Research has shown that maternal obesity and underweight are major risk factors for reduced initiation, duration, and exclusivity of breastfeeding. This prospective, cohort study analysed the association between gestational body mass index (BMI) and symptoms of eating disorders (ED) in breastfeeding women.

The study involved 1318 consecutive, at term, healthy mothers, who delivered at the division of Perinatal Medicine of Policlinico Abano Terme, located in a North-Eastern Italy industrialized area, supporting advanced educational levels, good socio-economic status and low and late fertility. The day of discharge mothers completed the completed the eating disorder examination-questionnaire (Fairburn and Beglin, 2008), including four subscales, restraint (R), shape concerns (SC), weight concerns (WC), eating concerns (EC) and a global score (GS). Mothers’ BMI groups were categorized as underweight, normal weight, overweight and obese, according to 2009 IOM guidelines.

EDE-Q mean values ( ± SD) significantly increased with BMI increasing categories. Compared to normal weight mothers (n = 290, 22.0%), obese women (n = 273, 20.7%) had higher significant GS (0.6 ± 0.7 vs. 0.2 ± 0.3; P = 0.006), R (0.6 ± 0.9 vs. 0.3 ± 0.6; P < 0.0001), EC (0.4 ± 0.6 vs. 0.3 ± 0.5; P < 0.0001), SC (0.9 ± 1.0 vs. 0.3 ± 0.5; P < 0.0001) and WC (0.7 ± 0.8 vs. 0.1 ± 0.3; P < 0.0001). In addition, formula-feeding adoption at discharge significantly increased with BMI increasing categories (P per trend = 0.01).

We present evidence that gestational obesity is associated with reduced breastfeeding rates at discharge and higher ED symptomatology. Women need information and support to gain adequate weight during pregnancy.

The authors have not supplied their declaration of competing interest.