Open AccessSocial support modifies the association between pre-pregnancy body mass index and breastfeeding initiation in Brazil
Author(s) -
Mariana Pujól von Seehausen,
Rafael PérezEscamilla,
Maria Inês Couto de Oliveira,
María do Carmo Leal,
Cristiano Siqueira Boccolini
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0233452
Subject(s) - breastfeeding , overweight , medicine , demography , body mass index , social support , pregnancy , odds ratio , population , odds , obesity , obstetrics , gerontology , pediatrics , psychology , environmental health , logistic regression , social psychology , biology , sociology , genetics
Background Many biological, social and cultural barriers for suboptimal breastfeeding practices have been identified in literature. Among these, excessive pre-pregnancy weight has been identified as a risk factor for not initiating breastfeeding early. Social support, coming from social networks (e.g. a partner, family or friends) or health care providers, has been positively associated with breastfeeding. This study aimed to examine the association between pre-pregnancy excessive weight and breastfeeding within the first hour after birth and if social support modifies this association. Design National population-based study conducted with 21,086 postpartum women from February 1, 2011 to October 31, 2012 in 266 hospitals from all five regions of Brazil. Social support was defined as having a companion at the hospital. Main effects and interactions were tested with multivariable regression analyses. Results Multivariate regression analyses indicated that class I and class II obese women had lower odds of breastfeeding within the first hour when a companion was not present (AOR = 0.59, 95% CI 0.42–0.82 and AOR = 0.59, 95% CI 0.36–0.97, respectively), but there was no association when the companion was present. Among overweight and obese women, the predicted probability of breastfeeding within the first hour was lower for those without a companion. This association was not found among those with normal pre-pregnancy BMI. Conclusions Social support modifies the relationship between pre-gestational BMI and breastfeeding initiation among women who are overweight or obese, specifically it reduces the risk of delayed breastfeeding initiation.