I am quite familiar with large breasts and large women. Mississippi USA, I 
believe, leads the nation in obesity. Also New Orleans, where I am 
originally from, is a city with a large percent of obese residents.
It is often quite difficult to manage positioning with an obese mother who 
has large breasts. These strategies can work:
A pillow or two under the breast and then a pillow under the baby - the baby 
will not necessarily be wrapped around the mother but will be tucked close 
to the large breast. Make sure the heavy breast is not laying on top of the 
baby's chest, as most babies cannot feed with that pressure on them.
One can also use a bedside table to place the breast upon it and the baby. 
Be sure the baby is safe and not in danger of falling off. A sidecar 
arrangement can be used later with mother somewhat sidelying once she is 
able. Some mothers place their breasts in store-bought or homemade slings 
for support.
I usually find it easier for mothers to learn and for me to help with early 
bf if mothers do not wear a bra. However, large moms sometimes find wearing 
a well-fitting and supportive bra to help manage the heavy breasts.
I do feel that overlying is more possible with large mothers and large 
breasts (no flames please) because there is alot of "fluffy" tissue to mold 
around baby's face and these mothers can be less mobile. Also, be very 
sensitive, because having to do these modifications can make mothers very 
uncomfortable psychologically / embarrassed. Encourage mother, of course, 
letting her know that baby will get more "in control" and that she will 
become more mobile as her recovery proceeds.


Laurie Wheeler, IBCLC, MN, RN
No. Mississippi, s.e. USA

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