Pre-pregnancy obesity and the initiation/duration of breastfeeding in los angeles county

BACKGROUND: Obesity is a national epidemic with wide consequences and cost to America's health. In Los Angeles County 1 in 3 women of reproductive age are overweight or obese, with a disproportionately higher number of Hispanic and African American women being affected. Maternal overweight and obesity are linked to poor birth outcomes and lower breastfeeding rates. METHODS:A 2007 population-based mail survey of 6,044 Los Angeles County residents who recently gave birth to a live-born infant. Mothers were selected by randomly sampling birth certificates. Women reported their pre-pregnancy height and weight before pregnancy, BMI was calculated, and breastfeeding practices. Multiple logistic regression models were performed to assess the association between maternal obesity and breastfeeding practices after controlling for potential confounders. Appropriate sampling weights were used to adjust for design effect and non-response bias. RESULTS: Compared to normal weight women, obese women were less likely to initiate breastfeeding and more likely to stop breastfeeding within the first 3 and 6 months (OR=2.1,95%CI=1.9-4; a OR=2, 95%CI= 2-4, a OR=1.4,95%CI=1.4-3.1 respectively). No racial difference was found in breastfeeding initiation. However, compared to White women, Black and Latino women had higher risks of discontinuing breastfeeding at 3 months (OR:1.6 and 1.4) and 6 months (OR:1.2 and 1.5). Asian women had a higher risk of stopping breastfeeding at 6 months, compared to White women (OR=1.3,95%CI=1.1-4). CONCLUSIONS: Pre-pregnancy obesity and the initiation/duration of breastfeeding were inversely related. Policy initiatives and local interventions should continue to promote breastfeeding and prevent maternal obesity, especially among racial minority.