Obese women tend to evince less interest in breastfeeding their babies. The tendency is stronger among whites than among blacks, a US study says.
Actually, breastfeeding rates among the black women are lower. In 2005, white women in the United States had a higher breast-feeding initiation rate than African American women (76.8 vs. 61.4%). At 6 months, 43.2% of white women were still breast-feeding to some extent, a rate much higher than 29.3% for African American women.
As obesity rates among black women are higher, they are less likely to initiate breast-feeding, and, if they do so, they may not continue for long, one would be inclined to think obesity is a much greater risk factor among blacks.
It was in that backdrop researchers from the Normal School of Public Health, University of South Carolina examined the associations of maternal obesity with breast-feeding initiation and duration among white and black women.
Data from 2000 to 2005 South Carolina Pregnancy Risk Assessment Monitoring System (PRAMS) were used. The overall response rate was 71.0%; there were 3,517 white and 2,846 black respondents.
Black women were less likely to initiate breast-feeding and breast-fed their babies for a shorter duration than white women. Compared to normal-weight white women, very obese white women were less likely to initiate breast-feeding.
Among black women, pre-pregnancy Body Mass Index was neither associated with breast-feeding initiation nor with breast-feeding continuation within the first 6 months.
"We found a negative association between maternal obesity and breast-feeding initiation and duration among white women. The inverse relationship is the strongest among very obese white women. However, this association was not observed among black women. The significant results among white women are in agreement with earlier published studies," the researchers said in their findings published in the Obesity journal.
Breast-feeding practices should also be considered as a social act which is influenced by psychosocial and cultural factors. Thus, alternative explanations for the inverse relationship between BMI and breast-feeding practices were also possible. First, because obese women may have low self-esteem and poor mental health, they may be less likely to initiate breast-feeding and maintain breast-feeding, if initiated.
Given that the obesity rates were lower among white women than black women, we speculate that very obese white women may experience lower self-esteem than very obese black women. Second, maternal prenatal intention to breast-feed is known to be a strong predictor of breast-feeding initiation and duration.
Thus, it is possible that obese white women may be less motivated to breast-feed their infants for the health benefits of breast milk than normal-weight white women. Among black women, "preference for bottle-feeding" is often listed as a primary reason for them not to breast-feed their infants, and lack of social support for breast-feeding is considered a major barrier to initiate breast-feeding.
Possibly such psychosocial and cultural barriers among black women may be so dominant that they may override any potential biological mechanism between maternal obesity and breast-feeding practices suggested earlier. Future studies are needed to examine how the biological and psychosocial factors related to breast-feeding practices might interact with maternal prepregnancy weight status and the impact on initiation and/or premature cessation of breast-feeding for both white and black women.
"Because very obese white women are less likely to initiate or continue breast-feeding than other white women, health professionals should be aware that very obese white women need additional breast-feeding support," the research paper says.
All the same, it cautions, "Although maternal obesity is not associated with breast-feeding practices among black women, the lower rates of breast-feeding among black women vs. white women suggest that black women should continue to be the focus of the programs and policies aimed at promoting breast-feeding practices in the United States."