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 underand
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.
Am J Clin Nutr doi: 10.3945