1 Department of Neonatology, Tel Aviv Sourasky Medical Center, the Lis Maternity Hospital, Tel Aviv, Israel.
2 Sackler Faculty of Medicine, Tel Aviv, Israel.
Breastfeed Med. 2019 Jun;14(5):342-346. doi: 10.1089/bfm.2018.0262. Epub 2019 Apr 26.
We examined the influence of maternal body mass index (BMI), and of breast and nipple anatomic variations, on breastfeeding difficulties and duration. In this prospective observational study, we collected demographic and anthropometric data from 109 mothers of full-term newborns. Women were classified as underweight, normal weight, overweight, and obese using the World Health Organization definitions and were otherwise healthy. Breast anthropometrics assessments were recorded after delivery and during hospitalization. Latching difficulties were collected as reported by the mothers. Breastfeeding duration was assessed by phone interview at 3, 6, 1 year, or more postdelivery. The four prepregnancy BMI groups included 12 underweight, 59 normal weight, 20 overweight, and 18 obese women. The higher the BMI group, the larger the breast was ( = 0.005). In univariate regression, nipple diameter, nipple length, and areola diameter correlated significantly with breast size. The overall rate of latching difficulties was 15.5%, without significant differences among all four BMI groups. In multivariate analysis, the higher the BMI group the lower was the likelihood of breastfeeding at 6 months of age (odds ratio [OR] = 0.88, 95% confidence interval [CI]: 0.79-0.99), and the higher the birth order the higher was the likelihood of breastfeeding at 6 months of age (OR = 3.36, 95% CI: 1.44-7.83). Early latching difficulties predicted shorter breastfeeding duration. We conclude that high prepregnancy BMI has a negative impact on breastfeeding initiation and duration.
我们研究了母体体重指数（BMI）以及乳房和乳头解剖结构的变化对母乳喂养困难和持续时间的影响。在这项前瞻性观察研究中，我们从 109 名足月新生儿的母亲那里收集了人口统计学和人体测量学数据。根据世界卫生组织的定义，女性被分为消瘦、正常体重、超重和肥胖，且身体健康。分娩后和住院期间记录乳房人体测量评估。通过母亲报告收集了衔乳困难情况。通过产后 3、6、1 年或更长时间的电话访谈评估母乳喂养持续时间。四个孕前 BMI 组包括 12 名消瘦、59 名正常体重、20 名超重和 18 名肥胖女性。BMI 越高的组乳房越大（=0.005）。在单变量回归中，乳头直径、乳头长度和乳晕直径与乳房大小显著相关。总的衔乳困难发生率为 15.5%，四个 BMI 组之间无显著差异。在多变量分析中，BMI 越高的组，6 个月时母乳喂养的可能性越低（比值比[OR] = 0.88，95%置信区间[CI]：0.79-0.99），出生顺序越高的组，6 个月时母乳喂养的可能性越高（OR = 3.36，95% CI：1.44-7.83）。早期衔乳困难预测母乳喂养持续时间更短。我们的结论是，孕前 BMI 高对母乳喂养的启动和持续时间有负面影响。
