Associations among high prepregnancy body mass index, use of a breast pump and breastfeeding outcomes: Data from the Infant Feeding Practices Study II

Although high prepregnancy body mass index (PPBMI, > 25 kg/m 2 ) is associated with less successful breastfeeding (BF), it is unknown whether this extends to the use of a breast pump (BP). The associations among high PPBMI, use of a BP and BF outcomes were studied among the 2279 women in the Infant Feeding Practices Study II who ever breastfed; 1874 of these women used a BP. Data were analyzed by regression analysis in models adjusted for confounding factors. There was no difference between those with high or a normal PPBMI in whether a mother used a BP, was successful at expressing her milk if she did use a BP, why she chose to use a BP or when she started to use a BP. However, high PPBMI was associated ( P < 0.03) with an earlier last use of a BP. Among women with a high PPBMI, those who used a BP breastfed for a longer period ( P < 0.001) and ceased BF for different reasons than those who did not use a BP. Among women with a high PPBMI who used a BP, those who were unsuccessful at expressing their milk experienced several difficulties with BF and stopped BF sooner ( P = 0.0003) than those who were successful at expressing their milk. Thus, high PPBMI was not a barrier to use of a BP and those who chose to use one were able to maintain dyadic BF for a longer period. (Funded in part by USDA Hatch grant NYC399427 and FDA.)