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The association between maternal adiposity and breastfeeding initiation and duration: evidence from the Southampton Women's Survey

The association between maternal adiposity and breastfeeding initiation and duration: evidence from the Southampton Women's Survey
The association between maternal adiposity and breastfeeding initiation and duration: evidence from the Southampton Women's Survey
Background: most mothers in the UK are not meeting the breastfeeding recommendations set by the World Health Organisation (WHO, Breastfeeding - Recommendations. https://www.who.int/health-topics/breastfeeding#tab=tab_2, 2023). Maternal obesity has variably been associated with lower initiation and shorter duration of breastfeeding, but few studies have examined the impact of maternal adiposity estimated from skinfold thicknesses.

Aim: to investigate the relationship between maternal adiposity and breastfeeding initiation and duration.

Methods: data from 2,873 mother-offspring pairs in the Southampton Women’s Survey (SWS) mother-offspring cohort study were used to assess the relationship between a mother’s adiposity and breastfeeding initiation and duration. The exposure variables were body mass index (BMI) and body fat percentage, calculated from 4-site skinfold thickness measurements measured prior to conception. The outcome variables were breastfeeding initiation and duration. All analyses were adjusted for confounders identified using a Directed Acyclic Graph.

Results: after adjustment for confounders, no associations were found between maternal BMI (RR 0.99 per 5 kg/m2, 95% CI 0.97, 1.01) or body fat percentage (RR 0.99 per 5%, 95% CI 0.97, 1.00) and initiation of breastfeeding. After adjustment for confounders, amongst women who initiated breastfeeding, higher maternal BMI (β −0.09 SDs per 5 kg/m2, 95% CI −0.13, −0.04) and body fat percentage (β −0.10 SDs per 5%, 95% CI −0.16, −0.04) were associated with shorter breastfeeding duration.

Conclusions: in this study maternal adiposity had little impact on breastfeeding initiation but higher maternal adiposity was associated with shorter breastfeeding duration. This study suggests that more support should be given to mothers with overweight and obesity to promote longer duration of breastfeeding.
1092-7875
Bird, Amelia Grace
90600878-402a-47c4-bd83-4029f9015b49
Inskip, Hazel
5fb4470a-9379-49b2-a533-9da8e61058b7
Godfrey, Keith M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Crozier, Sarah
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Baird, Janis
f4bf2039-6118-436f-ab69-df8b4d17f824
SWS Study Group
Bird, Amelia Grace
90600878-402a-47c4-bd83-4029f9015b49
Inskip, Hazel
5fb4470a-9379-49b2-a533-9da8e61058b7
Godfrey, Keith M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Crozier, Sarah
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Baird, Janis
f4bf2039-6118-436f-ab69-df8b4d17f824

Bird, Amelia Grace, Inskip, Hazel, Godfrey, Keith M., Harvey, Nicholas C., Crozier, Sarah and Baird, Janis , SWS Study Group (2026) The association between maternal adiposity and breastfeeding initiation and duration: evidence from the Southampton Women's Survey. Maternal and Child Health Journal. (doi:10.1007/s10995-025-04211-6).

Record type: Article

Abstract

Background: most mothers in the UK are not meeting the breastfeeding recommendations set by the World Health Organisation (WHO, Breastfeeding - Recommendations. https://www.who.int/health-topics/breastfeeding#tab=tab_2, 2023). Maternal obesity has variably been associated with lower initiation and shorter duration of breastfeeding, but few studies have examined the impact of maternal adiposity estimated from skinfold thicknesses.

Aim: to investigate the relationship between maternal adiposity and breastfeeding initiation and duration.

Methods: data from 2,873 mother-offspring pairs in the Southampton Women’s Survey (SWS) mother-offspring cohort study were used to assess the relationship between a mother’s adiposity and breastfeeding initiation and duration. The exposure variables were body mass index (BMI) and body fat percentage, calculated from 4-site skinfold thickness measurements measured prior to conception. The outcome variables were breastfeeding initiation and duration. All analyses were adjusted for confounders identified using a Directed Acyclic Graph.

Results: after adjustment for confounders, no associations were found between maternal BMI (RR 0.99 per 5 kg/m2, 95% CI 0.97, 1.01) or body fat percentage (RR 0.99 per 5%, 95% CI 0.97, 1.00) and initiation of breastfeeding. After adjustment for confounders, amongst women who initiated breastfeeding, higher maternal BMI (β −0.09 SDs per 5 kg/m2, 95% CI −0.13, −0.04) and body fat percentage (β −0.10 SDs per 5%, 95% CI −0.16, −0.04) were associated with shorter breastfeeding duration.

Conclusions: in this study maternal adiposity had little impact on breastfeeding initiation but higher maternal adiposity was associated with shorter breastfeeding duration. This study suggests that more support should be given to mothers with overweight and obesity to promote longer duration of breastfeeding.

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MCHJ.Manuscript.V2_20.10.25 - Accepted Manuscript
Restricted to Repository staff only until 9 January 2027.
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MCHJ.titlepage.v1 - Accepted Manuscript
Restricted to Repository staff only until 9 January 2027.
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More information

Accepted/In Press date: 4 December 2025
Published date: 9 January 2026

Identifiers

Local EPrints ID: 508444
URI: http://eprints.soton.ac.uk/id/eprint/508444
ISSN: 1092-7875
PURE UUID: 9a471bdf-cf59-4e8a-84e2-57ecdacee204
ORCID for Hazel Inskip: ORCID iD orcid.org/0000-0001-8897-1749
ORCID for Keith M. Godfrey: ORCID iD orcid.org/0000-0002-4643-0618
ORCID for Nicholas C. Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for Sarah Crozier: ORCID iD orcid.org/0000-0002-9524-1127
ORCID for Janis Baird: ORCID iD orcid.org/0000-0002-4039-4361

Catalogue record

Date deposited: 21 Jan 2026 17:51
Last modified: 24 Jan 2026 02:44

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Contributors

Author: Amelia Grace Bird
Author: Hazel Inskip ORCID iD
Author: Sarah Crozier ORCID iD
Author: Janis Baird ORCID iD
Corporate Author: SWS Study Group

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