Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, Guy's Hospital, King's College London, London, UK.
Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
Matern Child Nutr. 2019 Oct;15(4):e12837. doi: 10.1111/mcn.12837. Epub 2019 Jun 7.
Public health guidelines recommend women establish and maintain exclusive breastfeeding to 6 months postpartum. Women with a body mass index (BMI, kg/m ) in the overweight or obese range are less likely to initiate and continue breastfeeding than healthy weight women. Evidence for psychological mechanisms of this association using validated methods of measurement is limited, but factors such as attitudes and intentions for infant feeding are implicated. This study aimed to investigate the associations between maternal BMI, antenatal attitudes and intentions for infant feeding, and subsequent breastfeeding practices. A total of N = 128 women completed an online questionnaire antenatally, and n = 48 were followed-up in the first month postpartum. Validated measures of intentions (Infant Feeding Intentions Scale) and attitudes (Iowa Infant Feeding Attitude Scale) for infant feeding were used. One-way analysis of variance and multivariate regression analyses assessed study objectives. Infant feeding attitudes (p = .327) and intentions (p = .254) were similar among healthy weight, overweight, and obese women and did not differ significantly. In adjusted regression models, only intentions significantly predicted early breastfeeding behaviour (p = .036; AR = .301). Missing data analysis revealed no significant differences in the profile of completing versus noncompleting women. Evidence suggests postnatal factors contribute significantly to lower breastfeeding rates in cohorts of women with overweight or obese BMIs. Further investigations should consider using theory and methods from behavioural science to longitudinally investigate modifiable mechanisms of action responsible for lower breastfeeding rates among overweight and obese women to inform practices that support prolonged breastfeeding.
公共卫生指南建议女性在产后 6 个月内建立并坚持纯母乳喂养。与健康体重女性相比，超重或肥胖女性更不可能开始并持续母乳喂养。使用经过验证的测量方法，针对这种关联的心理机制的证据有限，但涉及到态度和婴儿喂养意图等因素。本研究旨在调查产妇 BMI、产前婴儿喂养态度和意图与随后的母乳喂养实践之间的关联。共有 128 名女性在产前完成了在线问卷，其中 48 名在产后第一个月进行了随访。使用婴儿喂养意图的经过验证的措施（婴儿喂养意图量表）和态度（爱荷华婴儿喂养态度量表）进行测量。采用单因素方差分析和多元回归分析来评估研究目标。健康体重、超重和肥胖女性的婴儿喂养态度（p=.327）和意图（p=.254）相似，没有显著差异。在调整后的回归模型中，只有意图显著预测了早期母乳喂养行为（p=.036；AR = 0.301）。缺失数据分析显示，完成和未完成的女性之间没有显著差异。有证据表明，产后因素对超重或肥胖 BMI 女性的母乳喂养率有显著影响。进一步的研究应该考虑使用行为科学的理论和方法，从纵向角度研究超重和肥胖女性中导致母乳喂养率较低的可改变作用机制，为支持延长母乳喂养的实践提供信息。
