Excesso de peso materno pré-gestacional, ganho de peso na gestação e interrupção precoce do aleitamento materno exclusivo no primeiro mês de vida

Abstract

Despite the vast literature on the benefits of breastfeeding for maternal and child health, its prevalence remains low in Brazil, especially in relation to exclusive breastfeeding. In addition, national surveys indicate a high percentage of overweight among women of reproductive age. These scenarios have been shown to be convergent, in that there is some evidence about the association between mother´s overweight and breastfeeding. To contribute to this debate, the current study investigated the relationships among maternal prepregnant overweight, gestational weight gain and early interruption of exclusive breastfeeding in the first month of life. This is a cross-sectional study, inserted in a prospective cohort, involving 592 adult women in the immediate postpartum and their newborns, admitted in four primary health care units in Rio de Janeiro, Brazil. We used data from the first interview of the follow-up, obtained from June 2005 to July 2008. Breastfeeding status was assessed with 24-hour dietary recall. Early interruption of exclusive breastfeeding was defined as the introduction of water, tea, juice, other types of milk or food. Body Mass Index before pregnancy was categorized according to the cutoffs for adult women defined by the World Health Organization. Gestational weight gain was classified according to the guidelines from the Institute of Medicine. For the analysis we used logistic regression models, estimating the crude and adjusted odds ratios and their respective 95% confidence intervals and p- values for the associations investigated. The prevalence of early interruption of exclusive breastfeeding was 22.6% in the sample. Obese women were 2.14 (p=0,01) more likely to suspend exclusive breastfeeding in the first month postpartum, compared with normal BMI women. Both overweight (OR= 2,11; p=0,03) and obese (OR= 3,10; p=0,01) women, who exceeded the IOM recommendations, had higher odds of early interruption of exclusive breastfeeding, compared to normal-weight who gained within the recommendations. These findings highlight the importance of conceiving at a healthy weight, and gaining the recommended amount of weight during pregnancy, for the successful establishment of exclusive breastfeeding