Dear Diane:

When working with the moms in the immediate postpartum period, I find
obese women's breasts generally easy to achieve a good latch with.  In
most obese women, the skin is supple and lends itself well to the
teacup hold.

However, I think there is a tendency in obese women not to notice the
early signs of engorgement, and they need to be warned about this and
encouraged to continue to breastfeed often in the early days.

I would include info about c/sec, gestational and Type I diabetes, and
other complications more prevalent in the obese.  How to prevail in
these situations, etc.

Perhaps the most troubling complication is the perception in many obese
women of one's body as a betrayer and a failure, before they even have
a chance to find out what a wonderful job their body will do in
nourishing their children.

Arly Helm, MS, IBCLC

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