Overweight mothers are more likely to stop breastfeeding

September 12, 2018, London School of Economics (LSE)
Credit: CC0 Public Domain

Overweight mothers are more likely than those classed as being of a healthy weight to stop breastfeeding in the first week after having a baby and less likely to continue past four months, according to a new study from the London School of Economics and Political Science and the University of Auckland.

Despite heavily promoted benefits to infant and maternal health, a very small percentage of all mothers in the UK meet World Health Organisation recommendations of exclusive for the first six months of life. While around 80 percent initiate breastfeeding, less than one-fifth of babies are breast fed exclusively to three months (17 percent) and very few (1 percent) are breast fed exclusively to six months.

The study of 17,113 mothers from the UK Millennium Cohort Study (MCS), a nationally representative longitudinal survey of live babies born in the UK between 2000 and 2002, found that of the sample, 70 per cent of mothers initiated breastfeeding. Once researchers accounted for background characteristics such as education level and age, they found that underweight, healthy weight, and overweight mothers are similarly likely to begin breastfeeding.

But, having initiated breastfeeding, overweight mothers are more likely to cease within the first week. Among all those who initiate breastfeeding, overweight mothers are also less likely to continue beyond the 4 months stage, and the introduction of solid foods. For example, controlling for background characteristics, 18% of healthy weight mothers who begin breastfeeding cease within the first week, compared to 26% of overweight mothers. Also, 38% of healthy weight mothers who initiate breastfeeding continue beyond the 4 month mark, compared to 32% of mothers whose BMI is classed as overweight, and 27% of mothers whose BMI is classed as obese.

Dr. Tammy Campbell, Research Fellow at LSE's Centre for Analysis of Social Exclusion, who authored the research, said: "Improving breastfeeding rates has been a priority for successive governments, so our findings can provide some tentative indications of one group of mothers who could potentially be helped. However, we caution against simplistic interpretations of our findings, and clumsy solutions, as mothers' breastfeeding decisions and behaviours are complex and nuanced.

"Because we find no substantial differences in initiating breastfeeding between healthy/overweight women, we speculate that a substantial proportion of overweight women are likely to want to breastfeed – but have more difficulty doing so, and could benefit from good quality support.

"We would like to emphasise, though, that this support really does need to be good quality – practical and sensitive, for those who want it. Breastfeeding seems to be beneficial for those for whom it works – but experiences around it can be fraught and complex. We don't want this research to be interpreted in a way that guilt-trips women, which can add to post-natal depression and other negative post-natal experiences, as this can obviously be very detrimental to mothers and babies. And we don't want to advocate clumsy box-ticking or flagging, or deficit-based approaches to mothers. We think that interpreted sensitively, and with the right resources, our findings could help breastfeeding to work for more women."

The researchers examined several mechanisms which might explain the tendencies of overweight mothers to cease breastfeeding early and continue for less time. They tested baby's birth weight; pre-term birth; mother's gestational diabetes; type of delivery; reported labour complications. These factors did not help to explain the patterns. They conclude that more research is needed to understand why overweight mothers stop breastfeeding sooner. The paper says: "Previous studies indicate, tentatively, that psychological factors such as body image may play a part in breastfeeding behaviours. Physiological explanations have also been proposed, such as dysregulation of the hypothalamic-pituitary-gonadal axis and in fat metabolism affecting milk production and composition. Low prolactin levels in response to infant suckling after initiating breastfeeding reducing the ability of overweight/obese women to produce milk is another possible explanation, along with delayed onset of lactation perhaps resulting in early cessation."

Dr. Nichola Shackleton, co-author and Research Fellow at the University of Auckland, points out that, "exclusive breastfeeding can be a viable means of reducing the risk of childhood obesity and may help cognitive development. It can also result in a quicker return to normal BMI in the mother."

The paper concludes: "Whatever the explanation for the associations, pre-pregnancy overweight may provide a useful means through which to target early postnatal support services, which have been indicated as effective in promoting initiation and continuation of breastfeeding.

"BMI at first antenatal appointment is easily and reliably measured. By prioritising for breastfeeding support, both in the initial period of establishment and in later months, services may reach those less likely to continue breastfeeding. This may prove an effective use of resources: both because of the estimated health benefits to breastfed babies and their mothers and because research suggests relationships between prenatal BMI and child BMI and cognitive development – associations within which breastfeeding may be a malleable mediating factor."

The research also found that initiation of varied considerably by ethnicity: white (68 per cent), mixed ethnicity (87 per cent), Indian (84 per cent), Pakistani (76 per cent), Bangladeshi (87 per cent), black Caribbean (92 per cent), black African (95 per cent), and any other ethnicity (91 per cent). Of the 70 per cent who initiated, 17 per cent ceased breastfeeding at one week or earlier, and 39 per cent breast fed for more than four months.

Explore further: Good news, bad news in U.S. breastfeeding report

More information: Tammy Campbell et al. Pre-pregnancy body mass index and breastfeeding initiation, early cessation and longevity: evidence from the first wave of the UK Millennium Cohort Study, Journal of Epidemiology and Community Health (2018). DOI: 10.1136/jech-2017-209074

Related Stories

Good news, bad news in U.S. breastfeeding report

August 20, 2018
(HealthDay)—Most new mothers in the United States start out breastfeeding, but many stop sooner than recommended, a new federal government report says.

Breastfeeding benefits mom and baby both in the short- and long-term

August 6, 2018
Breastfeeding has benefits for both infants and mothers, both in the short-term and the long-term alike, according to Ohio University's Ilana Chertok, who added that the World Health Organization recommends exclusive breastfeeding ...

Exclusive breastfeeding in hospital associated with longer breastfeeding duration

March 12, 2018
New findings from AllerGen's CHILD Study show that exclusive breastfeeding during the first few days of life is positively associated with longer-term breastfeeding, while in-hospital formula use is associated with breastfeeding ...

Breastfeeding mothers stop nursing sooner when living with smokers

June 28, 2018
Nursing mothers who live with two or more smokers are more likely to stop breastfeeding sooner than those who live in nonsmoking households. In a Hong Kong-based study, researchers discovered that these mothers are at 30 ...

Victims of violence stop breastfeeding sooner

March 9, 2016
More than two out of ten women who have been victims of sexual abuse as children are likely to stop breastfeeding before their babies reach four months, according to a new study.

What causes women to stop breastfeeding early?

June 7, 2017
A recent systematic literature review has investigated potential sociodemographic, physical, mental, and social factors that may cause breastfeeding mothers to stop breastfeeding before infants reach 6 months of age.

Recommended for you

New approach improves detection of diseases at birth

September 13, 2018
The combination of a new sequencing technique and machine learning can speed up the diagnosis of diseases in newborns and reduce false-positive results, Yale researchers and their collaborators report.

Rising European life expectancy undermined by obesity: WHO

September 12, 2018
Life expectancy in Europe continues to increase but obesity and the growing proportion of people who are overweight risks reversing this trend, the World Health Organization warned Wednesday.

Rethinking an inflammatory receptor's obesity connection

September 12, 2018
Toll-like receptor 4 (TLR4) is a protein that plays a vital role in the body's immune response by sensing the presence of infection. It has long been thought to also sense particular types of fats, which suggested a mechanism ...

Study finds that kids are more likely to drink healthier beverages if adults speak the truth—subtly

September 12, 2018
What's the best way to persuade children to drink water instead of unhealthy, sugar-laced beverages? Do you:

Boys and girls share similar math abilities at young ages, study finds

September 10, 2018
There has been much speculation about whether lower female participation rates in STEM fields can be traced to an innate male superiority in math and science. But a new University of Chicago study wanted to test whether boys ...

Brief sleep intervention works long-term to prevent child obesity

September 6, 2018
When it comes to obesity prevention, sleep is not usually something that springs to mind, but a University of Otago research team has found we should not underestimate its importance.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.