Hi all,

I agree with Dawn and Lara.  The research indicates there is more than 
hormones affecting breastfeeding rates and milk production among obese 
women.  Below is an excerpt with references from my 2010 book, 
Breastfeeding Answers Made Simple: A Guide for Helping Mothers (for 
more, see the Obesity section on pp. 526-530).

Warm regards,

Nancy Mohrbacher, IBCLC, FILCA, who is also taking the IBLCE exam this 
year for the third time
Lactation Consultant, Ameda Breastfeeding Products
Chicago suburbs

How a culture views overweight and obesity can affect breastfeeding 
behaviors.Mothers who are unhappy with their body shape or weight have 
been found to be less likely to breastfeed (Barnes, Stein, Smith, & 
Pollock, 1997).

U.S. research has also found that overweight and obese women are less 
likely to put their newborns to the breast within the first 2 hours 
after birth, which has also been associated with a delay in milk 
increase (Bystrova et al., 2007; Kugyelka, Rasmussen, & Frongillo, 2004).

When comparing breastfeeding initiation among obese and normal-weight 
women, [a meta-analysis] noted that in areas where virtually all women 
breastfeed, obese women began breastfeeding at the same rate as 
normal-weight women (Amir & Donath, 2007).

Amir, L. H., & Donath, S. (2007). A systematic review of maternal 
obesity and breastfeeding intention, initiation and duration. /BMC 
Pregnancy Childbirth, 7/, 9.

Barnes, J., Stein, A., Smith, T., & Pollock, J. I. (1997). Extreme 
attitudes to body shape, social and psychological factors and a 
reluctance to breast feed. ALSPAC Study Team. Avon Longitudinal Study of 
Pregnancy and Childhood. /J R Soc Med, 90/(10), 551-559.

Bystrova, K., Widstrom, A. M., Matthiesen, A. S., Ransjo-Arvidson, A. 
B., Welles-Nystrom, B., Vorontsov, I., et al. (2007). Early lactation 
performance in primiparous and multiparous women in relation to 
different maternity home practices. A randomised trial in St. 
Petersburg. /Int Breastfeed J, 2/, 9.

Kugyelka, J. G., Rasmussen, K. M., & Frongillo, E. A. (2004). Maternal 
obesity is negatively associated with breastfeeding success among 
Hispanic but not Black women. /J Nutr, 134/(7), 1746-1753.

> Lara,
> You are so right -  we are only in the baby stages of knowing what is going
> on with high BMI moms (my new resolution - since "obese" and morbidly obese"
> are such hot button terms) and their breastfeeding experiences. We blame the
> fat too often (the adipose tissue and the adipose person!)
>
> Check out Danish Health Care *Providers*' Perception of *Breastfeeding
> *Difficulty
> Experienced by Women Who Are Obese, Have Large *Breasts*, or
> Both<http://jhl.sagepub.com/content/26/2/138.short>  in
> JHL 2010 - it's a study from Cornell researchers....
>
> Abstract:
> Maternal obesity is associated with short duration of breastfeeding, and
> many obese women also have large breasts. To determine if health
> professionals who support lactating women can distinguish between these
> maternal characteristics as obstacles to breastfeeding, the authors
> conducted a mail survey of 242 Danish health professionals. They thought
> that initiating was more difficult (*P*<  .0001) than continuing
> breastfeeding for women with large breasts and/or obesity. These
> difficulties were thought to be lowest for women with large breasts, higher
> for obese women, and highest for obese women with large breasts (*P*<
> .0001). These difficult ratings were significantly related in a complex
> manner to the respondents’ personal characteristics and type of training.
> These findings indicate the importance of recognizing and treating large
> breasts and maternal obesity as separate obstacles to successful
> breastfeeding and that interventions to reduce these obstacles should be
> designed to account for characteristics of the person providing them.
>
> (I may look like a "soft brain" on Lactnet sometimes but I actually read a
> lot of research to keep myself up to date - it better help when I sit the
> exam for the 3rd time next year!)
>


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