The Relationship Between Internalized Weight Stigma During Pregnancy and Breastfeeding: A Prospective Longitudinal Study

Abstract

Objective: This study aimed to examine the relationship between internalized weight stigma during pregnancy and breastfeeding outcomes at 1 month post partum among individuals with prepregnancy overweight or obesity. Secondarily, the study explored the temporal stability of internalized weight stigma from the third trimester to 1 month post partum via the Weight Bias Internalization Scale (WBIS).

Methods: A total of 103 pregnant individuals with overweight or obesity were recruited for this study. Participants completed the WBIS during the third trimester and self-reported breastfeeding initiation, continuation, and exclusivity outcomes at 1 month post partum. A paired t test and binomial logistic regression were conducted with covariates hierarchically added to the model.

Results: The average prepregnancy BMI was 33.53 (SD 7.17) kg/m² (range = 25.4-62), and average prenatal WBIS scores were 25.95 (SD 11.83). No difference was found in mean prenatal and postpartum scores (25.95 [SD 11.83]; 26.86 [SD 13.03], respectively; t₉₄ = -0.83, P = 0.41), evidencing temporal stability in WBIS scores from pre to post partum. Prenatal WBIS scores did not predict breastfeeding initiation, continuation, or exclusivity at 1 month post partum in either unadjusted or adjusted models.

Conclusions: Collectively, this sample displayed low weight bias internalization, which was not predictive of breastfeeding initiation, continuation, or exclusivity at 1 month post partum. Future research is needed to develop a pregnancy-specific weight stigma measure.