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Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study

Bish, Melanie Rae, Faulks, Fiona, Amir, Lisa Helen, Huxley, Rachel R., Mcintyre, Harold David, James, Rachel and Mnatzaganian, George 2021, Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study, BMJ Open, vol. 11, no. 2, pp. 1-8, doi: 10.1136/bmjopen-2020-044884.

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Title Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study
Author(s) Bish, Melanie Rae
Faulks, Fiona
Amir, Lisa Helen
Huxley, Rachel R.ORCID iD for Huxley, Rachel R. orcid.org/0000-0002-2705-6616
Mcintyre, Harold David
James, Rachel
Mnatzaganian, George
Journal name BMJ Open
Volume number 11
Issue number 2
Article ID e044884
Start page 1
End page 8
Total pages 8
Publisher BMJ
Place of publication London, Eng.
Publication date 2021-02-10
ISSN 2044-6055
2044-6055
Keyword(s) neonatology
nutrition & dietetics
obstetrics
public health
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
nutrition &
dietetics
Summary Objectives Using routinely collected hospital data, this study explored secular trends over time in breast feeding initiation in a large Australian sample. The association between obesity and not breast feeding was investigated utilising a generalised estimating equations logistic regression that adjusted for sociodemographics, antenatal, intrapartum and postpartum conditions, mode of delivery and infant’s-related covariates.Design Population-based retrospective panel.Setting A regional hospital that serves 26% of Victoria’s 6.5 million population in Australia.Participants All women experiencing live births between 2010 and 2017 were included. Women with missing body mass index (BMI) were excluded.Results A total of 7491 women contributed to 10 234 live births. At baseline, 57.2% of the women were overweight or obese, with obesity increasing over 8 years by 12.8%, p=0.001. Although, breast feeding increased over time, observed in all socioeconomic status (SES) and BMI categories, the lowest proportions were consistently found among the obese and morbidly obese (78.9% vs 87.1% in non-obese mothers, p<0.001). In the multivariable analysis, risk of not breast feeding was associated with higher BMI, teenage motherhood, smoking, belonging to the lowest SES class, gravidity >4 and undergoing an assisted vaginal or caesarean delivery. Compared with women with a normal weight, the obese and morbidly obese were 66% (OR 1.66, 95% CI 1.40 to 1.96, p<0.001) to 2.6 times (OR 2.61, 95% CI 2.07 to 3.29, p<0.001) less likely to breast feed, respectively. The detected dose–response effect between higher BMI and lower breast feeding was not explained by any of the study covariates.Conclusion This study provides evidence of increasing breast feeding proportions in regional Victoria over the past decade. However, these proportions were lowest among the obese and morbidly obese and those coming from the most disadvantaged backgrounds suggesting the need for targeted interventions to support breast feeding among these groups. The psychosocial and physiological associations between obesity and breast feeding should further be investigated.
Language eng
DOI 10.1136/bmjopen-2020-044884
Indigenous content off
Field of Research 1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30148816

Document type: Journal Article
Collections: Faculty of Health
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.