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Table 5 Complications and discomfort during hospitalisation and at home related to breastfeeding according to maternal BMI

From: Relationship between maternal body mass index with the onset of breastfeeding and its associated problems: an online survey

VariableBMI 
Did you encounter any difficulty with breastfeeding while in hospital due toNormoweight
n (%)
Overweight
n (%)
Obesity type I
n (%)
Obesity type II
n (%)
Obesity type III
n (%)
Total values
n (%)
Pain?
 No902 (58.2)1508 (57.8)616 (55.9)154 (55.6)50 (58.8)3230 (55.0)
 Yes647 (41.8)1100 (42.2)486 (44.1)123 (44.4)35 (41.2)2391 (45.0)
 OR CI 951 (ref.)1.02 (0.90, 1.16)1.10 (0.94, 1.29)1.11 (0.86, 1.44)0.98 (0.63, 1.52) 
aAOR CI 95%1 (ref.)1.01 (0.88, 1.15)1.06 (0.90, 1.25)1.03 (0.79, 1.35)0.95 (0.60, 1.49) 
aAOR CI 95% Total1.00 (0.99, 1.01) 
Cracked nipples?
 No1092 (70.5)1777 (68.1)754 (68.5)189 (68.2)64 (74.4)3876 (66.0)
 Yes457 (29.5)831 (31.9)346 (31.5)88 (31.8)22 (25.6)1744 (34.0)
 OR CI 95%1 (ref.)1.12 (0.98, 1.28)1.10 (0.94, 1.29)1.11 (0.85, 1.47)0.82 (0.50, 1.35) 
bAOR CI 95%1 (ref.)1.11 (0.96, 1.27)1.06 (0.89, 1.26)1.05 (0.79, 1.39)0.80 (0.48–1.32) 
bAOR CI 95% Total1.00 (0.99, 1.01) 
Difficulties for latching on to the breast/not proper latching on?
 No912 (59.2)1481 (56.7)575 (52.1)134 (48.6)51 (60.0)3153 (53.7)
 Yes629 (40.8)1131 (43.3)528 (47.9)142 (51.4)34 (40.0)2464 (46.3)
 OR CI 95%1 (ref.)1.11 (0.98, 1.26)1.33 (1.14, 1.56)1.54 (1.19, 1.99)0.97 (0.62, 1.51) 
aAOR CI 95%1 (ref.)1.11 (0.97, 1.27)1.27 (1.08, 1.50)1.42 (1.08, 1.87)0.86 (0.54, 1.37) 
aAOR CI 95% Total1.02 (1.00, 1.03) 
Difficulties with positioning the child due to C-section injury or episiotomy/tearing stitching?
 No1290 (83.5)2059 (79.0)838 (76.0)200 (73.0)63 (73.3)4450 (75.8)
 Yes254 (16.5)547 (21.0)265 (24.0)74 (27.0)23 (26.7)1163 (24.2)
 OR CI 95%1 (ref.)1.35 (1.15, 1.59)1.61 (1.32, 1.95)1.88 (1.39, 2.53)1.85 (1.13, 3.05) 
aAOR CI 95%1 (ref.)1.22 (1.03, 1.46)1.29 (1.05, 1.58)1.32 (0.96, 1.82)1.27 (0.75, 2.16) 
aAOR CI 95% Total1.02 (1.00, 1.04) 
Engorgement (swollen, tight, hard, hot breasts…)?
 No1312 (85.3)2227 (85.7)969 (88.3)243 (88.7)79 (91.9)4830 (82.3)
 Yes227 (14.7)373 (14.3)129 (11.7)31 (11.3)7 (8.1)767 (17.7)
 OR CI 95%1 (ref.)0.97 (0.81, 1.16)0.77 (0.61, 0.97)0.74 (0.50, 1.10)0.51 (0.23, 1.12) 
aAOR CI 95%1 (ref.)0.94 (0.78, 1.13)0.70 (0.55, 0.89)0.63 (0.42, 0.94)0.42 (0.19, 0.94) 
aAOR CI 95% Total0.96 (0.94, 0.97) 
Your own nervousness?
 No1125 (72.9)1790 (68.7)713 (64.8)165 (60.2)51 (60.0)3844 (68.6)
 Yes418 (27.1)814 (31.3)387 (35.2)109 (39.8)34 (40.0)1762 (31.4)
 OR CI 95%1 (ref.)1.22 (1.07, 1.41)1.46 (1.24, 1.73)1.78 (1.36, 2.32)1.79 (1.15, 2.81) 
aAOR CI 95%1 (ref.)1.23 (1.06, 1.43)1.37 (1.15–1.64)1.60 (1.20, 2.14)1.69 (1.05, 2.74) 
aAOR CI 95% Total1.03 (1.02, 1.05) 
Your feeling unsure of yourself?
 No987 (64.0)1603 (61.5)624 (56.6)152 (55.3)53 (62.4)3419 (60.9)
 Yes556 (36.0)1002 (38.5)478 (43.4)123 (44.7)32 (37.6)2191 (29.1)
 OR CI 95%1 (ref.)1.11 (0.97, 1.26)1.36 (1.16, 1.59)1.44 (1.11, 1.86)1.07 (0.68, 1.68) 
aAOR CI 95%1 (ref.)1.15 (0.99, 1.32)1.36 (1.15, 1.62)1.44 (1.08, 1.91)1.09 (0.67, 1.79) 
aAOR CI 95% Total1.02 (1.01, 1.04) 
Did you encounter any difficulty with breastfeeding while at home due toNormoweight
n (%)
Overweight
n (%)
Obesity type I
n (%)
Obesity type II
n (%)
Obesity type III
n (%)
Total values
n (%)
Pain?
 No746 (48.2)1234 (47.3)515 (46.8)131 (48.0)50 (58.8)2676 (47.7)
 Yes801 (51.8)1373 (52.7)585 (53.2)142 (52.0)35 (41.2)2936 (52.3)
 OR CI 95%1 (ref.)1.04 (0.91, 1.19)1.06 (0.91, 1.24)1.01 (0.78, 1.31)0.65 (0.42, 1.02) 
bAOR CI 95%1 (ref.)1.04 (0.92, 1.18)1.04 (0.89, 1.22)0.98 (0.75, 1.28)0.67 (0.43, 1.06) 
bAOR CI 95% Total0.99 (0.98, 1.01) 
Cracked nipples?
 No915 (59.2)1473 (56.6)618 (56.3)164 (60.7)63 (74.1)3233 (57.7)
 Yes631 (40.8)1129 (43.4)479 (43.7)106 (39.3)22 (25.9)2367 (42.3)
 OR CI 95%1 (ref.)1.11 (0.98, 1.26)1.12 (0.96, 1.31)0.94 (0.72, 1.22)0.51 (0.31, 0.83) 
bAOR CI 95%1 (ref.)1.12 (0.98, 1.27)1.12 (0.95, 1.31)0.91 (0.69, 1.20)0.52 (0.31, 0.86) 
bAOR CI 95% Total0.99 (0.98, 1.01) 
Difficulties for latching on to the breast/not proper latching on?
 No966 (62.6)1662 (63.7)639 (58.1)150 (55.1)55 (64.0)3472 (61.8)
 Yes578 (37.4)947 (36.3)461 (41.9)133 (44.9)31 (36.0)2150 (38.2)
 OR CI 95%1 (ref.)0.95 (0.84, 1.09)1.21 (1.03, 1.41)1.36 (1.05, 1.76)0.94 (0.60, 1.48) 
bAOR CI 95%1 (ref.)0.95 (0.83, 1.09)1.16 (0.99, 1.37)1.29 (0.98, 1.70)0.88 (0.55, 1.41) 
bAOR CI 95% Total1.01 (0.99, 1.03) 
Difficulties with positioning the child due to C-section injury or episiotomy/tearing stitching?
 No1288 (83.2)2094 (80.4)862 (78.2)211 (77.6)69 (80.2)4524 (80.6)
 Yes261 (16.8)512 (19.6)240 (21.8)61 (22.4)17 (19.8)1091 (19.4)
 OR CI 95%1 (ref.)1.21 (1.02, 1.42)1.37 (1.13, 1.67)1.43 (1.04, 1.95)1.22 (0.70, 2.10) 
bAOR CI 95%1 (ref.)1.12 (0.95, 1.33)1.17 (0.95, 1.43)1.13 (0.81, 1.57)0.93 (0.53, 1.65) 
bAOR CI 95% Total1.02 (1.00, 1.04) 
Engorgement (swollen, tight, hard, hot breasts…)?
 No930 (60.2)1633 (62.6)696 (63.3)193 (71.2)70 (81.4)3522 (62.8)
 Yes614 (39.8)975 (37.4)403 (36.7)78 (28.8)16 (18.6)2086 (37.2)
 OR CI 95%1 (ref.)0.90 (0.80, 1.03)0.88 (0.75, 1.03)0.61 (0.46, 0.81)0.35 (0.20, 0.60) 
bAOR CI 95%1 (ref.)0.90 (0.79, 1.02)0.85 (0.72, 1.00)0.58 (0.43, 0.77)0.33 (0.19, 0.58) 
bAOR CI 95% Total0.96 (0.95, 0.98) 
Candidiasis (fungus)?
 No1486 (96.1)2486 (95.6)1035 (94.5)263 (96.7)83 (96.5)5353 (95.6)
 Yes61 (3.9)115 (4.4)60 (5.5)9 (3.3)3 (3.5)248 (4.4)
 OR CI 95%1 (ref.)1.13 (0.82, 1.54)1.41 (0.98, 2.04)0.83 (0.41, 1.70)0.88 (0.27, 2.87) 
bAOR CI 95%1 (ref.)1.10 (0.80, 1.52)1.36 (0.94, 1.98)0.75 (0.36, 1.54)0.83 (0.25, 2.73) 
bAOR CI 95% Total1.00 (0.97, 1.03) 
Delayed milk production (after the 5th day of delivery)?
 No1406 (90.8)2343 (89.9)959 (87.2)233 (86.0)71 (82.6)5012 (89.3)
 Yes142 (9.2)262 (10.1)141 (12.8)38 (14.0)15 (17.4)598 (10.7)
 OR CI 95%1 (ref.)1.11 (0.89, 1.37)1.46 (1.14, 1.86)1.62 (1.10, 2.37)2.09 (1.17, 3.75) 
bAOR CI 95%1 (ref.)1.08 (0.86, 1.35)1.31 (1.01, 1.71)1.43 (0.94, 2.16)1.83 (0.96, 3.50) 
bAOR CI 95% Total1.03 (1.01, 1.05) 
The baby not gaining enough weight?
 No1180 (76.1)1976 (76.0)847 (77.0)188 (69.4)57 (66.3)4248 (75.7)
 Yes371 (23.9)624 (24.0)253 (23.0)83 (30.6)29 (33.7)1360 (24.3)
 OR CI 95%1 (ref.)1.00 (0.87, 1.16)0.95 (0.79, 1.14)1.40 (1.06, 1.86)1.62 (1.02, 2.57) 
bAOR CI 95%1 (ref.)1.00 (0.86, 1.16)0.93 (0.77, 1.13)1.37 (1.01, 1.84)1.79 (1.10, 2.90) 
bAOR CI 95% Total1.01 (0.99, 1.03) 
  1. For the multivariate analysis, the ENTER method for binary logistic regression was used
  2. All variables adjusted by: Maternal age, nulliparity, twin pregnancy, previous caesarean, smoking habit, economic income, level of education, nationality, maternity training, pregnancy composite morbidity, delivery composite morbidity, postpartum composite morbidity, neonatal composite morbidity, and breastfeeding previous children
  3. aAdjusted by: Breastfeeding first hour
  4. bAdjusted by: Lactation type after hospital discharge
  5. Pregnancy composite morbidity: including preeclampsia during pregnancy, diet-controlled gestational diabetes, insulin-controlled gestational diabetes, hyperthyroidism, hypothyroidism, anaemia, intrahepatic cholestasis, risk of preterm birth, deep vein thrombosis
  6. Delivery composite morbidity: including altered foetal heart rate (FHR) during delivery, stained amniotic fluid (AF), vaginal bleeding, non-progression of delivery, cephalopelvic disproportion, intrapartum fever (body temperature higher than 38 °C), intrapartum preeclampsia, induced delivery, end of delivery by caesarean, and severe tearing (type III-IV)
  7. Postpartum composite morbidity: including maternal postpartum surgery related to the delivery, maternal admission to intensive care unit, and maternal re-admission
  8. Neonatal composite morbidity: including prematurity, low weight (< 2.500 g), macrosomia (> 4.000 g), and neonatal admission to intensive care unit