1. Comparison of Dietary Intake of Overweight Postpartum
Mothers Practicing Breastfeeding or Formula Feeding
Holiday A. Durham PhD, RD: Louisiana State University
Cheryl A. Lovelady PhD, MPH, RD, FADA: University North Carolina at Greensboro
Rebecca J. N. Brouwer MS: Duke University Medical Center (DUMC)
Katrina M. Krause MS: DUMC
Truls Østbye PhD, MD: DUMC
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Durham HA, et al, J Am Diet Assoc ; 111 (January).

2. Rates of overweight & obesity in childbearing years
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Rates of overweight & obesity in childbearing years
The postpartum period is a critical time for weight-management interventions because weight retention and weight gain in this period are significant predictors of long-term obesity 2,3.
In , percentage of women ages years who were overweight or obese 1
1. National Center for Health Statistics. Health, United States, With Chartbook. Hyattsville, Maryland: Web site. Published March Updated August Accessed September 1, 2009.
2. Gunderson EP, Abrams B. Epidemiology of gestational weight gain and body weight changes after pregnancy. Epidemiol Rev ;22:
3. Rooney BL, Schauberger CW. Excess pregnancy weight gain and long-term obesity: one decade later. Obstet Gynecol ;100:
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Durham HA, et al. J Am Diet Assoc ; 111 (January).

3. Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Objectives
Compare nutrient, meal and snack intakes, food group servings and prevalence of dieting among fully breastfeeding, mixed breast and formula feeding, and formula feeding, overweight and obese women.
Compare nutrient intakes and food group servings to the Dietary Reference Intake and MyPyramid recommendations, respectively.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Durham HA, et al. J Am Diet Assoc ; 111 (January).

4. Serum Vitamin C (mg/dl) by Salad Intake
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Serum Vitamin C (mg/dl) by Salad Intake
Study Design
Infant feeding practices, demographic information, and dietary information were collected on 450 women between six and nine weeks postpartum.
Two 24-hour dietary recalls were completed by phone, using Nutrition Data Systems for Research1,2.
1. Nutrition Coordinating Center, University of Minnesota. Nutrition Data System (NDS). NDS-R[5.0] Minneapolis, MN, University of Minnesota.
2. Nutrition Coordinating Center, University of Minnesota. Nutrition Data System (NDS). NDS-R[2005] Minneapolis, MN, University of Minnesota.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Durham HA, et al. J Am Diet Assoc ; 111 (January).

5. Serum Vitamin C (mg/dl) by Salad Intake
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Comparison of energy intake and supplement use of women fully breastfeeding (FB), mixed feeding (MF) or formula feeding (FF)
Serum Vitamin C (mg/dl) by Salad Intake
FB (n=160)
MF (n= 128)
FF (n=162)
Percent taking Vitamin/Mineral/Fatty Acid Supplements *
80%
72%
43%
Percent reporting dieting * 5%
13%
21%
Estimated Energy Requirement (kcal)
2407 ± 11
2478 ± 18
2523 ± 18
Energy Intake (kcal)
Total sample
Dieters
Non-Dieters
2107 ± 50 a
2095 ± 363
2110 ± 54
1866 ± 56 b
1468 ± 105
1915 ± 57
1657 ± 50 c
1342 ± 92
1717 ± 59
a, b, c Groups with different letters are significantly different, P ≤ 0.001
* Significantly different between groups, Chi-square, P ≤ 0.05.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Durham HA, et al. J Am Diet Assoc ; 111 (January).

6. Serum Vitamin C (mg/dl) by Salad Intake
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Serum Vitamin C (mg/dl) by Salad Intake
Percentage of women consuming less than the Estimated Average Requirement (EAR)
Total Vitamin A
Vitamin C
group
group
percentage
percentage
Vitamin E
Total Folate
group
group
percentage
percentage
% < EAR is the percentage of group whose intake was below the Estimated Average Requirements.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Durham HA, et al. J Am Diet Assoc ; 111 (January).

7. Serum Vitamin C (mg/dl) by Salad Intake
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Serum Vitamin C (mg/dl) by Salad Intake
Percentage of women consuming less than the Adequate Intakes (AI)
Calcium
group
percentage
% < AI is the percentage of group whose intake was below the Adequate Intake recommendation.
Durham HA, et al. J Am Diet Assoc ; 111 (January).
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION

8. Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Percentage of fully breastfeeding, mixed feeding or formula feeding women consuming meals and snacks on both days
*p= 0.06
* p < 0.01
* p < 0.01
percentage
The majority of women (n=399) reported consuming dinner on both days, with no differences between groups.
* Significantly different between groups, Chi-square, P ≤ 0.05.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Durham HA, et al. J Am Diet Assoc ; 111 (January).

9. Serum Vitamin C (mg/dl) by Salad Intake
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Serum Vitamin C (mg/dl) by Salad Intake
Breastfeeding (BF), mixed feeding (MF) and formula feeding (FF) women did not meet MyPyramid1 recommendations for any food group
Recommended food group servings based on MyPyramid1 guidelines for reference participants who represents the average Active Mother’s Postpartum participant (sedentary, 165 cm, 89 kg, 31 years old, with a 2 month old baby, who was either FB, MF, or FF). a
a, b
serving b a a b
Food Groups
food groups
Groups with different letters are significantly different, P ≤ (when adjusted for group differences in participant characteristics: pre-pregnancy BMI, race, age, education, income, marital status).
1U.S. Department of Agriculture. MyPyramid Web site. Published October Updated March 2009.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Durham HA, et al. J Am Diet Assoc ; 111 (January).

10. Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Comparison of beverage and dessert intake among fully breastfeeding, mixed feeding or formula feeding women
serving a a b
Groups with different letters are significantly different, P ≤ (when adjusted for group differences in participant characteristics: pre-pregnancy BMI, race, age, education, income, marital status).
food groups
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Durham HA, et al. J Am Diet Assoc ; 111 (January).

11. Serum Vitamin C (mg/dl) by Salad Intake
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Summary
Serum Vitamin C (mg/dl) by Salad Intake
Formula feeding women:
Consumed less energy, servings of grains, and desserts
More likely to diet
Less likely to consume a multivitamin supplement
Breastfeeding women:
Consumed more energy and more refined grains and desserts
Snacked more frequently
All groups were at risk for inadequate intake of vitamins A, C, E, and folate.
In addition, the intakes of vitamin D and calcium were low in all groups.
All groups did not consume the recommended servings of any of the MyPyramid
food groups.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Durham HA, et al. J Am Diet Assoc ; 111 (January).

12. Serum Vitamin C (mg/dl) by Salad Intake
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Conclusion
Serum Vitamin C (mg/dl) by Salad Intake
To help increase intakes of nutrients that are lacking in the diet and promote postpartum weight loss, dietitians should encourage women to:
Increase
Fruits
Vegetables
Low-fat dairy
Whole grains
Legumes
Healthy types of fat
Decrease
Refined grains
Regular soda
Sweetened beverages
Desserts
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Durham HA, et al. J Am Diet Assoc ; 111 (January).