Pre-pregnancy BMI, gestational weight gain and breast-feeding: a cohort study in China

Objective: The purpose of the present study was to examine the influence of maternal pre-pregnancy BMI and gestational weight gain (GWG) on initiation and duration of infant breast-feeding in a prospective birth cohort study. Design: Breast-feeding information was collected at 1, 3, 6 and 12 months postpartum. The association of pre-pregnancy BMI and GWG with delayed lactogenesis II and termination of exclusive breast-feeding was assessed with logistic regression analysis. The risk of early termination of any breast-feeding during the first year postpartum was assessed with Cox proportional hazards models. Setting: Urban city in China. Subjects: Women with infants from the Ma'anshan Birth Cohort Study (n 3196). Results: The median duration of any breast-feeding in this cohort was 7.0 months. Pre-pregnancy obese women had higher risks of delayed lactogenesis II (risk ratio=1.89; 95 % CI 1.04, 3.43) and early termination of any breast-feeding (hazard ratio=1.38; 95 % CI 1.09, 1.75) adjusted for potential maternal and infant confounders, when compared with normal-weight women. No differences in breast-feeding initiation or duration of exclusive breast-feeding according to pre-pregnancy BMI were found. Moreover, GWG was not associated with any poor breast-feeding outcomes. Conclusions: The present study indicated that pre-pregnancy obesity increases the risks of delayed lactogenesis II and early termination of any breast-feeding in Chinese women.