Multimorbidity and breastfeeding practices: findings  from a population-based survey in Peru during 2024

Dayana Barriga Rodriguez; José Chaquila Cubillas

doi:10.12873/461jachaquila

Autores/as

Dayana Barriga-Rodriguez Carrera Profesional de Nutrición, Universidad Peruano Cayetano Heredia, Lima, Perú https://orcid.org/0000-0002-4603-9619
José A. Chaquila Sociedad Peruana de Nutrición https://orcid.org/0000-0002-2303-0486

DOI:

https://doi.org/10.12873/461jachaquila

Palabras clave:

Enfermedades no transmisibles, Salud materna, Promoción de la salud, Atención posnatal

Resumen

Objetivo: Examinar la asociación entre la multimorbilidad y las prácticas de lactancia materna entre mujeres peruanas en edad reproductiva que participaron en una encuesta nacional.
Materiales y Métodos: Se realizó un análisis secundario de la Encuesta Demográfica y de Salud Familiar del Perú 2024. La variable de exposición fue la multimorbilidad, construida a partir de tres posibles enfermedades crónicas no transmisibles (ECNT): obesidad, diabetes mellitus tipo 2 e hipertensión. Esta variable incluyó tres categorías: ninguna condición, una condición y dos o más condiciones. Los desenlaces fueron dos prácticas de lactancia materna: lactancia materna exclusiva (LME) e inicio temprano de la lactancia materna, ambas categorizadas dicotómicamente. También se consideraron posibles factores de confusión. Se realizaron análisis bivariados y multivariados utilizando regresión de Poisson con varianza robusta.
Resultados: Un total de 8,163 mujeres fueron elegibles para el análisis. En general, el 65.3% no practicó LME y el 45.3% tuvo un inicio tardío de la lactancia. Además, el 42.1% presentó una ECNT y el 4.4% presentó dos o más. Un mayor número de ECNT se asoció con una menor prevalencia de prácticas óptimas de lactancia, mostrando un patrón dosis–respuesta. En el modelo multivariado, las mujeres con dos o más ECNT tuvieron un 33% menor prevalencia de inicio temprano de lactancia materna (RP: 0.67; IC 95%: 0.55–0.82). Sin embargo, la multimorbilidad no se asoció significativamente con la LME.
Conclusión: Estos hallazgos subrayan la necesidad de estrategias de apoyo específicas para mujeres con múltiples ECNT con el fin de promover prácticas óptimas de lactancia materna en el contexto latinoamericano.

Referencias

[1] Taheri Soodejani M. Non-communicable diseases in the world over the past century: a secondary data analysis. Front Public Health 2024;12:1436236. https://doi.org/10.3389/fpubh.2024.1436236.

[2] Murray CJL, Aravkin AY, Zheng P, et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet 2020;396:1223–49. https://doi.org/10.1016/S0140-6736(20)30752-2.

[3] Almirall J, Fortin M. The Coexistence of Terms to Describe the Presence of Multiple Concurrent Diseases. J Comorbidity 2013;3:4–9. https://doi.org/10.15256/joc.2013.3.22.

[4] Skou ST, Mair FS, Fortin M, et al. Multimorbidity. Nat Rev Dis Primer 2022;8:48. https://doi.org/10.1038/s41572-022-00376-4.

[5] Read JR, Sharpe L, Modini M, et al. Multimorbidity and depression: A systematic review and meta-analysis. J Affect Disord 2017;221:36–46. https://doi.org/10.1016/j.jad.2017.06.009.

[6] Kelishadi R, Farajian S. The protective effects of breastfeeding on chronic non-communicable diseases in adulthood: A review of evidence. Adv Biomed Res 2014;3:3. https://doi.org/10.4103/2277-9175.124629.

[7] Chowdhury R, Sinha B, Sankar MJ, et al. Breastfeeding and maternal health outcomes: a systematic review and meta-analysis. Acta Paediatr Oslo Nor 1992 2015;104:96–113. https://doi.org/10.1111/apa.13102.

[8] Zheng S-W, Lin X-Y, Xie N-S, et al. Breastfeeding was associated with lower risks of maternal postpartum hypertension and diabetes mellitus: A systematic review and meta-analysis. World J Diabetes 2025;16. https://doi.org/10.4239/wjd.v16.i11.111578.

[9] Tschiderer L, Seekircher L, Kunutsor SK, et al. Breastfeeding Is Associated With a Reduced Maternal Cardiovascular Risk: Systematic Review and Meta‐Analysis Involving Data From 8 Studies and 1 192 700 Parous Women. J Am Heart Assoc 2022;11:e022746. https://doi.org/10.1161/JAHA.121.022746.

[10] Muro-Valdez JC, Meza-Rios A, Aguilar-Uscanga BR, et al. Breastfeeding-Related Health Benefits in Children and Mothers: Vital Organs Perspective. Medicina (Mex) 2023;59:1535. https://doi.org/10.3390/medicina59091535.

[11] Modak A, Ronghe V, Gomase KP. The Psychological Benefits of Breastfeeding: Fostering Maternal Well-Being and Child Development. Cureus 2023;15:e46730. https://doi.org/10.7759/cureus.46730.

[12] Patnode CD, Henrikson NB, Webber EM, et al. Breastfeeding and Health Outcomes for Infants and Children: A Systematic Review. Pediatrics 2025;156:e2025071516. https://doi.org/10.1542/peds.2025-071516.

[13] Salama ES, Hussein M, Fetih AN, et al. High-risk pregnancy and risk of breastfeeding failure. J Egypt Public Health Assoc 2024;99:27. https://doi.org/10.1186/s42506-024-00172-w.

[14] Joham AE, Nanayakkara N, Ranasinha S, et al. Obesity, polycystic ovary syndrome and breastfeeding: an observational study. Acta Obstet Gynecol Scand 2016;95:458–66. https://doi.org/10.1111/aogs.12850.

[15] ENDES n.d. https://proyectos.inei.gob.pe/endes/ (accessed November 27, 2025).

[16] Goodarzynejad H, Meaney C, Brauer P, et al. Recent trends in adult body mass index and prevalence of excess weight. Can Fam Physician 2022;68:128–38. https://doi.org/10.46747/cfp.6802128.

[17] World Health Assambly. Global strategy for infant and young child feeding: the optimal duration of exclusive breastfeeding. Geneva: World Health Organization; 2001.

[18] Al-Chalabi M, Bass AN, Alsalman I. Physiology, Prolactin. StatPearls, Treasure Island (FL): StatPearls Publishing; 2025.

[19] Chauhan G, Tadi P. Physiology, Postpartum Changes. StatPearls, Treasure Island (FL): StatPearls Publishing; 2025.

[20] Matias SL, Dewey KG, Quesenberry CP, et al. Maternal prepregnancy obesity and insulin treatment during pregnancy are independently associated with delayed lactogenesis in women with recent gestational diabetes mellitus. Am J Clin Nutr 2014;99:115–21. https://doi.org/10.3945/ajcn.113.073049.

[21] Rasmussen KM, Kjolhede CL. Prepregnant Overweight and Obesity Diminish the Prolactin Response to Suckling in the First Week Postpartum. Pediatrics 2004;113:e465–71. https://doi.org/10.1542/peds.113.5.e465.

[22] Putra IGNE, Daly M, Sutin A, et al. Obesity, psychological well-being related measures, and risk of seven non-communicable diseases: evidence from longitudinal studies of UK and US older adults. Int J Obes 2024;48:1283–91. https://doi.org/10.1038/s41366-024-01551-1.

[23] Scime NV, Patten SB, Tough SC, et al. Maternal chronic disease and breastfeeding outcomes: a Canadian population-based study. J Matern Fetal Neonatal Med 2022;35:1148–55. https://doi.org/10.1080/14767058.2020.1743664.

[24] Chen Q-F, Ni C, Jiang Y, et al. Global burden of disease and its risk factors for adults aged 70 and older across 204 countries and territories: a comprehensive analysis of the Global Burden of Disease Study 2021. BMC Geriatr 2025;25:462. https://doi.org/10.1186/s12877-025-06095-1.

[25] Templin T, Cravo Oliveira Hashiguchi T, Thomson B, et al. The overweight and obesity transition from the wealthy to the poor in low- and middle-income countries: A survey of household data from 103 countries. PLoS Med 2019;16:e1002968. https://doi.org/10.1371/journal.pmed.1002968.