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Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study

OBJECTIVES: Using routinely collected hospital data, this study explored secular trends over time in breast feeding initiation in a large Australian sample. The association between obesity and not breast feeding was investigated utilising a generalised estimating equations logistic regression that a...

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Autores principales: Bish, Melanie Rae, Faulks, Fiona, Amir, Lisa Helen, Huxley, Rachel R, McIntyre, Harold David, James, Rachel, Mnatzaganian, George
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878145/
https://www.ncbi.nlm.nih.gov/pubmed/33568376
http://dx.doi.org/10.1136/bmjopen-2020-044884
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author Bish, Melanie Rae
Faulks, Fiona
Amir, Lisa Helen
Huxley, Rachel R
McIntyre, Harold David
James, Rachel
Mnatzaganian, George
author_facet Bish, Melanie Rae
Faulks, Fiona
Amir, Lisa Helen
Huxley, Rachel R
McIntyre, Harold David
James, Rachel
Mnatzaganian, George
author_sort Bish, Melanie Rae
collection PubMed
description OBJECTIVES: Using routinely collected hospital data, this study explored secular trends over time in breast feeding initiation in a large Australian sample. The association between obesity and not breast feeding was investigated utilising a generalised estimating equations logistic regression that adjusted for sociodemographics, antenatal, intrapartum and postpartum conditions, mode of delivery and infant’s-related covariates. DESIGN: Population-based retrospective panel. SETTING: A regional hospital that serves 26% of Victoria’s 6.5 million population in Australia. PARTICIPANTS: All women experiencing live births between 2010 and 2017 were included. Women with missing body mass index (BMI) were excluded. RESULTS: A total of 7491 women contributed to 10 234 live births. At baseline, 57.2% of the women were overweight or obese, with obesity increasing over 8 years by 12.8%, p=0.001. Although, breast feeding increased over time, observed in all socioeconomic status (SES) and BMI categories, the lowest proportions were consistently found among the obese and morbidly obese (78.9% vs 87.1% in non-obese mothers, p<0.001). In the multivariable analysis, risk of not breast feeding was associated with higher BMI, teenage motherhood, smoking, belonging to the lowest SES class, gravidity >4 and undergoing an assisted vaginal or caesarean delivery. Compared with women with a normal weight, the obese and morbidly obese were 66% (OR 1.66, 95% CI 1.40 to 1.96, p<0.001) to 2.6 times (OR 2.61, 95% CI 2.07 to 3.29, p<0.001) less likely to breast feed, respectively. The detected dose–response effect between higher BMI and lower breast feeding was not explained by any of the study covariates. CONCLUSION: This study provides evidence of increasing breast feeding proportions in regional Victoria over the past decade. However, these proportions were lowest among the obese and morbidly obese and those coming from the most disadvantaged backgrounds suggesting the need for targeted interventions to support breast feeding among these groups. The psychosocial and physiological associations between obesity and breast feeding should further be investigated.
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spelling pubmed-78781452021-02-24 Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study Bish, Melanie Rae Faulks, Fiona Amir, Lisa Helen Huxley, Rachel R McIntyre, Harold David James, Rachel Mnatzaganian, George BMJ Open Obstetrics and Gynaecology OBJECTIVES: Using routinely collected hospital data, this study explored secular trends over time in breast feeding initiation in a large Australian sample. The association between obesity and not breast feeding was investigated utilising a generalised estimating equations logistic regression that adjusted for sociodemographics, antenatal, intrapartum and postpartum conditions, mode of delivery and infant’s-related covariates. DESIGN: Population-based retrospective panel. SETTING: A regional hospital that serves 26% of Victoria’s 6.5 million population in Australia. PARTICIPANTS: All women experiencing live births between 2010 and 2017 were included. Women with missing body mass index (BMI) were excluded. RESULTS: A total of 7491 women contributed to 10 234 live births. At baseline, 57.2% of the women were overweight or obese, with obesity increasing over 8 years by 12.8%, p=0.001. Although, breast feeding increased over time, observed in all socioeconomic status (SES) and BMI categories, the lowest proportions were consistently found among the obese and morbidly obese (78.9% vs 87.1% in non-obese mothers, p<0.001). In the multivariable analysis, risk of not breast feeding was associated with higher BMI, teenage motherhood, smoking, belonging to the lowest SES class, gravidity >4 and undergoing an assisted vaginal or caesarean delivery. Compared with women with a normal weight, the obese and morbidly obese were 66% (OR 1.66, 95% CI 1.40 to 1.96, p<0.001) to 2.6 times (OR 2.61, 95% CI 2.07 to 3.29, p<0.001) less likely to breast feed, respectively. The detected dose–response effect between higher BMI and lower breast feeding was not explained by any of the study covariates. CONCLUSION: This study provides evidence of increasing breast feeding proportions in regional Victoria over the past decade. However, these proportions were lowest among the obese and morbidly obese and those coming from the most disadvantaged backgrounds suggesting the need for targeted interventions to support breast feeding among these groups. The psychosocial and physiological associations between obesity and breast feeding should further be investigated. BMJ Publishing Group 2021-02-10 /pmc/articles/PMC7878145/ /pubmed/33568376 http://dx.doi.org/10.1136/bmjopen-2020-044884 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Obstetrics and Gynaecology
Bish, Melanie Rae
Faulks, Fiona
Amir, Lisa Helen
Huxley, Rachel R
McIntyre, Harold David
James, Rachel
Mnatzaganian, George
Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study
title Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study
title_full Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study
title_fullStr Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study
title_full_unstemmed Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study
title_short Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study
title_sort relationship between obesity and lower rates of breast feeding initiation in regional victoria, australia: an 8-year retrospective panel study
topic Obstetrics and Gynaecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878145/
https://www.ncbi.nlm.nih.gov/pubmed/33568376
http://dx.doi.org/10.1136/bmjopen-2020-044884
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