The effect of maternal obesity on initiation and duration of breast-feeding in Greece: the GENESIS study

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Abstract
ObjectiveThe current paper aims to describe the characteristics of mothers failing to initiate breast-feeding, provide information on the factors contributing to longer duration of breast-feeding and identify the association of maternal obesity with both initiation and duration of breast-feeding in the Greek population.DesignData from the cross-sectional GENESIS (Growth, Exercise and Nutrition Epidemiological Study In preSchoolers) study were used. Mothers were categorized by their pre-pregnancy BMI and their gestational weight gain according to guidelines from the Institute of Medicine.SettingPreschool children aged 1–5 years in five counties in Greece.SubjectsPreschoolers (n 2374) with full maternal anthropometric data before and during pregnancy and breast-feeding data.ResultsA higher percentage of mothers with increased pre-pregnancy BMI or high gestational weight gain failed to initiate breast-feeding compared with their normal-weight counterparts. Obese mothers were 2·86 times more likely to fail in initiating breast-feeding in a multiple logistic regression model. Multiple linear regression analysis showed that among women initiating breast-feeding, those who were either underweight before pregnancy or smoked at the third trimester of pregnancy breast-fed their children for about 1·5 weeks less than their normal-weight or non-smoking counterparts, respectively. Similarly, multiparous women breast-fed their children for about 7 weeks less than uniparous women. In women who initiated breast-feeding, no significant differences in breast-feeding duration were found between women of different gestational weight gains.ConclusionsMothers with high pre-pregnancy BMI are less likely to initiate breast-feeding while high gestational weight gain has no effect on either the initiation or duration of breast-feeding in Greece.