Exploring psychological factors associated with breastfeeding in women with a BMI ≥ 30 kg/m2

Objective: Women with a BMI ≥ 30 kg/m2 are less likely to initiate and maintain breastfeeding compared to normal-weight women. Psychological factors have been linked with breastfeeding, but their influence on women with a BMI ≥ 30 kg/m2 experiences needs further exploration. The aim of this study was to investigate whether psychological factors are voiced by women with a BMI ≥ 30 kg/m2, and how these factors influence their breastfeeding. Design: A secondary analysis of eighteen semi-structured interviews with women with a BMI ≥ 30 kg/m2 who had breastfed. Main outcome measures: Deductive thematic analysis was used to apply a framework of psychological factors to the data, and investigate the extent to which they feature within the women’s breastfeeding experiences. Results: All psychological factors were reported as part of women’s experiences. Planning to breastfeed, planning short durations and having high confidence, factual and social knowledge positively influenced initiation and maintenance. Believing in their ability to produce nutritionally adequate and sufficient milk, that breastfeeding would assist weight loss, and that others around them approved of breastfeeding also had a positive impact. Novel relationships between psychological factors were found. Conclusions: Psychological factors influence women’s breastfeeding experiences. A model of breastfeeding in women with a BMI ≥ 30 kg/m2 has been developed, and can inform future intervention development.