: 10.16948/zktipb.338783] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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"You just need to leave the room when you breastfeed" Breastfeeding experiences among obese women in Sweden - A qualitative study. BMC Pregnancy Childbirth 2018; 18:39. [PMID: 29357814 PMCID: PMC5778622 DOI: 10.1186/s12884-017-1656-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 12/29/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The benefits of breastfeeding for the infant as well for the mother are well-known. It is recognized that obese (Body Mass Index ≥30 kg/m2) women may have less antenatal intention to breastfeed, and shortened duration of breastfeeding compared with normal-weight women. This may result in adverse short- and long-term health for both mother and child, such as a shortened lactational amenorrhoea and decreased protection against breast cancer for the women, and an increased risk for infectious diseases and overweight/obesity among the children. Therefore, it is important to gain more knowledge and understanding of obese women's experiences of breastfeeding in order to attain good health care. Hence, the aim of this study was to identify and describe obese women's experiences of breastfeeding. METHODS This is an explorative study. Data was collected 2 - 18 months after childbirth through semi-structured face-to-face interviews with 11 obese women with breastfeeding experience. The interviews were recorded and transcribed verbatim. Thematic analysis was used. RESULTS Three themes emerged from the data analysis: Breastfeeding - a part of motherhood, the challenges of breastfeeding, and support for breastfeeding. The women described an antenatal hope for breastfeeding, the body's ability to produce milk fascinated them, and the breast milk was seen as the best way to feed the child and also as promoting the attachment between mother and child. Breastfeeding was described as a challenge even though it is natural. The challenges concerned technical difficulties such as the woman finding a good body position and helping the child to achieve an optimum grip of the nipple. Another challenge was the exposure of the body connected to public breastfeeding. Support of breastfeeding was described as the importance of being confirmed as an individual behind the obesity, rather than an individual with obesity, and to obtain enough professional breastfeeding support. CONCLUSIONS Breastfeeding was experienced as a natural part of being a mother. There were practical challenges for obese women concerning how to manage breastfeeding and how to handle the public exposure of the body. There was a need for realistic information about breastfeeding concerning both the child and the woman.
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Han SY, Brewis AA. Influence of weight concerns on breastfeeding: Evidence from the Norwegian mother and child cohort study. Am J Hum Biol 2017; 30. [PMID: 29193610 PMCID: PMC5947548 DOI: 10.1002/ajhb.23086] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 10/12/2017] [Accepted: 11/11/2017] [Indexed: 11/18/2022] Open
Abstract
Objectives High body mass index (BMI) often predicts truncated breastfeeding, although why is unclear. We test a proposed mediating role of body concerns on breastfeeding initiation and child's age at weaning using longitudinal data for 55,522 mothers from the Norwegian Mother and Child Cohort Study (MoBa). Methods A linear regression‐based mediation analysis with bootstrapping estimates the indirect effects of BMI on breastfeeding decisions (ever‐initiation of breastfeeding, child's age at weaning, and duration of any breastfeeding beyond six months) through the variables of concern around prepregnancy weight and weight gains due to pregnancy. Results Contrary to prediction, Norwegian mothers with greater prepregnancy weight concerns had a higher likelihood of initiating breastfeeding. Concerns about weight gain during pregnancy, however, predicted earlier weaning. This relationship was the same for higher and lower BMI mothers. Conclusion In this very large sample, body image affects some breastfeeding decisions. However, this effect is independent of mother's body size.
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Affiliation(s)
- Seung-Yong Han
- Mayo Clinic/Arizona State University Obesity Solutions, Tempe, Arizona 85287
| | - Alexandra A Brewis
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona 85287
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Boudet-Berquier J, Salanave B, Desenclos JC, Castetbon K. Association between maternal prepregnancy obesity and breastfeeding duration: Data from a nationwide prospective birth cohort. MATERNAL AND CHILD NUTRITION 2017; 14:e12507. [PMID: 28851047 DOI: 10.1111/mcn.12507] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 07/05/2017] [Accepted: 07/22/2017] [Indexed: 01/18/2023]
Abstract
Association of maternal obesity with shorter breastfeeding duration may involve different factors and might be modified by parity. In a national birth cohort, we aimed to estimate the association between prepregnancy body mass index (pBMI) and breastfeeding duration after adjustment for sociodemographic, pregnancy, and other characteristics and assess the effect modification of parity in such associations. In 2012, 3,368 mother-infant dyads were randomly included at birth in the French Epifane cohort. Breastfeeding information was collected in maternity wards and by phone interview at 1, 4, 8, and 12 months postpartum. Poisson regression analyses estimated the association of pBMI with the number of days of "any breastfeeding" (ABF) and "exclusive breastfeeding" (EBF) in unadjusted and adjusted models. Interactions between parity and pBMI were tested. Obesity before pregnancy was independently associated with shorter ABF duration (incidence rate ratio [IRR] = 0.86, 95%CI [0.74, 0.99]) compared to normal-weight status. Parity showed an effect modification only with EBF duration. Among primiparae, no association was found for obesity, but overweight was significantly associated with shorter EBF duration independently of all covariates (IRR = 0.74 [0.58, 0.95]). Among multiparas, obesity was associated with shorter EBF duration after controlling for sociodemographic factors (IRR = 0.71 [0.53, 0.95]). This association was no longer statistically significant after controlling for other covariates. Obesity appears to be a strong risk factor in shorter ABF duration. Furthermore, parity is a key factor in the relationship of pBMI to shorter EBF duration. Overweight primiparous and obese multiparous women need additional support to prolong breastfeeding duration.
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Affiliation(s)
- Julie Boudet-Berquier
- Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Paris-13 University, Centre de recherche en épidémiologie et statistiques, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Benoit Salanave
- Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Paris-13 University, Centre de recherche en épidémiologie et statistiques, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Jean-Claude Desenclos
- French Public Health Agency (Agence nationale de Santé Publique), Saint Maurice, France
| | - Katia Castetbon
- School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Roomruangwong C, Kanchanatawan B, Sirivichayakul S, Maes M. High incidence of body image dissatisfaction in pregnancy and the postnatal period: Associations with depression, anxiety, body mass index and weight gain during pregnancy. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 13:103-109. [PMID: 28844350 DOI: 10.1016/j.srhc.2017.08.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/17/2017] [Accepted: 08/05/2017] [Indexed: 10/19/2022]
Abstract
This study aimed to delineate the prevalence of body image dissatisfaction in pregnant women and parturients in relation to depression and anxiety symptoms. We assessed 126 pregnant women during the third trimester and 2-3days and 4-6weeks after delivery using the Body Image Scale (BIS). Many pregnant participants (34.1%) showed body image dissatisfaction (BIS score ≤3) which was associated with current antenatal depression, severity of depression, a lifetime history of mood disorders, trait anxiety, body mass index (BMI) and weight gain during pregnancy. The BIS score improved after delivery but was still associated with depression, lifetime history of mood disorders, age, BMI and weight gain during pregnancy. These findings suggest that about a third of pregnant women have a body image disturbance which is strongly associated with current and a life history of clinical depression and anxiety symptoms. Medical personnel should be alert to detect body image dissatisfaction in pregnant women because it may indicate an underlying mood disorder.
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Affiliation(s)
- Chutima Roomruangwong
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Buranee Kanchanatawan
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; IMPACT Research Center, Deakin University, Geelong, Australia; Department of Psychiatry, Faculty of Medicine, State University of Londrina, Londrina, Brazil. http://scholar.google.co.th/citations?user=1wzMZ7UAAAAJ&hl=th&oi=ao
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Intentions and barriers toward breastfeeding among Jordanian mothers—A cross sectional descriptive study using quantitative method. Women Birth 2017; 30:e152-e157. [DOI: 10.1016/j.wombi.2016.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 11/01/2016] [Accepted: 11/03/2016] [Indexed: 11/21/2022]
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Meireles JFF, Neves CM, de Carvalho PHB, Ferreira MEC. Body dissatisfaction among pregnant women: an integrative review of the literature. CIENCIA & SAUDE COLETIVA 2017; 20:2091-103. [PMID: 26132248 DOI: 10.1590/1413-81232015207.05502014] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 09/19/2014] [Indexed: 12/19/2022] Open
Abstract
The body image of pregnant women is an issue that should be further investigated by professionals in the area, especially in view of the fact that maternal and infant health has gained such prominence. The scope of this integrative review is to analyze the literature relating to body image and body dissatisfaction among pregnant women. Research was based on articles extracted from the Scopus, PubMed, BVS and PsycINFO databases, by cross-referencing "pregnancy" with the keywords "body image" and "body dissatisfaction." Once the inclusion and exclusion criteria had been adopted, forty studies were analyzed. These produced inconclusive data about body dissatisfaction during pregnancy. Symptoms of depression, low self-esteem, an inadequate approach towards healthy eating and weight gain above recommended limits have been associated with a negative body image. The contradictory findings could be related to the different instruments used to measure body image. In view of the possible impact that a negative body image can have on maternal and infant health during pregnancy, it is recommended that further investigations are made, in particular related to the development of a specific tool to evaluate the body image of pregnant women.
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Swanson V, Keely A, Denison FC. Does body image influence the relationship between body weight and breastfeeding maintenance in new mothers? Br J Health Psychol 2017; 22:557-576. [DOI: 10.1111/bjhp.12246] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 04/12/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Vivien Swanson
- Psychology Division; Faculty of Natural Sciences; University of Stirling; UK
| | | | - Fiona C. Denison
- Maternal and Fetal Health; MRC Centre for Reproductive Health; Queen's Medical Research Institute; Edinburgh UK
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Breastfeeding after Gestational Diabetes: Does Perceived Benefits Mediate the Relationship? J Pregnancy 2017; 2017:9581796. [PMID: 28421146 PMCID: PMC5380849 DOI: 10.1155/2017/9581796] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 03/16/2017] [Indexed: 12/20/2022] Open
Abstract
Introduction. Breastfeeding is recognized as one of the best ways to decrease infant mortality and morbidity. However, women with gestational diabetes mellitus (GDM) may have breastfeeding barriers due to the increased risk of neonatal and pregnancy complications. While the prevalence of GDM is increasing worldwide, it is important to understand the full implications of GDM on breastfeeding outcomes. The current study aims to investigate the (1) direct effect of GDM on breastfeeding duration and (2) indirect effect of GDM on breastfeeding duration through perceived benefits of breastfeeding. Methods. Prospective cohort data from the Infant Feeding and Practices Study II was analyzed (N = 4,902). Structural equation modeling estimated direct and indirect effects. Results. Perceived benefits of breastfeeding directly influenced breastfeeding duration (β = 0.392, p ≤ 0.001). GDM was not directly associated with breastfeeding duration or perceived benefits of breastfeeding. Similarly, GDM did not have an indirect effect on breastfeeding duration through perceived benefits of breastfeeding. Conclusions. Perceived benefits of breastfeeding are an important factor associated with breastfeeding duration. Maternal and child health care professionals should enhance breastfeeding education efforts.
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Meireles JFF, Neves CM, Carvalho PHBD, Ferreira MEC. Imagem corporal, atitudes alimentares, sintomas depressivos, autoestima e ansiedade em gestantes de Juiz de Fora, Minas Gerais, Brasil. CIENCIA & SAUDE COLETIVA 2017. [DOI: 10.1590/1413-81232017222.23182015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Resumo As mudanças vivenciadas pelas gestantes podem impactar negativamente as atitudes corporais e as variáveis associadas. Dessa forma, o objetivo deste estudo foi verificar a influência das atitudes alimentares, sintomas depressivos, autoestima, ansiedade e IMC na imagem corporal de gestantes. Este estudo quantitativo e transversal contou com 386 gestantes de todas as idades gestacionais, entre 18 a 46 anos de idade (média de 29,32 ± 6,04 anos) da cidade de Juiz de Fora-MG. Foram aplicados instrumentos para avaliar atitudes corporais, atitudes alimentares, sintomas depressivos, autoestima e ansiedade. Foram coletados dados antropométricos e obstétricos. Realizou-se análises estatísticas descritivas, comparativas e correlacionais. Os achados indicaram correlações significativas entre as atitudes corporais e: atitudes alimentares inadequadas (r = 0,478), sintomas depressivos (r = 0,387), baixa autoestima (r = 0,431) e elevado IMC (r = 0,339). Além disso, essas variáveis juntas exerceram influência de 41,4% sobre a imagem corporal negativa das gestantes. Assim, recomenda-se a avaliação e a orientação nutricional e psicológica a fim de detectar e prevenir psicopatologias, tendo em vista a saúde materna e infantil.
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Meireles JFF, Neves CM, Carvalho PHBD, Ferreira MEC. Imagem corporal de gestantes: um estudo longitudinal. JORNAL BRASILEIRO DE PSIQUIATRIA 2016. [DOI: 10.1590/0047-2085000000128] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
RESUMO Objetivos Comparar atitudes corporais, atitudes alimentares, sintomas depressivos, autoestima, ansiedade e índice de massa corporal (IMC) de gestantes em diferentes momentos ao longo da gestação, bem como verificar a influência que as variáveis estudadas exercem sobre as atitudes corporais no primeiro, segundo e terceiro trimestre gestacional. Métodos Foram incluídas 17 gestantes que frequentavam o exame pré-natal na cidade de Juiz de Fora-MG, entre 22 e 41 anos de idade (média de 30,76 ± 5,65 anos), excluindo-se aquelas com dados incompletos. Como instrumentos de avaliação utilizaram-se: Body Attitudes Questionnaire, Eating Attitudes Test-26, Beck Depression Inventory, Rosenberg Self-esteem Scale, a versão curta do Brazilian State-Trait Anxiety Inventory e o questionário sociodemográfico. Ademais, foram coletados dados antropométricos e obstétricos. Foram realizadas análises estatísticas descritivas, comparativas e correlacionais. Resultados O IMC, as atitudes corporais negativas e a subescala “sentimento de gordura” aumentaram progressivamente ao longo da gestação (p < 0,01). As atitudes alimentares, os sintomas depressivos, a autoestima e a ansiedade-estado não diferiram estatisticamente nos três momentos avaliados (p > 0,05). Além disso, o IMC explicou 31% da variância das atitudes direcionadas ao corpo no primeiro trimestre, enquanto as atitudes alimentares foram responsáveis por 30% e 46% das atitudes corporais no segundo e terceiro trimestre, respectivamente. Conclusões As atitudes corporais, as atitudes alimentares, os sintomas depressivos, a autoestima e a ansiedade mantiveram-se constantes ao longo da gestação. O IMC e as atitudes alimentares influenciaram a imagem corporal em gestantes. Sugere-se a criação de instrumentos específicos a fim de um melhor entendimento das preocupações relacionadas ao corpo de gestantes.
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Garner CD, McKenzie SA, Devine CM, Thornburg LL, Rasmussen KM. Obese women experience multiple challenges with breastfeeding that are either unique or exacerbated by their obesity: discoveries from a longitudinal, qualitative study. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 27452978 DOI: 10.1111/mcn.12344] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/17/2016] [Accepted: 05/18/2016] [Indexed: 12/01/2022]
Abstract
Obese women are at risk for shorter breastfeeding duration, but little is known about how obese women experience breastfeeding. The aim of this study was to understand obese women's breastfeeding experiences. We enrolled pregnant women in upstate New York, who were either obese [n = 13; body mass index (BMI) ≥30 kg/m2 ] or normal weight (n = 9; BMI 18.5-24.9 kg/m2 ) before conception and intended to breastfeed. A longitudinal, qualitative study was conducted from February 2013 through August 2014 with semi-structured interviews during pregnancy and at specific times post-partum through 3 months. Interviews were audio recorded, transcribed and analyzed using content analysis. Themes that emerged in analysis were compared between obese and normal-weight women. Differences were identified and described. Prenatally, obese women expressed less confidence about breastfeeding than normal-weight women. Post-partum, obese women and their infants had more health issues that affected breastfeeding, such as low infant blood glucose. Compared with normal-weight women, they also experienced more challenges with latching and positioning their infants. Breastfeeding required more time, props and pillows, which limited where obese women could breastfeed. Obese women also experienced more difficulty finding nursing bras and required more tangible social support than normal-weight women. In conclusion, obese women experienced more challenges than women of normal weight; some challenges were similar to those of normal-weight women but were experienced to a greater degree or a longer duration. Other challenges were unique. Obese women could benefit from targeted care prenatally and during the hospital stay as well as continued support post-partum to improve breastfeeding outcomes. © 2016 John Wiley & Sons Ltd.
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Affiliation(s)
| | | | - Carol M Devine
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Loralei L Thornburg
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York, USA
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Masho SW, Morris MR, Wallenborn JT. Role of Marital Status in the Association between Prepregnancy Body Mass Index and Breastfeeding Duration. Womens Health Issues 2016; 26:468-75. [DOI: 10.1016/j.whi.2016.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 05/11/2016] [Accepted: 05/16/2016] [Indexed: 10/21/2022]
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36
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Garcia AH, Voortman T, Baena CP, Chowdhurry R, Muka T, Jaspers L, Warnakula S, Tielemans MJ, Troup J, Bramer WM, Franco OH, van den Hooven EH. Maternal weight status, diet, and supplement use as determinants of breastfeeding and complementary feeding: a systematic review and meta-analysis. Nutr Rev 2016; 74:490-516. [PMID: 27330143 DOI: 10.1093/nutrit/nuw016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
CONTEXT Infant feeding practices are influenced by maternal factors. OBJECTIVE The aim of this review is to examine the associations between maternal weight status or dietary characteristics and breastfeeding or complementary feeding. DATA SOURCES A systematic literature search of the Embase, Cochrane Library, Google Scholar, MEDLINE, PubMed, and Web of Science databases was performed. STUDY SELECTION Interventional and cohort studies in healthy mothers and infants that reported on maternal weight status, diet, or supplement use were selected. DATA EXTRACTION Outcomes assessed included delayed onset of lactogenesis; initiation, exclusivity, duration, and cessation of breastfeeding; and timing of complementary feeding. DATA ANALYSIS Eighty-one studies were included. Maternal underweight, diet, and supplement use were not associated with infant feeding practices. Obese women had a relative risk of failure to initiate breastfeeding (risk ratio [RR] = 1.23; 95%CI, 1.03-1.47) and a delayed onset of lactogenesis (RR = 2.06; 95%CI, 1.18-3.61). The RR for breastfeeding cessation was 1.11 (95%CI, 1.07-1.15) per increase in category of body mass index. CONCLUSIONS Prevention of obesity in women of reproductive age, as well as counseling of obese women after delivery, could be targeted to improve infant feeding practices.
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Affiliation(s)
- Audry H Garcia
- A.H. Garcia, T. Voortman, C.P. Baena, T. Muka, L. Jaspers, M.J. Tielemans, J. Troup, O.H. Franco, and E.H. van den Hooven are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. C.P. Baena is with the Pontifical Catholic University of Parana, Curitiba, Brazil. R. Chowdhurry and S. Warnakula are with the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Trudy Voortman
- A.H. Garcia, T. Voortman, C.P. Baena, T. Muka, L. Jaspers, M.J. Tielemans, J. Troup, O.H. Franco, and E.H. van den Hooven are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. C.P. Baena is with the Pontifical Catholic University of Parana, Curitiba, Brazil. R. Chowdhurry and S. Warnakula are with the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
| | - Cristina P Baena
- A.H. Garcia, T. Voortman, C.P. Baena, T. Muka, L. Jaspers, M.J. Tielemans, J. Troup, O.H. Franco, and E.H. van den Hooven are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. C.P. Baena is with the Pontifical Catholic University of Parana, Curitiba, Brazil. R. Chowdhurry and S. Warnakula are with the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
| | - Rajiv Chowdhurry
- A.H. Garcia, T. Voortman, C.P. Baena, T. Muka, L. Jaspers, M.J. Tielemans, J. Troup, O.H. Franco, and E.H. van den Hooven are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. C.P. Baena is with the Pontifical Catholic University of Parana, Curitiba, Brazil. R. Chowdhurry and S. Warnakula are with the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Taulant Muka
- A.H. Garcia, T. Voortman, C.P. Baena, T. Muka, L. Jaspers, M.J. Tielemans, J. Troup, O.H. Franco, and E.H. van den Hooven are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. C.P. Baena is with the Pontifical Catholic University of Parana, Curitiba, Brazil. R. Chowdhurry and S. Warnakula are with the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Loes Jaspers
- A.H. Garcia, T. Voortman, C.P. Baena, T. Muka, L. Jaspers, M.J. Tielemans, J. Troup, O.H. Franco, and E.H. van den Hooven are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. C.P. Baena is with the Pontifical Catholic University of Parana, Curitiba, Brazil. R. Chowdhurry and S. Warnakula are with the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Samantha Warnakula
- A.H. Garcia, T. Voortman, C.P. Baena, T. Muka, L. Jaspers, M.J. Tielemans, J. Troup, O.H. Franco, and E.H. van den Hooven are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. C.P. Baena is with the Pontifical Catholic University of Parana, Curitiba, Brazil. R. Chowdhurry and S. Warnakula are with the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Myrte J Tielemans
- A.H. Garcia, T. Voortman, C.P. Baena, T. Muka, L. Jaspers, M.J. Tielemans, J. Troup, O.H. Franco, and E.H. van den Hooven are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. C.P. Baena is with the Pontifical Catholic University of Parana, Curitiba, Brazil. R. Chowdhurry and S. Warnakula are with the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Jenna Troup
- A.H. Garcia, T. Voortman, C.P. Baena, T. Muka, L. Jaspers, M.J. Tielemans, J. Troup, O.H. Franco, and E.H. van den Hooven are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. C.P. Baena is with the Pontifical Catholic University of Parana, Curitiba, Brazil. R. Chowdhurry and S. Warnakula are with the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Wichor M Bramer
- A.H. Garcia, T. Voortman, C.P. Baena, T. Muka, L. Jaspers, M.J. Tielemans, J. Troup, O.H. Franco, and E.H. van den Hooven are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. C.P. Baena is with the Pontifical Catholic University of Parana, Curitiba, Brazil. R. Chowdhurry and S. Warnakula are with the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Oscar H Franco
- A.H. Garcia, T. Voortman, C.P. Baena, T. Muka, L. Jaspers, M.J. Tielemans, J. Troup, O.H. Franco, and E.H. van den Hooven are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. C.P. Baena is with the Pontifical Catholic University of Parana, Curitiba, Brazil. R. Chowdhurry and S. Warnakula are with the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Edith H van den Hooven
- A.H. Garcia, T. Voortman, C.P. Baena, T. Muka, L. Jaspers, M.J. Tielemans, J. Troup, O.H. Franco, and E.H. van den Hooven are with the Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. C.P. Baena is with the Pontifical Catholic University of Parana, Curitiba, Brazil. R. Chowdhurry and S. Warnakula are with the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. W.M. Bramer is with the Medical Library, Erasmus MC, University Medical Center Rotterdam, the Netherlands
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Newby RM, Davies PSW. Antenatal breastfeeding intention, confidence and comfort in obese and non-obese primiparous Australian women: associations with breastfeeding duration. Eur J Clin Nutr 2016; 70:935-40. [DOI: 10.1038/ejcn.2016.29] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 01/05/2016] [Accepted: 01/15/2016] [Indexed: 02/05/2023]
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Brown A. Breast is best, but not in my back-yard. Trends Mol Med 2015; 21:57-9. [PMID: 25662875 DOI: 10.1016/j.molmed.2014.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 11/18/2014] [Accepted: 11/20/2014] [Indexed: 11/15/2022]
Abstract
Breastfeeding may be the biological norm, but in Western culture it is not the social norm. Although intention to breastfeed is high, new mothers emerge into a formula-feeding culture where formula milk appears as the solution to the public harassment, negative attitudes, and lack of support that breastfeeding women face.
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Affiliation(s)
- Amy Brown
- Department of Public Health and Policy Studies, Swansea University, Swansea, SA2 8PP, UK.
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Herskin CW, Stage E, Barfred C, Emmersen P, Ladefoged Nichum V, Damm P, Mathiesen ER. Low prevalence of long-term breastfeeding among women with type 2 diabetes. J Matern Fetal Neonatal Med 2015; 29:2513-8. [DOI: 10.3109/14767058.2015.1092138] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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40
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Marchi J, Berg M, Dencker A, Olander EK, Begley C. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev 2015; 16:621-38. [PMID: 26016557 DOI: 10.1111/obr.12288] [Citation(s) in RCA: 555] [Impact Index Per Article: 61.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 04/08/2015] [Accepted: 04/08/2015] [Indexed: 01/08/2023]
Abstract
Maternal obesity is linked with adverse outcomes for mothers and babies. To get an overview of risks related to obesity in pregnant women, a systematic review of reviews was conducted. For inclusion, reviews had to compare pregnant women of healthy weight with women with obesity, and measure a health outcome for mother and/or baby. Authors conducted full-text screening, quality assurance using the AMSTAR tool and data extraction steps in pairs. Narrative analysis of the 22 reviews included show gestational diabetes, pre-eclampsia, gestational hypertension, depression, instrumental and caesarean birth, and surgical site infection to be more likely to occur in pregnant women with obesity compared with women with a healthy weight. Maternal obesity is also linked to greater risk of preterm birth, large-for-gestational-age babies, foetal defects, congenital anomalies and perinatal death. Furthermore, breastfeeding initiation rates are lower and there is greater risk of early breastfeeding cessation in women with obesity compared with healthy weight women. These adverse outcomes may result in longer duration of hospital stay, with concomitant resource implications. It is crucial to reduce the burden of adverse maternal and foetal/child outcomes caused by maternal obesity. Women with obesity need support to lose weight before they conceive, and to minimize their weight gain in pregnancy.
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Affiliation(s)
- J Marchi
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - M Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - A Dencker
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - E K Olander
- Centre for Maternal and Child Health Research, City University London, London, United Kingdom
| | - C Begley
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Bever Babendure J, Reifsnider E, Mendias E, Moramarco MW, Davila YR. Reduced breastfeeding rates among obese mothers: a review of contributing factors, clinical considerations and future directions. Int Breastfeed J 2015; 10:21. [PMID: 26140049 PMCID: PMC4488037 DOI: 10.1186/s13006-015-0046-5] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 06/06/2015] [Indexed: 02/06/2023] Open
Abstract
Maternal obesity is associated with significantly lower rates of breastfeeding initiation, duration and exclusivity. Increasing rates of obesity among reproductive-age women has prompted the need to carefully examine factors contributing to lower breastfeeding rates in this population. Recent research has demonstrated a significant impact of breastfeeding to reduce the risk of obesity in both mothers and their children. This article presents a review of research literature from three databases covering the years 1995 to 2014 using the search terms of breastfeeding and maternal obesity. We reviewed the existing research on contributing factors to lower breastfeeding rates among obese women, and our findings can guide the development of promising avenues to increase breastfeeding among a vulnerable population. The key findings concerned factors impacting initiation and early breastfeeding, factors impacting later breastfeeding and exclusivity, interventions to increase breastfeeding in obese women, and clinical considerations. The factors impacting early breastfeeding include mechanical factors and delayed onset of lactogenesis II and we have critically analyzed the potential contributors to these factors. The factors impacting later breastfeeding and exclusivity include hormonal imbalances, psychosocial factors, and mammary hypoplasia. Several recent interventions have sought to increase breastfeeding duration in obese women with varying levels of success and we have presented the strengths and weaknesses of these clinical trials. Clinical considerations include specific techniques that have been found to improve breastfeeding incidence and duration in obese women. Many obese women do not obtain the health benefits of exclusive breastfeeding and their children are more likely to also be overweight or obese if they are not breastfed. Further research is needed into the physiological basis for decreased breastfeeding among obese women along with effective interventions supported by rigorous clinical research to advance the care of obese reproductive age women and their children.
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Affiliation(s)
- Jennie Bever Babendure
- />College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004 USA
| | - Elizabeth Reifsnider
- />College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004 USA
| | - Elnora Mendias
- />University of Texas Medical Branch at Galveston, School of Nursing, Galveston, TX 77555 USA
| | - Michael W. Moramarco
- />College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004 USA
| | - Yolanda R. Davila
- />University of Texas Medical Branch at Galveston, School of Nursing, Galveston, TX 77555 USA
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Keely A, Lawton J, Swanson V, Denison FC. Barriers to breast-feeding in obese women: A qualitative exploration. Midwifery 2015; 31:532-9. [DOI: 10.1016/j.midw.2015.02.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 01/20/2015] [Accepted: 02/01/2015] [Indexed: 11/28/2022]
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Verret-Chalifour J, Giguère Y, Forest JC, Croteau J, Zhang P, Marc I. Breastfeeding initiation: impact of obesity in a large Canadian perinatal cohort study. PLoS One 2015; 10:e0117512. [PMID: 25659144 PMCID: PMC4320116 DOI: 10.1371/journal.pone.0117512] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 12/26/2014] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To evaluate incidence of breastfeeding initiation according to maternal pre-pregnancy body mass index (BMI) in "Grossesse en Santé", a large prospective birth cohort in Quebec City. METHODS Breastfeeding initiation in the post-partum period, pre-pregnancy BMI, sociodemographic determinants and obstetrical and neonatal factors were collected from years 2005 to 2010 in 6592 women with single pregnancies. Prenatal non-intention to breastfeed was documented in a subgroup of the cohort (years 2009-2010). Log-binomial regression analyses were performed to assess relative risk (RR) of non-initiation of breastfeeding between maternal BMI categories in models including pre- and post-natal determinants, after exclusion of variables with a mediating effect. RESULTS Twenty percent (20%) of obese women did not initiate breastfeeding in the post-natal period at hospital compared to 12% for normal weight women. Compared with those having a normal pre-pregnancy BMI, obese women had a higher risk of non-initiation of breastfeeding (RRunadj 1.69, 95% CI 1.44-1.98), even after adjustment for prenatal and sociodemographic factors (RRadj 1.26, 95% CI 1.08-1.46). Furthermore, the risk of non-initiation of breastfeeding in obese women still remained higher after introduction of per- and post-natal factors (RR 1.22, 95% CI 1.04-1.42). The prenatal non-intention to breastfeed was strongly associated with the non-initiation of breastfeeding for all categories of BMI. CONCLUSION Maternal obesity is associated with a two-fold rate of non-initiation of breastfeeding. Considering the benefits of breastfeeding and the increasing obesity rate, adapted interventions and specialized support should target both pre- and immediate post-natal periods in this population.
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Affiliation(s)
- Julie Verret-Chalifour
- Departments of Pediatrics, Centre hospitalier universitaire (CHU) de Quebec, Quebec city, Quebec, Canada
| | - Yves Giguère
- Departments of Medical Biology, Centre hospitalier universitaire (CHU) de Quebec, Quebec city, Quebec, Canada
| | - Jean-Claude Forest
- Departments of Medical Biology, Centre hospitalier universitaire (CHU) de Quebec, Quebec city, Quebec, Canada
| | - Jordie Croteau
- Laboratory of Biostatistics, Centre de recherche de l’institut universitaire en santé mentale de Quebec (Université Laval), Quebec city, Quebec, Canada
| | - Peiyin Zhang
- Departments of Pediatrics, Centre hospitalier universitaire (CHU) de Quebec, Quebec city, Quebec, Canada
| | - Isabelle Marc
- Departments of Pediatrics, Centre hospitalier universitaire (CHU) de Quebec, Quebec city, Quebec, Canada
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Benton PM, Skouteris H, Hayden M. Does maternal psychopathology increase the risk of pre-schooler obesity? A systematic review. Appetite 2015; 87:259-82. [PMID: 25572134 DOI: 10.1016/j.appet.2014.12.227] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 11/14/2014] [Accepted: 12/24/2014] [Indexed: 11/29/2022]
Abstract
The preschool years may be a critical period for child obesity onset; however, literature examining obesity risk factors to date has largely focused on school-aged children. Several links have been made between maternal depression and childhood obesity risks; however, other types of maternal psychopathology have been widely neglected. The aim of the present review was to systematically identify articles that examined relationships between maternal psychopathology variables, including depressive and anxiety symptoms, self-esteem and body dissatisfaction, and risks for pre-schooler obesity, including weight outcomes, physical activity and sedentary behaviour levels, and nutrition/diet variables. Twenty articles meeting review criteria were identified. Results showed positive associations between maternal depressive symptoms and increased risks for pre-schooler obesity in the majority of studies. Results were inconsistent depending on the time at which depression was measured (i.e., antenatal, postnatal, in isolation or longitudinally). Anxiety and body dissatisfaction were only measured in single studies; however, both were linked to pre-schooler obesity risks; self-esteem was not measured by any studies. We concluded that maternal depressive symptoms are important to consider when assessing risks for obesity in preschool-aged children; however, more research is needed examining the impact of other facets of maternal psychopathology on obesity risk in pre-schoolers.
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Affiliation(s)
- Pree M Benton
- School of Psychology, Deakin University, Melbourne, Australia.
| | - Helen Skouteris
- School of Psychology, Deakin University, Melbourne, Australia
| | - Melissa Hayden
- School of Psychology, Deakin University, Melbourne, Australia
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Thompson AL. Intergenerational impact of maternal obesity and postnatal feeding practices on pediatric obesity. Nutr Rev 2014; 71 Suppl 1:S55-61. [PMID: 24147925 DOI: 10.1111/nure.12054] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The postnatal feeding practices of obese and overweight mothers may place their children at increased risk for the development of obesity through shared biology and family environments. This article reviews the feeding practices of obese mothers, describes the potential mechanisms linking maternal feeding behaviors to child obesity risk, and highlights the potential avenues of intervention. Strategies important for improving the quality of the eating environment and preventing the intergenerational transmission of obesity include supporting breastfeeding, improving the food choices of obese women, and encouraging the development of feeding styles that are responsive to hunger and satiety cues.
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Affiliation(s)
- Amanda L Thompson
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Brown A. Maternal restraint and external eating behaviour are associated with formula use or shorter breastfeeding duration. Appetite 2014; 76:30-5. [DOI: 10.1016/j.appet.2013.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 10/19/2013] [Accepted: 12/19/2013] [Indexed: 02/02/2023]
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Hauff LE, Leonard SA, Rasmussen KM. Associations of maternal obesity and psychosocial factors with breastfeeding intention, initiation, and duration. Am J Clin Nutr 2014; 99:524-34. [PMID: 24401717 PMCID: PMC3927688 DOI: 10.3945/ajcn.113.071191] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Psychosocial factors influence breastfeeding outcomes, but little is known about these characteristics and how they influence breastfeeding behavior of obese women, who are a group that experiences poor breastfeeding outcomes. OBJECTIVES Our objectives were to determine whether 1) maternal prepregnancy body mass index (BMI) is associated with social knowledge of, social influence toward, maternal confidence in, and behavioral beliefs about breastfeeding; 2) BMI and these psychosocial factors predict outcomes of intention to breastfeed, ever breastfed, and the duration of breastfeeding; and 3) BMI and psychosocial factors are associated with these breastfeeding outcomes independent of each other. DESIGN Participants (n = 2824) in the Infant Feeding Practices Study II provided data on psychosocial characteristics and breastfeeding outcomes. In this prospective cohort study, data were analyzed by using logistic and proportional hazards regression models. RESULTS Prepregnancy BMI was associated with confidence in (P < 0.0001), social influence toward (P = 0.02), and social knowledge of (P < 0.0001) breastfeeding but not with behavioral beliefs about breastfeeding (P = 0.45). Obese women did not differ from under- and normal-weight women in the intention to breastfeed (P = 0.07) but had lower odds of ever breastfeeding (P = 0.04) and were at greater risk of an earlier cessation of exclusive (P = 0.0009) and any (P = 0.03) breastfeeding. Only the association with exclusive breastfeeding remained significant after controlling for psychosocial factors (P = 0.01). All psychosocial factors were positively associated with each breastfeeding outcome. CONCLUSIONS Despite their intentions to breastfeed, women with high prepregnancy BMI had psychosocial characteristics associated with poor breastfeeding outcomes. However, these characteristics did not fully explain the association between maternal obesity and breastfeeding outcomes.
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Affiliation(s)
- Laura E Hauff
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
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Chapman DJ, Morel K, Bermúdez-Millán A, Young S, Damio G, Pérez-Escamilla R. Breastfeeding education and support trial for overweight and obese women: a randomized trial. Pediatrics 2013; 131:e162-70. [PMID: 23209111 PMCID: PMC3529944 DOI: 10.1542/peds.2012-0688] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate a specialized breastfeeding peer counseling (SBFPC) intervention promoting exclusive breastfeeding (EBF) among overweight/obese, low-income women. METHODS We recruited 206 pregnant, overweight/obese, low-income women and randomly assigned them to receive SBFPC or standard care (controls) at a Baby-Friendly hospital. SBFPC included 3 prenatal visits, daily in-hospital support, and up to 11 postpartum home visits promoting EBF and addressing potential obesity-related breastfeeding barriers. Standard care involved routine access to breastfeeding support from hospital personnel, including staff peer counselors. Data collection included an in-hospital interview, medical record review, and monthly telephone calls through 6 months postpartum to assess infant feeding practices, demographics, and health outcomes. Bivariate and logistic regression analyses were conducted. RESULTS The intervention had no impact on EBF or breastfeeding continuation at 1, 3, or 6 months postpartum. In adjusted posthoc analyses, at 2 weeks postpartum the intervention group had significantly greater odds of continuing any breastfeeding (adjusted odds ratio [aOR]: 3.76 [95% confidence interval (CI): 1.07-13.22]), and giving at least 50% of feedings as breast milk (aOR: 4.47 [95% CI: 1.38-14.5]), compared with controls. Infants in the intervention group had significantly lower odds of hospitalization during the first 6 months after birth (aOR: 0.24 [95% CI: 0.07-0.86]). CONCLUSIONS In a Baby-Friendly hospital setting, SBFPC targeting overweight/obese women did not impact EBF practices but was associated with increased rates of any breastfeeding and breastfeeding intensity at 2 weeks postpartum and decreased rates of infant hospitalization in the first 6 months after birth.
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Affiliation(s)
| | | | | | - Sara Young
- Hartford Hospital, Hartford, Connecticut
| | - Grace Damio
- Hispanic Health Council, Hartford, Connecticut
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