title: Maternal obesity and breast-feeding practices among white and black women.
abstract: Despite the increase in obesity among women of reproductive ages, few studies have considered maternal obesity as a risk factor for breast-feeding success. We tested the hypothesis that women who are obese (BMI = 30-34.9) and very obese (BMI >or=35) before pregnancy are less likely to initiate and maintain breast-feeding than are their normal-weight counterparts (BMI = 18.5-24.9) among white and black women. Data from 2000 to 2005 South Carolina Pregnancy Risk Assessment Monitoring System (PRAMS) were used. The overall response rate was 71.0%; there were 3,517 white and 2,846 black respondents. Black women were less likely to initiate breast-feeding and breast-fed their babies for a shorter duration than white women. Compared to normal-weight white women, very obese white women were less likely to initiate breast-feeding (odds ratio: 0.63; 95% confidence interval (CI) = 0.42, 0.94) and more likely to discontinue breast-feeding within the first 6 months (hazard ratio (HR) = 1.89; 95% CI: 1.39, 2.58). Among black women, prepregnancy BMI was neither associated with breast-feeding initiation nor with breast-feeding continuation within the first 6 months. Because very obese white women are less likely to initiate or continue breast-feeding than other white women, health professionals should be aware that very obese white women need additional breast-feeding support. Lower rates of breast-feeding among black women suggest that they should continue to be the focus of the programs and policies aimed at breast-feeding promotion in the United States.
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold J. Norman School of Public Health, University of South Carolina, Columbia, South Carolina, USA. jliu@mailbox.sc.edu
authors.forename: Jihong
authors.initials: J
authors.lastname: Liu
authors.forename: Michael G
authors.initials: MG
authors.lastname: Smith
authors.forename: Mirela A
authors.initials: MA
authors.lastname: Dobre
authors.forename: James E
authors.initials: JE
authors.lastname: Ferguson
mesh_terms: D001741:Black or African American / Q000208:ethnology; D015992:Body Mass Index; D001942:Breast Feeding / Q000453:epidemiology*; D003431:Cross-Cultural Comparison; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D009035:Mothers; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D011247:Pregnancy; D015995:Prevalence; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000208:ethnology