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Maternal and Child Health Journal

, Volume 20, Issue 2, pp 270–280 | Cite as

The Associations of Maternal Weight Change with Breastfeeding, Diet and Physical Activity During the Postpartum Period

  • Nancy López-Olmedo
  • Sonia Hernández-CorderoEmail author
  • Lynnette M. Neufeld
  • Armando García-Guerra
  • Fabiola Mejía-Rodríguez
  • Ignacio Méndez Gómez-Humarán
Article

Abstract

Objective To determine the association between breastfeeding practices, diet and physical activity and maternal postpartum weight. Methods This was a secondary data analysis of a randomized community trial on beneficiaries of the Programa de Desarrollo Humano Oportunidades, recently renamed Prospera (n = 314 pregnant women), without any diseases that could affect body weight. Generalized estimating equations were used to determine the association between postpartum weight change and changes in diet, physical activity and type of breastfeeding. Results The mean postpartum weight change from the first to the third month was 0.6 ± 2.2 kg. Women who breastfed exclusively for 3 months had a 4.1 (SE = 1.9) kg weight reduction in comparison with women who did not provide exclusive breastfeeding or who discontinued breastfeeding before 3 months (p = 0.04). There was no association between postpartum weight change and physical activity (p = 0.24) or energy intake (p = 0.06). Conclusions Exclusive breastfeeding was associated with maternal postpartum weight reduction. These results reinforce the World Health Organization recommendation of exclusive breastfeeding during the first 6 months of life in order to reduce the risk of weight retention or weight gain in postpartum women. It has been well established that exclusive breastfeeding is beneficial for both infants and mothers, but promoting breastfeeding as a strategy to promote postpartum weight loss is of paramount importance, especially in countries like Mexico where excessive weight in women of reproductive age is a public health problem.

Keywords

Body weight Postpartum period Breastfeeding Mexico 

Notes

Acknowledgments

This study was funded by National Commission for Health Protection, the Ministry of Health and the National Coordinator of the Prospera program for the primary study. We are grateful to Katia Ortiz Toledo for assistance with manuscript preparation.

Supplementary material

10995_2015_1826_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 16 kb)

References

  1. 1.
    World Health Organization. (2000). Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. Geneva: WHO. (Technical report series 894).Google Scholar
  2. 2.
    Gutiérrez, J. P., Rivera-Dommarco, J., Shamah-Levy, T., Villalpando-Hernández, S., Franco, A., Cuevas-Nasu, L., et al. (2012). Encuesta Nacional de Salud y Nutrición 2012. Resultados Nacionales. Cuernavaca: Instituto Nacional de Salud Pública.Google Scholar
  3. 3.
    Institute of Medicine. (2009). Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: National Academies Press.Google Scholar
  4. 4.
    Linné, Y., Dye, L., Barkeling, B., & Rössner, S. (2004). Long-term weight development in women: a 15-year follow-up of the effects of pregnancy. Obesity Research, 12, 1166–1178.CrossRefPubMedGoogle Scholar
  5. 5.
    Gunderson, E. P., Abrams, B., & Selvin, S. (2000). The relative importance of gestational gain and maternal characteristics associated with the risk of becoming overweight after pregnancy. International Journal of Obesity, 24, 1660–1668.CrossRefPubMedGoogle Scholar
  6. 6.
    Nohr, E. A., Vaeth, M., Baker, J. L., Sørensen, T. I. A., Olsen, J., & Rasmussen, K. M. (2008). Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. American Journal of Clinical Nutrition, 87, 1750–1759.PubMedGoogle Scholar
  7. 7.
    Dugdale, A. E., & Eaton-Evans, J. (1989). The effect of lactation and other factors on post-partum changes in body-weight and triceps skinfold thickness. British Journal of Nutrition, 61, 149–153.CrossRefPubMedGoogle Scholar
  8. 8.
    Haiek, L. N., Kramer, M. S., Ciampi, A., & Tirado, R. (2001). Postpartum weight loss and infant feeding. The Journal of the American Board of Family Medicine, 14, 85–94.Google Scholar
  9. 9.
    Gunderson, E. P., Lewis, C. E., Wei, G. S., Whitmer, R. A., Quesenberry, C. P., & Sidney, S. (2007). Lactation and changes in maternal metabolic risk factors. Obstetrics and Gynecology, 109, 729–738.PubMedCentralCrossRefPubMedGoogle Scholar
  10. 10.
    Brewer, M. M., Rates, M. R., & Vannoy, L. P. (1989). Postpartum changes in maternal weight and body fat depots in lactating vs nonlactating women. American Journal of Clinical Nutrition, 49, 259–265.PubMedGoogle Scholar
  11. 11.
    Janney, C. A., Zhang, D., & Sowers, M. F. (1997). Lactation and weight retention. American Journal of Clinical Nutrition, 66, 1116–1124.PubMedGoogle Scholar
  12. 12.
    Adair, L. S., & Popkin, B. M. (1992). Prolonged lactation contributes to depletion of maternal energy reserves in Filipino women. Journal of Nutrition, 122, 1643–1655.PubMedGoogle Scholar
  13. 13.
    Motil, K. J., Sheng, H. P., Kertz, B. L., Montandon, C. M., & Ellis, K. J. (1998). Lean body mass of well-nourished women is preserved during lactation. American Journal of Clinical Nutrition, 67, 292–300.PubMedGoogle Scholar
  14. 14.
    Butte, N. F., Barbosa, L., Villalpando, S., Wong, W. W., & Smith, E. O. (1997). Total energy expenditure and physical activity level of lactating mesoamerindians. Journal of Nutrition, 127, 299–305.PubMedGoogle Scholar
  15. 15.
    Piperata, B. A., & Dufour, D. L. (2007). Diet, energy expenditure and body composition of lactating Ribeirinha women in the Brazilian Amazon. American Journal of Human Biology, 19, 722–734.CrossRefPubMedGoogle Scholar
  16. 16.
    Rivera, J. A., Barquera, S., Campirano, F., Campos, I., Safdie, M., & Tovar, V. (2002). Epidemiological and nutritional transition in Mexico: Rapid increase of non-communicable chronic disease and obesity. Public Health Nutrition, 5, 113–122.CrossRefPubMedGoogle Scholar
  17. 17.
    Neufeld, L. M., García-Guerra, A., Leroy, L. J., Flores-López, M. L., Fernández-Gaxiola, A. C., & Rivera-Dommarco, J. A. (2006). Impacto del Programa Oportunidades en nutrición y alimentación en zonas urbanas de México. In B. Hernández-Prado & M. Hernández-Ávila (Eds.), Evaluación externa de impacto del Programa Oportunidades 2006. Tomo II, Alimentación. Instituto Nacional de Salud Pública: Cuernavaca.Google Scholar
  18. 18.
    Nuefeld, L. M., García Guerra, A., Quezada, A. D., Fernández Gaxiola, A. C., Mejía, F., & Pfeffer, F. (2011). Oportunidades y nutrición de la población urbana. Situación nutricional a mediano plazo de niños y mujeres beneficiarios de Oportunidades en zonas urbanas (2002–2009). In Evaluación Externa del Programa Oportunidades 2010 en zonas urbanas. Efectos de Oportunidades en Salud y Nutrición (20022009) (pp. 100–166). Secretaría de Desarrollo Social. México, D.F.: Coordinación Nacional del Programa de Desarrollo Humano Oportunidades.Google Scholar
  19. 19.
    Shamah-Levy, T., Villalpando, S., Mundo-Rosas, V., De la Cruz-Góngora, V., Mejía-Rodríguez, F., & Méndez Gómez-Humarán, I. (2013). Prevalencia de anemia en mujeres mexicanas en edad reproductiva, 1999–2012. Salud Publica de Mexico, 55(supl 2), S190–S198.PubMedGoogle Scholar
  20. 20.
    Mejía-Rodríguez, F., Shamah-Levy, T., Villalpando, S., García-Guerra, A., & Méndez-Gómez Humarán, I. (2013). Iron, zinc, copper and magnesium deficiencies in Mexican adults from the National Health and Nutrition Survey 2006. Salud Publica de Mexico, 55(suppl 2), S275–S284.Google Scholar
  21. 21.
    Rivera-Dommarco, J. A., Cuevas-Nasu, L., González de Cosío, T., Shamah-Levy, T., & García-Feregrino, R. (2013). Desnutrición crónica en México en el último cuarto de siglo: análisis de cuatro encuestas nacionales. Salud Publica de Mexico, 55(suppl 2), S161–S169.PubMedGoogle Scholar
  22. 22.
    Morales-Ruán, M. C., Villalpando, S., García-Guerra, A., Shamah-Levy, T., Robledo-Pérez, R., Ávila-Arcos, M. A., et al. (2012). Iron, zinc, copper, and magnesium nutritional status in Mexican children aged 1 to 11 years. Salud Publica de Mexico, 54, 125–134.CrossRefGoogle Scholar
  23. 23.
    Morales-Ruán, M. C., Shamah-Levy, T., Mundo-Rosas, V., Cuevas-Nasu, L., Romero-Martínez, M., Villalpando, S., & Rivera-Dommarco, J. A. (2013). Programas de ayuda alimentaria en México, cobertura y focalización. Salud Publica de Mexico, 55(supl 2), S199–S205.Google Scholar
  24. 24.
    Lohman, T., Roche, A., & Martorell, R. (Eds.). (1998). Anthropometric standardization reference manual. Champaign: Human Kinetics.Google Scholar
  25. 25.
    Rodríguez-Ramírez, S., Mundo-Rosas, V., Jiménez-Aguilar, A., Shamah-Levy, T. (2009). Methodology for the analysis of dietary data from the Mexican National Health and Nutrition Survey 2006. Salud Publica de Mexico, 51(suppl 4), S523–S529.PubMedGoogle Scholar
  26. 26.
    International Physical Activity Questionnaire (2002). Long last 7 days self-administered version of the IPAQ. USA Spanish version translated 3/2003. http://www.ipaq.ki.se/downloads.htm. Accessed 21 April 2009.
  27. 27.
    World Health Organization. (1995). Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series 854. Geneva: World Health Organization.Google Scholar
  28. 28.
    World Health Organization. (2008). Indicators for assessing infant and young child feeding practices: conclusions of a consensus meeting held 6-8 November 2007 in Washington D.C., USA. Geneva: WHO Press.Google Scholar
  29. 29.
    International Physical Activity Questionnaire. (2005). Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ). http://www.ipaq.ki.se/scoring.htm. Accessed 21 April 2009.
  30. 30.
    Amorim, A. R., Linné, Y., Kac, G., & Lourenco, P. M. (2008). Assessment of weight changes during and after pregnancy: Practical approaches. Maternal & Child Nutrition, 4, 1–13.CrossRefGoogle Scholar
  31. 31.
    Reyment, R. A., & Jvreskog, K. G. (1996). Applied factor analysis in the natural sciences. Cambridge: Cambridge University Press.Google Scholar
  32. 32.
    Vyas, S., & Kumaranayake, L. (2006). Constructing socio-economic status indices: How to use principal components analysis. Health Policy and Planning, 21(6), 459–468.CrossRefPubMedGoogle Scholar
  33. 33.
    Lipsitz, S., & Fitzmaurice, G. (2009). Generalized estimating equations for longitudinal data analysis. In G. Fitzmaurice, M. Davidian, G. Verbeke, & G. Molenberghs (Eds.), longitudinal data analysis. Nueva York: CRC Press.Google Scholar
  34. 34.
    Baker, J. L., Gamborg, M., Heitmann, B. L., Lissner, L., Sorensen, T. I. A., & Rasmussen, K. M. (2008). Breastfeeding reduces postpartum weight retention. American Journal of Clinical Nutrition, 88, 1543–1551.CrossRefPubMedGoogle Scholar
  35. 35.
    Hytten, F. E., & Leitch, I. (1971). The physiology of pregnancy (2a ed.). Oxford: Blackwell Scientific Publications.Google Scholar
  36. 36.
    Goldberg, G. R., Prentice, A. M., Coward, W. A., Davies, H. L., Murgatrovd, P. R., Sawyer, M. B., et al. (1991). Longitudinal assessment of the components of energy balance in well-nourished lactating women. American Journal of Clinical Nutrition, 54, 788–798.PubMedGoogle Scholar
  37. 37.
    Olson, C. M., Strawderman, M. S., Hinton, P. S., & Pearson, T. A. (2003). Gestational weight gain and postpartum behaviors associated with weight change from early pregnancy to 1y postpartum. International Journal of Obesity, 27, 117–127.CrossRefPubMedGoogle Scholar
  38. 38.
    Heitmann, B. L., & Lissner, L. (1995). Dietary underreporting by obese individuals—Is it specific or non-specific? British Medical Journal, 311, 985–989.CrossRefGoogle Scholar
  39. 39.
    Lichtman, S. W., Pisarska, K., Berman, E. R., Pestone, M., Dowling, H., Offenbacher, E., et al. (1992). Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. The New England Journal of Medicine, 31, 1893–1898.CrossRefGoogle Scholar
  40. 40.
    Campirano, F., Barquera, S., Rivera, J., Hernández-Prado, B., Flores, M., & Monterrubio, E. (2001). Estimation of energy under-reporting in obese and non-obese Mexican women using different equations: Analysis of the Mexican Nutrition Survey. Ann Nutr Metabol, 45, 146.Google Scholar
  41. 41.
    Pereira, M., Rifas-Shiman, S., Kleinman, K., Rich-Edwards, J., Peterson, K., & Gillman, M. (2007). Predictors of change in physical activity during and after pregnancy: Project viva. American Journal of Preventive Medicine, 32, 312–319.PubMedCentralCrossRefPubMedGoogle Scholar
  42. 42.
    Treuth, M. S., Butte, N. F., & Puyau, M. (2003). Pregnancy-related changes in physical activity, fitness, and strength. Medicine and Science in Sports and Exercise, 37(5), 832–837.CrossRefGoogle Scholar
  43. 43.
    Gunderson, E. P., Rifas-Shiman, S. L., Oken, E., Rich-Edwards, J. W., Kleinman, K. P., Taveras, E. M., et al. (2007). Association of fewer hours of sleep at 6 months postpartum with substantial weight retention at 1 year postpartum. American Journal of Epidemiology, 167, 178–187.PubMedCentralCrossRefPubMedGoogle Scholar
  44. 44.
    Fraser, A. M., Brockert, J. E., & Ward, R. H. (1995). Association of young maternal age with adverse reproductive outcomes. The New England Journal of Medicine, 332, 1113–1117.CrossRefPubMedGoogle Scholar
  45. 45.
    Gunderson, E. P., Abrams, B., & Selvin, S. (2001). Does the pattern of postpartum weight change differ according to pregravid body size? International Journal of Obesity, 25, 853–858.CrossRefPubMedGoogle Scholar
  46. 46.
    Scanlon, K. S., Grummer-Strawn, L., Shealy, K. R., Jefferds, M. E., Chen, J., Singleton, J. A., et al. (2007). Breastfeeding trends and updated national health objectives for exclusive breastfeeding—United States, birth years 2000–2004. Morbidity and Mortality Weekly Report, 56(30), 760–763.Google Scholar
  47. 47.
    Rooney, B., & Schauberger, C. (2002). Excess pregnancy weight gain and long-term obesity: One decade later. Obstetrics and Gynecology, 100, 245–252.CrossRefPubMedGoogle Scholar
  48. 48.
    Whitaker, R. C. (2004). Predicting preschooler obesity at birth: The role of maternal obesity in early pregnancy. Pediatrics, 114, e29–e36.CrossRefPubMedGoogle Scholar
  49. 49.
    de Boo, H. A., & Harding, J. E. (2006). The developmental origins of adult disease (Barker) hypothesis. Australian and New Zealand Journal of Obstetrics and Gynaecology, 46, 4–14.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Nancy López-Olmedo
    • 1
  • Sonia Hernández-Cordero
    • 1
    Email author
  • Lynnette M. Neufeld
    • 2
  • Armando García-Guerra
    • 1
  • Fabiola Mejía-Rodríguez
    • 1
  • Ignacio Méndez Gómez-Humarán
    • 3
  1. 1.Nutrition and Health Research CenterNational Institute of Public HealthCuernavacaMexico
  2. 2.Global Alliance for Improved Nutrition (GAIN)GenevaSwitzerland
  3. 3.Centro de Investigación en Matemáticas A.C., Unidad AguascalientesAguascalientesMexico

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