Associations between Breastfeeding Intention and Accurate Body Size Estimation among Female College Students
Authors: Powell Katherine Dabney , Colby Sarah , Olfert Melissa D , Zhou Wenjun , Spence Marsha , Springer Cary , Kavanagh Katherine 
Published: June 2021

The study objectives were to determine if there was an association between intention to breastfeed and accuracy of body size estimation (BSE) among a sample of nulliparous undergraduate females, and to explore other potential explanatory factors, should such a relationship be detected. Female figure drawings from Gardner and Jappe's Body Image Assessment Scale‐Body Dimensions tool were used to determine perceived body size. BSE was measured by comparing participants' calculated body mass index (BMI) to the BMI of the figure drawing participants selected that they perceived to most accurately represent their body size. The Theory of Planned Behavior suggests that internal and external factors contribute to developing opinions about a behavior and subsequent expression of said behavior (i.e., “intention”). This theory is frequently utilized to describe development of breastfeeding intention. Though much of this research has been conducted during the prenatal or postpartum period, there is evidence suggesting that intent to breastfeed a future child may begin developing prior to conception. Negative body image has been shown to be a potential barrier to breastfeeding intention among pregnant and postpartum women, but little is known about how perceptions of body image may relate to developing this intention among those who are not yet parents. Secondary data analysis, using data from a multi‐university study, was used to explore the research objectives. No relationship was detected between accuracy of BSE and intent to breastfeed a future child (p=0.511). However, prior breastfeeding exposure was significantly, positively associated with future intent (p<0.001), and BMI status was significantly associated with accurate BSE (p<0.001). Compared to normal weight participants, the odds ratio for BSE showed overweight participants were more likely to inaccurately estimate their body size (p=0.008). However, obese participants were more likely than normal weight participants to accurately estimate their size (p<0.001). No difference was found between underweight and normal weight participants (p=0.185). In this sample of nulliparous, female undergraduates, greater prior breastfeeding exposure was associated with increased likelihood of intent to breastfeed a future child, which reinforces previous research findings in similar populations. The finding that over half the population (54.2%) was unable to accurately estimate their body size is supported by prior exploration in the youth population. Though the ability to accurately estimate body size was not associated with future breastfeeding intent in this population, identifying barriers that may develop during the time one is forming opinions about such a behavior remains an important area to explore. Approval to use the data set was granted by the University of Tennessee Institutional Review Board prior to study implementation.Support or Funding InformationThis material is based upon work that is supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, under award number 2014‐67001‐21851.