Effect of a Home-Based Lifestyle Intervention on Breastfeeding Initiation Among Socioeconomically Disadvantaged African American Women with Overweight or Obesity.
Adam K Lewkowitz, Julia D López, Richard I Stein, Janine S Rhoades, Rosa C Schulz, Candice L Woolfolk, George A Macones, Debra Haire-Joshu, Alison G Cahill
Author Information
Adam K Lewkowitz: 1 Department of Obstetrics and Gynecology, Washington University in St. Louis , St. Louis, Missouri.
Julia D López: 1 Department of Obstetrics and Gynecology, Washington University in St. Louis , St. Louis, Missouri.
Richard I Stein: 2 Center for Human Nutrition, Washington University in St. Louis , St. Louis, Missouri.
Janine S Rhoades: 1 Department of Obstetrics and Gynecology, Washington University in St. Louis , St. Louis, Missouri.
Rosa C Schulz: 1 Department of Obstetrics and Gynecology, Washington University in St. Louis , St. Louis, Missouri.
Candice L Woolfolk: 1 Department of Obstetrics and Gynecology, Washington University in St. Louis , St. Louis, Missouri.
George A Macones: 1 Department of Obstetrics and Gynecology, Washington University in St. Louis , St. Louis, Missouri.
Debra Haire-Joshu: 3 School of Public Health and Medicine, Washington University in St. Louis , St. Louis, Missouri.
Alison G Cahill: 1 Department of Obstetrics and Gynecology, Washington University in St. Louis , St. Louis, Missouri.
BACKGROUND: Socioeconomically disadvantaged (SED) African American women with overweight or obesity are less likely to breastfeed. OBJECTIVE: To test whether a home-based lifestyle intervention impacts breastfeeding initiation rates in SED African American women with overweight or obesity. STUDY DESIGN: This was a secondary analysis of a randomized controlled trial from October 2012 to March 2016 at a university-based hospital within the LIFE-Moms consortium. SED African American women with overweight or obesity and singleton gestations were randomized by 16 weeks to Parents as Teachers (PAT)-a home-based parenting support and child development educational intervention-or PAT+, PAT with additional content on breastfeeding. Participants completed a breastfeeding survey. Outcomes included breastfeeding initiation and reasons for not initiating or not continuing breastfeeding. RESULTS: One hundred eighteen women were included: 59 in PAT+; 59 in PAT. Breastfeeding initiation rates were similar in each group (78.00% in PAT+; 74.58% in PAT). On a one to four scale, with four denoting "very important," women in PAT+ and PAT were equally likely to rate their beliefs that formula was better than breast milk or breastfeeding would be too inconvenient as the most important reasons to not initiate breastfeeding. On the same scale, women similarly rated their difficulty latching or concern for low milk supply as the most important reasons for breastfeeding cessation. CONCLUSION: SED African American women with overweight or obesity who received a home-based educational intervention had higher breastfeeding rates than is reported nationally for black women (59%). However, the intervention with more breastfeeding content did not further increase breastfeeding rates or impact reasons for breastfeeding cessation. TRIAL REGISTRATION: ClinicalTrials.gov : NCT01768793.
