Hi Marie,
I'm morbidly obese and I can say that I've never had any problems in
terms of the reported prolactin issues. I do think this is very rare,
and only found in clinincal studies! One of those factors that does
exist, but isn't common in day to day experience.
Latch can be a huge issue if you have pendulous breasts, as you can't
see your nipple without touching your breast! And penduous breasts new
to breastfeeding are best not touched heavily by mother's own hand - I
started pulling in one side of my breast after a couple of days, and got
tingling, then numbness, as I was straining the milk ducts by flattening
them down. Latching on with breasts you can't see the ends of, with a
screaming and wriggling hungry baby, almost put us in the divorce
courts. The worst moment was when I hit on the sure fire method of
using a mirror, with my husband saying left a bit, right a bit - fire.
Mirrors and dyslexic Mummy... not a good option. We laugh now, but it
really didn't nearly kill us.
I'd suggest you prep your friend on baby led latching, and let the baby
get on with it, and get your friend to keep well meaning 'latch advice'
out of her way from the moment of birth. This is one area where she
really does need to find her own path, and the 'classic' holds are
likely to cause her great stress - for she has two moving objects to
bring together, her baby and her breast.
At birth, I'd go for the prone position, so the nipple is centred
upwards from centre of the breast, and is in a good place for the baby
to find it - exactly like the breast position on this video: (all the
way at the end). http://breastcrawl.org/video.htm
This second video shows the process well, and is useful, but for the
truly pendulous breast, if she gets things working with the utterly
prone position - I'd stick with it for a while. Mine did a perfect
latch on by himself at birth - we'd placed him on my chest and he just
did it. The problems came when I tried to do stuff like I was being
told to. I do support a lot of women with pendulous breasts, and they
do report lying more prone, and letting baby do the work for the first
two to three weeks, until skill levels build, is the least stressfull
way. (That's both Mama's skill levels, and baby's.)
http://www.ameda.com/breastfeeding/started/latch_on.aspx
Print resources showing same:
http://www.breastfeeding.asn.au/bfinfo/bla.html
http://www.biologicalnurturing.com/pdf/Poster%20for%20web%20site-locked.pdf
If the baby comes out disorganised, and isn't self-latching, my favoured
position was what we call the 'rugby' hold here, which I think is the
'football' hold in the USA. Baby is down by your side, supported by
pillows and your arm, and you raise the baby's head up to meet your
breast, keeping baby supported by pillows or your arm, once latching is
achieved. It is one way to bring baby up to the breast, without
interfereing too much with your own breast. You need to be fully
supported and comfortable semi-reclined. How reclined depends on how
tall mother is, and how long baby is.
And tell you friend there are huge advantages to floppy breasts once
breastfeeding in well underway. Those pendulous breasts can stretch a
long way and still be suckled on, and it affords the mother a lot of
freedom on position and movement when feeding is underway. She will
thank the System Overlords for them, when others around her are
complaining that their babies are on-off-on-off all the time looking at
stuff. Pendulous breasts are so much more flexible. It's incredible
how far they can go, when a latched on toddler falls off the bed! :-)
I'd also advise her to get a good and supportive nursing bra - they can
be found, I went for the Goddess 0511, which was too big at first! (No
financial interest) This site may be useful to here:
http://www.plus-size-pregnancy.org/PlusMat%20Clothing%20FAQs/PlusMat_Nursing.html
Babies love fat mamas - warm soft and squishy skin _everywhere_. :-)
Morgan Gallagher
Marie Merritt-Reed wrote:
> Hi, my name is Marie and I am a nursing student at Ivy Tech Community
> College. I have a close friend who is obese, and expecting her first child in
> Febuary. I am wondering if her weight will have any affect on her plans to
> breastfeed.
> I did some research on the matter, and I found that one study had observed a
> failure to initiate and also to sustain lactation in obese and/or prepregnant
> overweight women. A couple of possible factors seemed to affect this
> outcome. One factor was that being overweight or obese possibly made the
> mechanics of latching on and proper positioning of the infant difficult.
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