Prospective assessment of exclusive breastfeeding in relation to weight change in women.

ABSTRACT

OBJECTIVE: To study prospectively the relation of parity, prepregnancy body mass index (BMI), and exclusive breastfeeding to weight gain. DESIGN: The cohort of the Nurse's Health Study II, with analysis restricted to women who were aged 24 to 40 y at baseline (1989), who had a history of no more than one past full-term pregnancy at baseline, gave birth to one child between 1990 and 1991, but had no other pregnancies during the follow-up. SUBJECTS: 1538 of the 33 082 nulliparous women and 2810 of the 20 261 primiparous, in 1989. MEASUREMENTS Introduction of daily formula/milk was assumed to represent the end of exclusive breastfeeding period. Duration of exclusive breastfeeding was categorized into 0, 1-3, 4-7, 8-11, and 12 months or more. RESULTS: After adjusting for age, physical activity, and BMI in 1989, lactation was associated with a weight gain from 1989 to 1993 of approximately 1 kg (statistically significant only for women nulliparous in 1989 with a BMI <25 kg/m(2) (P=0.02) and for those women primiparous in 1989, with a BMI >/=25 kg/m(2) (P=0.04)) comparing women who breastfed with women who did not, and duration of lactation was unrelated to the magnitude of weight change (P>0.40 for all comparisons). CONCLUSIONS: Although promotion of breastfeeding has high priority because of its enormous advantages for a newborn child, the associated maternal weight reduction is minimal. Dietary guidelines for pregnant and breastfeeding women should include ways to prevent weight retention after parity.