Effect of Pathological Gestational Weight Gain on Subsequent Lactation

The onset, duration of lactation and exclusive breastfeeding (BF) depend on maternal factors. Objective:  The aim of our study was to investigate the effect of pathological gestational weight gain (GWG) on subsequent lactation. Design: This was a prospective cohort study of 219 women, aged 18 to 43 years, who were enrolled at 9-11 weeks and were followed-up at 22-24, 37-39 weeks of pregnancy, and 1 year postpartum.  Anthropometry, body mass index, GWG were calculated. The percentage of body fat mass (% FM) was calculated on the basis of bioelectrical impedance analysis (BIA) using the “Diamant-aist” analyzer (St. Petersburg). The delayed onset of lactation (more than 72 hours), the duration of lactation, exclusive BF were interviewed. The results were statistically analyzed using statistical analysis package based on Microsoft Excel and Statistica 6.0 program pack (StatSoft Inc., USA). Results: The total BF and exclusive BF median durations were 29.7±10.1 (95% Cl 25.7-33.7) weeks and 22.2±6.2 (95% Cl 18.2-26.2) weeks, respectively. A negative association between the elevation of the %FM during pregnancy and the duration of BF (r= - 0.21, p=0.001; r= - 0.32, p<0.0001; r=- 0.47, p<0.0001, respectively in the first, second and third trimesters) was diagnosed. It has been proved that excessive GWG was significantly associated with shorter duration of lactation (p<0.05), with shorter duration of exclusive BF (OR 0.5; 95% Cl 0.2-0.9, p=0.03), with increased chances of discontinuing BF before 6 month postpartum (OR 2.2; 95% Cl 1.0-4.5, p=0.04), and delayed onset of lactation (OR 2.1; 95% Cl 1.1-4.1, p=0.04) compared with the recommended GWG women. Conclusion: Informing the pregnant women about the negative effect of pathological GWG on subsequent lactation, regular assessing the dynamics of weight gain during pregnancy, and taking measures to prevent overweight and obesity in the postpartum period should be an important focus of antenatal care.