A prospective study of breastfeeding intentions of healthy weight and overweight women as predictors of breastfeeding outcomes

Highlights\ud \ud • Despite no statistically significant difference in intentions for breastfeeding, this study showed a differential impact of intentions on breastfeeding for healthy weight and overweight women at hospital discharge and 4 months post-partum.\ud \ud • High breastfeeding intentions was associated with exclusive breastfeeding in healthy weight but not overweight women at hospital discharge while high intentions was associated with exclusively/fully breastfeeding for both groups at 4 months post-partum.\ud \ud • Women who experienced a caesarean delivery were at a significant risk of giving formula supplementation by the time of hospital discharge, for overweight women this impact was much greater and was independent of their breastfeeding intentions.\ud \ud Abstract\ud \ud Objective\ud \ud Women with a higher BMI are at increased risk of breastfeeding for a shorter duration, however it is unclear if weight status itself or other factors such as feeding intentions are responsible for early breastfeeding cessation. The aim of this study was determine the influence of maternal pre-pregnancy weight status on infant feeding intentions during pregnancy using a validated scale and assess whether high intentions to exclusively breastfeed measured during pregnancy predicted feeding mode at discharge and at 4 months postpartum in both healthy weight (Hwt) (BMI< 25 kg/m2) and overweight (Owt)(BMI > 25 kg/m2) women.\ud \ud Design\ud \ud This prospective, observational study commenced when participants were <20 weeks gestation, continuing until four months post partum. Self-administered questionnaires assessed pre-pregnancy weight, infant feeding intentions at 36 weeks gestation, and breastfeeding practices at hospital discharge and 4 months postpartum. Hospital records provided details of delivery mode, gestation and breastfeeding during hospital stay. Binary logistic regression analyses were used to compare weight groups on the breastfeeding beliefs and practices adjusting for selected covariates\ud \ud Participants and setting\ud \ud A consecutive sample of pregnant women (n=715) were recruited from an Australian metropolitan hospital between August 2010 and January 2011. All women