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Included studies on maternal obesity and initiation of breastfeeding |
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| Authors, Year of Publication, Country, and Year(s) of Study |
Participants |
Definition of obesity |
Results |
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| Donath & Amir 2000 [13], Australia, 1992–95 |
1995 National Health Survey Children up to years 4 old n = 2612 |
BMI calculated from self-reported height and weight at time of interview WHO definition of obesity |
% (95% CI) Underweight 89.0 (85.8, 92.2) Normal weight 89.2 (87.4, 91.0) Overweight 86.9 (84.0, 89.9) Obese 82.3 (77.6, 87.0) OR* overweight 1.25 OR* obese 1.78 |
| Grjibovski et al 2005 [43], Severodvinsk, Russia, 1999 |
Antenatal community-based cohort n = 1078 |
Pre-pregnancy weight defined as under- normal and over-weight based on "doctor's diagnosis" [82] |
Underweight 98.3% Normal 98.7% Overweight 100.0% NS |
| Hilson et al 1997 [12] Cooperstown, NY, USA, 1992–94 |
Medical record review Eligibility: intended to bf (= bf at birth), healthy singleton infant n = 1109 |
IOM definition of obesity BMI calculated from pre-pregnancy weight and height |
Quit bf by hospital discharge 2 d after birth: Normal 4.3% Overweight 8.9% Obese 12.2% OR* overweight 2.17 OR* obese 3.09 Not bf at discharge (of women who attempted bf at birth): Odds Ratio Overweight 2.54 (p < 0.05) Obese 3.65 (p = 0.0007) |
| Hilson et al 2006 [39] Cooperstown, NY, USA, 1988–97 |
Expanded previous review of medical records [12] Eligibility: intended to bf (= bf at birth), singleton infant, no contraindications to bf, no diabetes n = 2783 |
IOM definition of obesity BMI calculated from pre-pregnancy weight and height |
Breastfeeding at 4 days: Underweight 89.0% Normal 90.1% Overweight 88.4% Obese 82.58% Obese women different from underweight and normal weight women OR* overweight 1.19 OR* obese 1.92 |
| Kugyelka et al 2004 [40] upstate New York, 1999–2000 |
Medical record review, including paediatric record to 6 months of age, all women of 'Hispanic ethnicity' (n = 235) or 'Black race' (n = 263) Eligibility: healthy mothers (BMI > 19) with healthy single, term infant, who attempted to breastfed |
IOM definition BMI calculated from pre-pregnancy weight and height |
Baby put to breast < 2 h: Hispanic women: Black women Normal 71.8% 75.1% Overweight 66.7% 69.2% Obese 61.5% 63.8% (p < 0.05) (p < 0.05) Fed formula only during last 5 feeds in hospital: Hispanic women: Black women: Normal weight 9.6% 5.1% Overweight 12.2% 8.0% Obese 12.4% 6.9% Hispanic women OR* overweight 1.48 OR* obese 1.50 Black women OR* overweight 1.62 OR* obese 1.38 Multivariate analysis: Hispanic women: obese OR 1.92 (95% CI 1.20, 3.08) of formula and breast in last 5 feeds before discharge compared to breast only (adjusted for maternal age, education, parity, gestation, birth wt, smoking and birth) Other groups NS |
| Li et al 2002 [83] USA, 1988–1994 |
The Third National Health and Nutrition Survey (NHANES III), children aged 2 mo to 6 yrs n = 8765 94% response for these children; 99% data of bf available |
BMI calculated from self-reported ht and wt at time of interview. WHO definition of obesity |
Ever breastfed: Normal 58.1% Overweight 46.4% Obese 44.8% OR* overweight 1.60 OR* obese 1.71 |
| Li et al 2003 [49] USA, 1996–98 |
Pediatric Nutrition Surveillance System and the Pregnancy Nutrition Surveillance System, children aged < 5 years n = 51,329 |
BMI calculated from self-reported pre-pregnancy wt IOM definition of obesity |
Obese women more likely to never breastfeed (p < 0.01) OR 1.28 estimated from Figure 1 |
| Oddy et al 2006 [44] Australia, 1989–1991 |
Western Australian Pregnancy Cohort Study. Pregnant women recruited from King Edward Memorial Hospital, Perth, WA n = 1803 |
BMI calculated from pre-pregnancy weight and height (measured by research midwives) WHO definition of obesity |
Never breastfed: Normal weight 8.2% Overweight 11.4% Obese women 12.4% NS OR* overweight 1.33 OR* obese 1.47 |
| Scott et al 2006 [45] Australia, 2002–2003 |
2nd Perth Infant Feeding Study, cohort of women recruited in hospital. n = 587 |
Measurement of maternal weight and height not reported WHO definition of obesity |
Any breastfeeding at hospital discharge: Normal weight 95.6% Overweight 91.5% Obese 90.7% OR 0.45 (95% CI 0.19, 1.09) OR* overweight 2.02 OR* obese 2.23 Exclusive breastfeeding at hospital discharge: Multivariate analysis, Adjusted OR (95% CI): Normal weight 1 (ref) Overweight 0.50 (0.28, 0.89) Obese 0.63 (0.33, 1.20) (adjusted for maternal age, smoking, marital status, occupation, country of birth, parity, antenatal classes, timing of infant feeding decision, delivery, birth weight, special care nursery, mothers' infant feeding attitude, fathers' infant feeding preference, grandmothers' infant feeding preference, whether grandmother had bf) OR* overweight 2.00 OR* obese 1.59 |
| Sebire et al 2001 [14] UK, 1989–1997 |
St Mary's Maternity Information system database, North West Thames region n = 325,395 |
BMI calculated from weight at antenatal booking Normal BMI 20-<25 Moderately obese 25-<30 Very obese BMI > 30 (BMI < 20 = underweight - excluded from study) |
Bf at hospital discharge: Multivariate analysis, Adjusted OR (99% CI): Normal weight 1 (ref) Mod obese 0.86 (0.84, 0.88) Very obese 0.58 (0.56, 0.60) (adjusted for ethnic group, parity, age, history of hypertension, diabetes) OR* overweight 1.16 OR* obese 1.72 |
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bf = breastfed, BMI = body mass index, ht = height, IOM = Institute of Medicine, mo = month, NS = not significant, OR* = our calculation of overweight and obese women not initiating bf compared with normal weight women, WHO = World Health Organization, wk = week, wt = weight | |||
Amir and Donath BMC Pregnancy and Childbirth 2007 7:9 doi:10.1186/1471-2393-7-9 |
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