Kirsten,
You mentioned in your post regarding the study, "Prepregnant Overweight and
Obesity Diminish the Prolactin Response to Suckling in the First Week
Postpartum," by Kathleen Rasmussen and Chris Kjolhede that there was "other data
supporting this finding."  The other data came from an abstract presented at the
FASEB experimental biology meeting in DC this April.  The abstract you mention,
"Maternal obesity and exclusive breastfeeding (EBF) success in Danish women,"
authored by, J.L.Baker et al.  Kathleen Rasmussen is one of the authors of
this abstract.  Should we accept as "evidence" another paper co-authored by the
same person?    J.L. Baker is the lead writer in this research abstract.    In
a web search there is a J. L. Baker  who is a professor of Agricultural and
Biosystems Engineering from Iowa State University.  He is a researcher.  Are
they one and the same persons?  The paper Rasmussen had published in Pediatrics
was supported by a grant from the USDA (United States Department of
Agriculture).  The USDA website states a strategic plan which includes:  "expand markets
for agricultural products and support international economic development,
further develop alternative markets for agricultural products and activities."
One would think that breastfeeding or increasing breastfeeding rates might
impinge on expanding agricultural products.

How does breastfeeding fit into a meeting on "experimental biology?" My
impression of the FASEB is that it supports genetic engineering.  Gene technology,
the molecular sciences has become the predominant science and is heavily
funded.  This science seems reductionist, everything can be explained in terms of
genes and genetics.  The Rasmussen study in Pediatrics reduces the explanation
of low rates of initiation and duration of breastfeeding to biology.  Not only
is that a simplistic explanation of reality, but has dismissed without
evidence the psychological and sociological possibilities of low initiation and
duration rates for overweight/obese women. If "plasma levels of prolactin rise and
fall in proportion to the frequency, intensity and duration of nipple
stimulation," we must have data that shows how often each mother had contact with
their infants prior to the prolactin measurements.  This was not done.

How does embarrassment about the body factor into whether or not someone
breastfeeds and sustains that behavior?  We know teens have low
initiation/duration rates and teens are particularly embarrassed/self-conscious about their
bodies.  In our society being overweight/obese is scorned, ridiculed.  Does
someone who is overweight feel comfortable about perceived attention to their body
when they breastfeed?  Does this psychological factor mean that a mother might
not want to breastfeed; or if she does, would she limit the amount of
breastfeeding?

Does being on the alert for breastfeeding problems with obese/overweight
mothers helpful?  It depends on how the lactation community presents this to the
mother.  If mothers who are overweight/obese feel that their bodies have "let
them down," then this study reinforces that there is something wrong with their
bodies.  If this study had concrete evidence that this was the case, then I
certainly believe that this evidence must be made known to them.

If one has the wrong population targeted as a risk, how helpful are we being?


Valerie W. McClain, IBCLC

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