title: Body image concerns during pregnancy are associated with a shorter breast feeding duration.
abstract: OBJECTIVE
  breast feeding is affected by numerous psycho-social factors. Antenatal concerns such as embarrassment regarding public feeding and the impact of breast feeding upon breast shape are known to lead to artificial milk use. However, although work has explored the relationship between maternal weight and infant feeding, wider body image concerns have not been examined. The aim of the current study was to explore the association between maternal body image concerns during pregnancy upon intended and actual breast feeding duration.
  
  
  METHODS
  a two stage self report questionnaire completed during pregnancy and at six months post partum.
  
  
  METHODS
  mothers were recruited from local mother and infant groups, nurseries and online mother and infant forums.
  
  
  METHODS
  128 pregnant women completed both stages.
  
  
  METHODS
  phase one: completion of a questionnaire exploring body image during pregnancy (concerns about stretch marks, weight gain and appearance) and planned breast feeding duration during the second/third trimester of pregnancy (body image, weight, intended duration) followed by a second questionnaire measuring actual breast feeding duration and breast feeding experiences.
  
  
  RESULTS
  factor analysis revealed three primary body image concerns: pregnancy body image, prospective postnatal body image and dieting during pregnancy. Higher concerns on all three factors were associated with both intended and actual shorter breast feeding duration. Amongst mothers who stopped breast feeding before six months, those with higher body image concerns were more likely to report stopping due to embarrassment or the perceived impact upon their breast shape. The relationship was not explained by maternal weight, although a higher residual weight gain at six months was associated with a shorter breast feeding duration.
  
  
  CONCLUSIONS
  mothers who are affected negatively by changes to their body during pregnancy may be less likely to plan to or initiate breast feeding potentially due to underlying issues such as embarrassment or perceived impact of feeding upon their appearance. The findings are important to those working with women during pregnancy and the postpartum period in understanding the impact of body image upon intention and ability to initiate and continue breast feeding.
authors.affiliation: Department of Public Health and Policy Studies, Swansea University, Swansea SA2 8PP, UK. Electronic address: a.e.brown@swansea.ac.uk.
authors.forename: Amy
authors.initials: A
authors.lastname: Brown
authors.affiliation: Department of Public Health and Policy Studies, Swansea University, Swansea SA2 8PP, UK.
authors.forename: J
authors.initials: J
authors.lastname: Rance
authors.affiliation: School of Healthcare Sciences, Cardiff University, UK.
authors.forename: L
authors.initials: L
authors.lastname: Warren
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image / Q000523:psychology*; D001942:Breast Feeding / Q000523:psychology*; D005260:Female; D006801:Humans; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D015430:Weight Gain
keywords: Attitudes; Body image; Breast feeding; Public feeding; Weight gain