This article was originally published in issue 2 of Nurture & Nutrition.
The information in this article is correct at date of publication, September 2004.
Opinions expressed by the author are not necessarily those of the publisher or editorial staff.
A 2004 study suggested that being overweight or obese may affect a mother’s ability to initiate breastfeeding1.
Maternal weight has always been an important factor for a new mother’s general health, but research has indicated that obesity may also affect the mother’s ability to breastfeed successfully
1. There are many reasons for this; for some women it could be a simple mechanical problem such as latching the baby on properly or positioning the infant, but excessive weight can cause other, more complicated problems.
Researchers have put forward various suggestions as to why this may be the case. For example, could it be that higher progesterone or estradiol concentrations in overweight/obese women compared with normal weight women might delay lactogenesis? Although at the current time the exact mechanism is not known.
While research in this area is still relatively new, evidence from population studies backs up the link between weight and breastfeeding. An American study revealed that areas with the highest proportion of overweight and obese women had the lowest rates of initiation and shortest durations of breastfeeding
1.
Obesity is obviously a complex issue both physiologically and socially. It is important to recognise that because obesity in the developed world is increasingly being linked to lower social status, fat is a compounding physiological factor in social groups where there is already more likely to be a failure to breastfeed for reasons of social pressure, family history and poor education. However, recognising that there are physical reasons why obese mothers are less likely to initiate or maintain breastfeeding, in addition to social factors, can help healthcare professionals support mothers to improve breastfeeding success.
Another factor to consider is that a significant association has been found between obesity and C-section, therefore obese women could be more likely to give birth by caesarean
2. Mothers who deliver by C-section are also less likely to breastfeed successfully. The following areas could be considered by healthcare professionals and may help obese mothers to overcome some of the problems they may face and increase the rate of breastfeeding success.
Identifying ‘at risk’ mothers-to-beThe first step is early identification. If you know a woman is at risk before she gives birth, there’s a much higher chance of helping her to understand the difficulties she may find with breastfeeding. A recent study has shown that both mothers with an overweight or obese Body Mass Index (BMI) classification are at risk from prolactin inhibition
1 .
Advising ‘at risk’ clientsTry to ensure that mothers at risk get coaching on breastfeeding techniques before the baby is born:
- After the birth, remember that an obese mother’s prolactin response may contribute to lactation failure. This could lead to a mother giving up early, so make sure you’re around to offer support as soon as possible after the baby is born.
- Women should not try to lose weight during pregnancy but should try to eat a healthy, balanced diet.
- Make sure mothers have a breastfeeding support network. You could put mothers in touch with local groups like the NCT. To download useful websites and phone numbers, click here
References1. Rasmussen KM, and Kjolhede CL, Prepregnant overweight and obesity diminish the prolactin response to suckling in the first week postpartum. Pediatrics 2004; 113: e465-e471.
2. Sheiner E et al. Maternal obesity as an independent risk factor for caesarean delivery. Paediatr Perinat Epidemiol 2004; 18: 196 - 201.
