Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Science, Little Rock, Arkansas, USA.
Arkansas Center for Health Improvement, Little Rock, Arkansas, USA.
Breastfeed Med. 2024 Apr;19(4):275-283. doi: 10.1089/bfm.2023.0262. Epub 2024 Mar 27.
The benefits of breastfeeding a newborn are well documented. Identification of mothers who do not initiate breastfeeding is essential for developing initiatives to improve breastfeeding initiation. The study used data from the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) birth certificate data (2014-2021) to identifying 15,599,930 in-hospital deliveries. We used multivariable logistic regression to assess the association between seven body mass index (BMI) categories and initiation of breastfeeding before hospital discharge. Prepregnancy BMI (weight in kilograms/height in meters) included underweight (<18.5), healthy weight (18.5-24.9), overweight (25.0-29.9), Obesity Class I (30-34.9), Obesity Class II (35-39.9), and Obesity Class III (40-49.9) classes, in addition to a class newly identified in the literature as super obese (≥50), hereafter "Obesity Class IV." "This project was deemed non-human subjects research." Approximately, 83% of mothers initiated breastfeeding before hospital discharge. Compared to mothers with a healthy prepregnancy BMI, the likelihood of breastfeeding initiation before hospital discharge decreased with increasing prepregnancy BMI. Specifically, we found reduced likelihood of initiation for mothers who were overweight (adjusted odds ratio [aOR]: 0.952, 95% confidence interval [CI]: [0.948-0.955]), Obesity Class I (aOR: 0.884, 95% CI: [0.880-0.888]), Obesity Class II (aOR: 0.816, 95% CI: [0.811-0.820]), Obesity Class III (aOR: 0.750, 95% CI: [0.745-0.755]), and Obesity Class IV (aOR 0.672: 95% CI: [0.662-0.683]). Mothers with prepregnancy BMI above the healthy range had reduced likelihood of initiating breastfeeding prior hospital discharge. This information should be used to develop and initiate interventions for mothers who wish to breastfeed but may need additional lactation assistance support.
母乳喂养新生儿的益处有充分的文献记载。确定哪些母亲没有开始母乳喂养，对于制定改善母乳喂养初始率的措施至关重要。本研究使用了国家卫生统计中心（NCHS）国家生命统计系统（NVSS）出生证明数据（2014-2021 年），识别出 15599930 例住院分娩。我们使用多变量逻辑回归评估了 7 个体重指数（BMI）类别与出院前开始母乳喂养之间的关系。孕前 BMI（体重以千克/身高以米为单位）包括体重不足（<18.5）、健康体重（18.5-24.9）、超重（25.0-29.9）、肥胖 I 级（30-34.9）、肥胖 II 级（35-39.9）和肥胖 III 级（40-49.9）类别，此外，还包括文献中确定的一个新类别为超级肥胖（≥50），以下简称“肥胖 IV 级”。“本项目被视为非人类研究对象研究。”大约 83%的母亲在出院前开始母乳喂养。与健康的孕前 BMI 相比，随着孕前 BMI 的增加，出院前开始母乳喂养的可能性降低。具体来说，我们发现超重（调整后的优势比[aOR]：0.952，95%置信区间[CI]：[0.948-0.955]）、肥胖 I 级（aOR：0.884，95%CI：[0.880-0.888]）、肥胖 II 级（aOR：0.816，95%CI：[0.811-0.820]）、肥胖 III 级（aOR：0.750，95%CI：[0.745-0.755]）和肥胖 IV 级（aOR 0.672：95%CI：[0.662-0.683]）的母亲开始母乳喂养的可能性降低。孕前 BMI 高于健康范围的母亲出院前开始母乳喂养的可能性降低。这些信息应该用于制定和启动干预措施，以帮助那些希望母乳喂养但可能需要额外哺乳支持的母亲。
