The optimal infant feeding practice is breastfeeding. Breast milk not only has macro and micronutrients that support a child’s growth and health, it also has non-nutritive components that support the child’s immune system. Furthermore, breastfeeding not only benefits infants, but it also has several health benefits for women, and it is environmentally friendly! However, although breastfeeding is natural, it is not always easy. Biological, cultural and system-level challenges may get in the way of establishing or continuing breastfeeding.
For women with a gestational diabetes mellitus (GDM) diagnostic, obesity, severity of GDM and suboptimal breastfeeding performance can increase the risk of delayed lactogenesis, defined as the arrival of copious milk takes more than 72 h after delivery (Matias et al., 2014). This information, generally available in clinical settings, could be used to screen women with GDM who may be at higher risk of delayed lactogenesis.
Hospital policies for the perinatal period can be supportive or discouraging of breastfeeding. In a nationally representative sample of women and children enrolled in WIC, we found that rooming-in and strong hospital staff support were positively associated with breastfeeding beyond the hospital stay until the baby was 5 months old, while giving a pro-formula gift pack to mothers was negatively associated with breastfeeding during the same time (French et al., 2023). Expanding breastfeeding friendly hospital policies in the US could increase breastfeeding rates.
Breastfeeding may also disrupt the intergenerational transmission of obesity. For instance, excessive gestational weight gain (GWG), more common among women with pre-pregnancy obesity, can increase obesity risk in the offspring. Conversely, a lower risk of obesity has been observed among children who were breastfed vs. those who were not. We studied women and children from the largest WIC agency in California and found that shorter breastfeeding duration was associated with greater obesity risk for children of mothers who gained more weight during pregnancy, but not for those whose mothers had low GWG (Matias et al., 2023). This indicates that longer breastfeeding duration may provide greater protection against obesity for children at higher risk due to intrauterine exposure to high gestational weight gain (Matias et al., 2023).
Ongoing Projects
- Maternal WIC participation during pregnancy and gestational weight gain
- Impact of increased meal reimbursement rates of the CACFP on program participation by family child care homes in California