Obese mothers may struggle with breastfeeding

By Lisa Rapaport

(Reuters Health) - Women who are obese may stop breastfeeding babies sooner than other mothers, at least in part because they're uncomfortable nursing their babies when people are nearby, an Australian study suggests.

Researchers surveyed first-time mothers and found most of them intended to breastfeed before their babies were born, regardless of how much the women weighed. Most of the women expressed plans to nurse for about one year, and this didn't differ much based on whether they were obese.

But obese women were significantly more likely to anticipate discomfort nursing in front of even close female friends. And, the women who felt awkward or anxious being seen while breastfeeding stopped much sooner than women who didn't mind nursing in front of others.

"They seem to have all the same intentions, and have made the same decisions as smaller women, but confidence and comfort issues are a problem," said study co-author Dr. Ruth Newby of the University of Queensland in Brisbane.

To see how obesity influences breastfeeding, Newby and her coauthor surveyed 462 women, giving them questionnaires once before the baby arrived and six times during the first year after birth. Each woman completed at least one of the questionnaires.

A total of 258 women provided a pre-pregnancy weight. Roughly one quarter of these women were overweight before pregnancy, and about 17 percent were obese.

Researchers had data on breastfeeding for 371 women, including 195 women who also provided information about their weight. Among 347 women who had babies born at full-term, 98 percent nursed their infants at least once.

Normal-weight women nursed significantly longer than overweight mothers, and obese women continued for much less time than even their overweight peers, according to the study in the European Journal of Clinical Nutrition, March 23.

Though there wasn't a meaningful difference in the women's confidence about achieving their breastfeeding goals among the 274 participants who answered this question, obese women expressed much more discomfort about nursing in different social situations than other mothers.

The study doesn't prove obesity causes difficulties with breastfeeding, the authors caution.

Other limitations include the high proportion of women who didn't participate in each of the questionnaires as well as the reliance on mothers to accurately recall and report their weight and expectations and experiences with breastfeeding.

Even so, the findings suggest that more research is needed to understand the drivers of social discomfort with breastfeeding among obese women, the authors conclude.

Interventions during pregnancy might help address any body image issues or psychological barriers to breastfeeding and help increase the odds that obese women achieve their breastfeeding goals, the authors note.

Obese women may also need help overcoming physical obstacles that get in the way of successful breastfeeding, Newby said by email. "Newborn babies have very tiny mouths, and larger women in particular may have quite large breasts," Newby said. "If the baby's mouth milks the breast in an effective way, it empties the breast of milk and sets up hormonal signals which make more milk," Newby said. "It's supply and demand."

"Babies of larger mums don't always get a good grip or latch and may not be as good at emptying the breast and stimulating that milk supply for themselves," Newby added.

SOURCE: http://bit.ly/1UNTQRO

Eur J Clin Nutr 2016.

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