Antenatal breastfeeding intention, confidence and comfort in obese and non-obese primiparous Australian women: associations with breastfeeding duration

R M Newby, P S W Davies

Maternal adiposity is known to affect breastfeeding initiation and duration via both antenatal and postnatal factors. This study investigates associations between maternal pregravid body mass index (BMI), breastfeeding duration and antenatal breastfeeding confidence, intention and social comfort among primiparous Australian women. Women in their first pregnancy (n=462) were recruited by convenience sampling in Queensland, Australia. Participants responded to an antenatal and six postnatal questionnaires during their infants' first year between June 2010 and March 2012. Maternal pregravid BMI was examined against breastfeeding duration, participants' antenatal infant feeding intentions and measures of breastfeeding confidence and social comfort. Breastfeeding initiation in this cohort was 97%, but 46% of mothers had ceased breastfeeding at 52 weeks postpartum. Breastfeeding duration differed significantly (χ(2) (2)=7.21, P=0.007) between normal, overweight and obese women. No differences were found in antenatal intention for feeding type nor intended breastfeeding duration by one-way ANOVA (F(2,178)=1.77, P=0.17). More than half of the pregnant respondents anticipated social discomfort breastfeeding in public, with obese women significantly more likely to anticipate discomfort breastfeeding in the presence of close female friends, (χ(2) (1)=5.53, P=0.019). This study confirmed the risk of premature cessation of breastfeeding for obese mothers. Interventions during pregnancy that address body image issues in relation to breastfeeding may facilitate breastfeeding success for obese mothers and their infants and accrue short- and long-term health benefits for both.European Journal of Clinical Nutrition advance online publication, 23 March 2016; doi:10.1038/ejcn.2016.29.