Electronic Thesis and Dissertation Repository


Master of Science


Epidemiology and Biostatistics


Dr. Karen Campbell


Introduction: Breast milk provides health benefits for both mother and child. Prominent reasons for not initiating breastfeeding include lactation problems and perceived insufficient milk supply. Animal studies have shown that a high fat diet is associated with negative changes in the lactation process, while omega-3 supplementation appears to have positive effects. Hypothesis: 1. High maternal fat intake during pregnancy is associated with breastfeeding non-initiation. 2. Long-chain omega-3 fatty acid intake (EPA+DHA) is associated with breastfeeding initiation. 3. Maternal EPA+DHA intake modifies the relationship between total fat intake during pregnancy and breastfeeding initiation. Materials and Methods: The data for this study were taken from the Prenatal Health Project, a prospective cohort study in London, Ontario. Women 10-22 week’s gestation were recruited from ultrasound clinics and followed-up at the perinatal, infant (yr) and toddler (2-5 yrs) stage. Multivariable logistic regression analyses were conducted with blockwise data entry based on a directed acyclic graph (DAG) created to conceptualize the hypothesized relationships and potential confounders. Results: Contrary to our hypothesis, higher maternal fat (>35% fat), compared to ≤35% fat, was associated with a higher odds of breastfeeding initiation (OR=2.014 (95% CI: 1.002, 4.045)). Mothers who met the dietary EPA+DHA recommendations may have been more likely to breastfeed, but this did not achieve statistical significance. There was no significant interaction between percent fat intake and EPA+DHA intake. Discussion and Summary: Mothers whose diets were composed of a higher fat percentage were more likely to initiate breastfeeding compared to mothers with a lower percentage.

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