Maternal and Child Health Journal

, Volume 23, Issue 1, pp 19–29 | Cite as

Breastfeeding Discontinuation Not Associated with Maternal Pregravid BMI But Associated with Native Hawaiian or Other Pacific Islander Race in Hawaii and Puerto Rico WIC Participants

  • Cheryl L. K. Gibby
  • Cristina Palacios
  • Maribel Campos
  • Eunjung Lim
  • Jinan BannaEmail author


Objectives This study investigated the association between maternal pregravid body mass index (BMI) and breastfeeding discontinuation at 4–6 months postpartum in Hawaii and Puerto Rico participants from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Methods A secondary data analysis was conducted from a text message-based intervention in WIC participants in Hawaii and Puerto Rico. The analysis included 87 women from the control group who initiated breastfeeding and whose breastfeeding status was known at the end of the study when infants were 4–6 months old. Pregravid BMI and breastfeeding discontinuation were assessed using questionnaires. Results The association between pregravid BMI and breastfeeding discontinuation was not significant in the unadjusted model or in the adjusted model. Native Hawaiian or Other Pacific Islander (NHOPI) participants showed significantly increased odds of discontinuing breastfeeding (adjusted odds ratio [AOR] 7.12; 95% CI 1.34, 37.97; p = .02) compared to all the other racial/ethnic participants, as did older women ages 32–39 years versus women who were 25–31 years old (AOR 4.21; 95% CI 1.13, 15.72; p = .03). Women who took vitamins while breastfeeding had decreased odds of discontinuing breastfeeding (AOR 0.15; 95% CI 0.05, 0.46; p = .0009). Conclusions for Practice Pregravid BMI was not significantly associated with breastfeeding discontinuation at 4–6 months postpartum in women from Hawaii and Puerto Rico WIC, but NHOPIs and women who were older had higher odds of discontinuing breastfeeding. The results of this study may inform strategies for breastfeeding promotion and childhood obesity prevention but should be further investigated in larger studies. Identifier: NCT02903186.


Pregravid BMI Breastfeeding WIC Low income 



This study was supported by the National Institute on Minority Health and Health Disparities (NIMHD) of the National Institutes of Health under award number U54MD008149 and in part by grant U54MD007584 (RMATRIX). Infrastructure support was also provided in part by the NIMHD RCMI Grant: 8G12MD007600. The authors acknowledge Linda Chock (Branch Chief), Iris Takahashi (Clinic Operations Section Chief), Laura Morihara (Wahiawa WIC Coordinator), Wendy Baker (Wahiawa WIC Office Assistant), Jean Kanda (Leeward WIC Coordinator), Dawn Fujimoto-Redoble (Leeward WIC Nutritionist), and Christina Mariano (Pearl City WIC Coordinator) from the Hawaii Department of Health WIC Services Branch. They also acknowledge the Puerto Rico WIC Program, including Dana Miró (Executive Director), Blanca Sastre (Interim supervisor of Nutrition and Lactation Division), Alexandra Reyes (Nutrition Education Coordinator), Iris Roldan (Breastfeeding Coordinator), Ivelisse Bruno (Breastfeeding Peer Support Coordinator), Sherley M. Panell (Nutrition Supervisor in Plaza las Americas WIC Clinic) and her team, and Marta Meaux (Nutrition Supervisor in Trujillo Alto WIC Clinic) and her team. They also thank the WIC participants and undergraduate and graduate research assistants.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10995_2018_2587_MOESM1_ESM.pdf (53 kb)
Supplementary material 1 (PDF 53 KB)


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human ResourcesUniversity of Hawaii at ManoaHonoluluUSA
  2. 2.Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social WorkFlorida International UniversityMiamiUSA
  3. 3.Dental and Craniofacial Genomics Unit, Endowed Health Services Research CenterMedical Sciences Campus, University of Puerto RicoSan JuanUSA
  4. 4.Department of Complementary and Integrative Medicine, Biostatistics Core Facility, John A. Burns School of MedicineUniversity of Hawaii at ManoaHonoluluUSA

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