Maternal obesity and breast-feeding practices among white and black women

Obesity (Silver Spring). 2010 Jan;18(1):175-82. doi: 10.1038/oby.2009.182. Epub 2009 Jun 11.


Despite the increase in obesity among women of reproductive ages, few studies have considered maternal obesity as a risk factor for breast-feeding success. We tested the hypothesis that women who are obese (BMI = 30-34.9) and very obese (BMI >or=35) before pregnancy are less likely to initiate and maintain breast-feeding than are their normal-weight counterparts (BMI = 18.5-24.9) among white and black women. Data from 2000 to 2005 South Carolina Pregnancy Risk Assessment Monitoring System (PRAMS) were used. The overall response rate was 71.0%; there were 3,517 white and 2,846 black respondents. Black women were less likely to initiate breast-feeding and breast-fed their babies for a shorter duration than white women. Compared to normal-weight white women, very obese white women were less likely to initiate breast-feeding (odds ratio: 0.63; 95% confidence interval (CI) = 0.42, 0.94) and more likely to discontinue breast-feeding within the first 6 months (hazard ratio (HR) = 1.89; 95% CI: 1.39, 2.58). Among black women, prepregnancy BMI was neither associated with breast-feeding initiation nor with breast-feeding continuation within the first 6 months. Because very obese white women are less likely to initiate or continue breast-feeding than other white women, health professionals should be aware that very obese white women need additional breast-feeding support. Lower rates of breast-feeding among black women suggest that they should continue to be the focus of the programs and policies aimed at breast-feeding promotion in the United States.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • African Americans / ethnology
  • Body Mass Index
  • Breast Feeding / epidemiology*
  • Cross-Cultural Comparison
  • European Continental Ancestry Group / ethnology
  • Female
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice*
  • Health Surveys
  • Humans
  • Kaplan-Meier Estimate
  • Longitudinal Studies
  • Mothers
  • Obesity / epidemiology*
  • Odds Ratio
  • Pregnancy
  • Prevalence
  • Surveys and Questionnaires
  • United States / epidemiology