Adjusting to motherhood. The importance of BMI in predicting maternal well-being, eating behaviour and feeding practice within a cross cultural setting.

Maternal body mass index (BMI) is associated with negative body image and restrained eating which are experienced differently across cultures. The present study aimed to: 1) examine if self-esteem, eating behaviours and body satisfaction changed from early pregnancy to 2-6 months after giving birth; 2) explore changes according to country (Israel vs. UK) and BMI; and 3) determine any relationship between these measurements and infant feeding. Participants completed questionnaires assessing self-esteem, body image and eating/feeding behaviours. Multilevel linear modelling was used to account for change and to assess the independent impact of BMI on outcomes. Seventy-three women and infants participated in the study in early pregnancy and again 16 (9) weeks following birth. Women gained 1.5 kg (range -12 + 23) and UK mothers reported significantly greater body dissatisfaction, but self-esteem and eating behaviours remained stable. BMI was the main predictor of self-esteem, eating behaviours and body satisfaction. Mothers' perceptions of infant's eating did not vary according to BMI or country; however, heavier mothers reported feeding their infants according to a schedule. The first months after giving birth are a key time to assess adjustment to motherhood but later assessments are necessary in order to track changes beyond the early period post-pregnancy.