Gibby Cheryl L K, Palacios Cristina, Campos Maribel, Lim Eunjung, Banna Jinan
Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Agricultural Sciences 216, 1955 East-West Rd, Honolulu, HI, 96822, USA.
Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, AHC 5 - 313, Miami, FL, 33199, USA.
Matern Child Health J. 2019 Jan;23(1):19-29. doi: 10.1007/s10995-018-2587-x.
Objectives This study investigated the association between maternal pregravid body mass index (BMI) and breastfeeding discontinuation at 4-6 months postpartum in Hawaii and Puerto Rico participants from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Methods A secondary data analysis was conducted from a text message-based intervention in WIC participants in Hawaii and Puerto Rico. The analysis included 87 women from the control group who initiated breastfeeding and whose breastfeeding status was known at the end of the study when infants were 4-6 months old. Pregravid BMI and breastfeeding discontinuation were assessed using questionnaires. Results The association between pregravid BMI and breastfeeding discontinuation was not significant in the unadjusted model or in the adjusted model. Native Hawaiian or Other Pacific Islander (NHOPI) participants showed significantly increased odds of discontinuing breastfeeding (adjusted odds ratio [AOR] 7.12; 95% CI 1.34, 37.97; p = .02) compared to all the other racial/ethnic participants, as did older women ages 32-39 years versus women who were 25-31 years old (AOR 4.21; 95% CI 1.13, 15.72; p = .03). Women who took vitamins while breastfeeding had decreased odds of discontinuing breastfeeding (AOR 0.15; 95% CI 0.05, 0.46; p = .0009). Conclusions for Practice Pregravid BMI was not significantly associated with breastfeeding discontinuation at 4-6 months postpartum in women from Hawaii and Puerto Rico WIC, but NHOPIs and women who were older had higher odds of discontinuing breastfeeding. The results of this study may inform strategies for breastfeeding promotion and childhood obesity prevention but should be further investigated in larger studies. ClinicalTrials.gov Identifier: NCT02903186.
目的 本研究调查了参加妇女、婴儿和儿童特别补充营养计划(WIC)的夏威夷和波多黎各参与者中,孕前体重指数(BMI)与产后4至6个月母乳喂养中断之间的关联。方法 对夏威夷和波多黎各WIC参与者基于短信的干预进行了二次数据分析。分析包括87名来自对照组的妇女,她们开始进行母乳喂养,并且在研究结束时婴儿4至6个月大时其母乳喂养状况已知。使用问卷评估孕前BMI和母乳喂养中断情况。结果 在未调整模型或调整模型中,孕前BMI与母乳喂养中断之间的关联均不显著。与所有其他种族/族裔参与者相比,夏威夷原住民或其他太平洋岛民(NHOPI)参与者停止母乳喂养的几率显著增加(调整后的优势比[AOR]为7.12;95%置信区间为1.34, 37.97;p = 0.02),32至39岁的老年妇女与25至31岁的妇女相比也是如此(AOR为4.21;95%置信区间为1.13, 15.72;p = 0.03)。母乳喂养期间服用维生素的妇女停止母乳喂养的几率降低(AOR为0.15;95%置信区间为0.05, 0.46;p = 0.0009)。实践结论 在夏威夷和波多黎各WIC的妇女中,孕前BMI与产后4至6个月母乳喂养中断无显著关联,但NHOPI和年龄较大的妇女停止母乳喂养的几率更高。本研究结果可能为母乳喂养促进和儿童肥胖预防策略提供参考,但应在更大规模的研究中进一步调查。临床试验.gov标识符:NCT02903186。