Background: Evidence suggests that prolonged and exclusive breastfeeding is associated with health benefits to children and nursing mothers beyond the period of breastfeeding. Studies that support the role of breastfeeding in postpartum weight change primarily focused on short-term weight change (within 12 to 24 months postpartum) (Binns et al. 2003; Lederman 2004; Johnson et al. 2006), while few focused on the association between breastfeeding and long-term weight change (5 years or more postpartum) (Rooney, Schauberger et al. 2005).

Purpose: This study investigated the role of breastfeeding in long-term weight change, specifically 1) whether breastfeeding protects against weight gain, and 2) whether there is a dose-response association between breastfeeding and weight gain that is independent of lifestyle behaviors.

Method: This cross-sectional study design focused on Non-Black (n=9,546) and Black women (n=l,652) aged >50 years who participated in the Adventist Health Study-2 and had at least 1 live birth. Measures observed were duration of breastfeeding over all pregnancies, recall of body weight across 10-year intervals, sociodemographic factors, and current lifestyle behaviors (dietary pattern, physical activity, sleep duration, and hours spent watching television).

Results: At age 20, BMI was similar among women that did not breastfeed versus those that breastfed12 months (mean ± SD, 21.0 ± 3.0 versus 21.0 ± 2.9 and 20.9 ± 2.7 kg/m2, respectively; p=0.2); however, BMI diverged among the three groups progressively at ages 30, 40 and 50 years. By age 50, non-breastfeeding women had a change in BMI (since age 20) of 5.5 ± 5.0 versus 4.9 ± 4.7 or 4.7 ± 4.6 kg/m in women who breastfed12 months, respectively (pO.OOOl). In logistic regression analysis, breastfeeding for >12 months was protective against > the median BMI change versus no breastfeeding (odds ratio [OR] 0.807; 95% confidence interval [Cl] 0.683- 0.954; p

Implications for Preventive Care: The findings from this current study may be used to inform Preventive Care Specialist on best practices for breastfeeding, and contribute to larger obesity prevention efforts.


School of Public Health

First Advisor

Serena Tonstad

Second Advisor

Synnøve Knutsen

Third Advisor

Susanne Montgomery

Degree Name

Doctor of Public Health (DrPH)

Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Obesity in women -- Prevention; Overweight women -- Conduct of life; Maternity nursing; Obesity -- prevention and control; Breast Feeding; Maternal-Child Nursing; Body Weight Changes -- nursing; Life Style; Cross-Cultural Studies.



Page Count

xii; 102

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives