Jarlenski Marian, McManus Jenny, Diener-West Marie, Schwarz Eleanor Bimla, Yeung Edwina, Bennett Wendy L
Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Sexual Health Innovations, New York, New York.
Womens Health Issues. 2014 Nov-Dec;24(6):641-8. doi: 10.1016/j.whi.2014.08.002. Epub 2014 Sep 18.
Obese women are less likely to initiate and continue breastfeeding. We described barriers to breastfeeding and examined the association between support from a health professional and breastfeeding knowledge and practices, by prepregnancy obesity status.
Using data from the Infant Feeding Practices Study II, a cohort of U.S. women (N = 2,997), we performed descriptive statistics to describe barriers to breastfeeding by prepregnancy obesity status. We conducted multivariable regression to examine the association of breastfeeding support from a physician or nonphysician health professional with knowledge of the recommended duration of breastfeeding, breastfeeding initiation, and breastfeeding duration, and whether breastfeeding support had different associations with outcomes by prepregnancy obesity status. Average marginal effects were calculated from regression models to interpret results as percentage-point changes.
Believing that formula was as good as breast milk was the most commonly cited reason for not initiating breastfeeding, and milk supply concerns were cited as reasons for not continuing breastfeeding. Physician breastfeeding support was associated with a 9.4 percentage-point increase (p < .05) in breastfeeding knowledge among obese women, although no increase was observed among nonobese women. Breastfeeding support from a physician or nonphysician health professional was associated with a significantly increased probability of breastfeeding initiation (8.5 and 12.5 percentage points, respectively) and breastfeeding for 6 months (12.5 and 8.4 percentage points, respectively), without differential associations by prepregnancy obesity.
Support for exclusive breastfeeding is an important predictor of breastfeeding initiation and duration among obese and nonobese women. Health educational interventions tailored to obese women might improve their breastfeeding initiation and continuation.
肥胖女性开始并持续母乳喂养的可能性较小。我们描述了母乳喂养的障碍，并按孕前肥胖状况研究了医疗保健专业人员的支持与母乳喂养知识及行为之间的关联。
利用来自美国女性队列（N = 2997）的婴儿喂养实践研究II的数据，我们进行了描述性统计，以按孕前肥胖状况描述母乳喂养的障碍。我们进行了多变量回归，以研究医生或非医生医疗保健专业人员提供的母乳喂养支持与对推荐母乳喂养持续时间的了解、母乳喂养开始情况和母乳喂养持续时间之间的关联，以及母乳喂养支持是否因孕前肥胖状况而与结果有不同的关联。从回归模型中计算平均边际效应，以便将结果解释为百分点变化。
认为配方奶与母乳一样好是最常被提及的不开始母乳喂养的原因，而对乳汁供应的担忧则被引述为不继续母乳喂养的原因。医生提供的母乳喂养支持与肥胖女性的母乳喂养知识增加9.4个百分点相关（p <.05），而非肥胖女性未观察到增加。医生或非医生医疗保健专业人员提供的母乳喂养支持与母乳喂养开始的可能性显著增加（分别为8.5和12.5个百分点）以及母乳喂养6个月的可能性显著增加（分别为12.5和8.4个百分点）相关，且不因孕前肥胖状况而有差异关联。
对纯母乳喂养的支持是肥胖和非肥胖女性开始和持续母乳喂养的重要预测因素。针对肥胖女性的健康教育干预措施可能会改善她们的母乳喂养开始情况和持续情况。
