Obese Moms May Have
Trouble Breastfeeding
NEW YORK (Reuters) -- Obese or significantly
overweight women may have more difficulty initiating
and continuing breastfeeding than their normal-weight
counterparts, according to New York researchers.
Weight-related complications of delivery, such as
cesarean section, as well as maternal health problems
associated with obesity can inhibit these women from
initiating early breastfeeding, the researchers report in
the December issue of the American Journal of
Clinical Nutrition.
In the United States, approximately 15% of white
women of reproductive age are overweight,
compared with 32% of blacks and 30% to 45% of
Hispanics. In the new study, Julie A. Hilson and
colleagues from the Mary Imogene Bassett Hospital
and Research Institute in Cooperstown, New York,
found that women who were overweight or obese
before becoming pregnant breastfed for shorter
periods of time than those with a normal
pre-pregnancy weight.
Cesarean delivery was more common among obese
and overweight women, a factor that may play a big
role in the decision not to breastfeed. Women
delivering by cesarean suffer more pain after delivery,
receive more pain medication and nurse their infants
later than women who deliver vaginally. These
conditions interfere with both the milk-ejection reflex
as well as milk production, according to Hilson.
``Women undergoing cesarean section are less likely
to try breastfeeding and have a lower rate of
breastfeeding at hospital discharge than do women not
undergoing this procedure,'' she said. Cesarean
delivery also may negatively affect breastfeeding
duration due to delayed introduction of the baby to its
mother's breast.
In addition to a higher risk of cesarean delivery,
women who are obese during pregnancy or
overweight before pregnancy have a greater risk of
high blood pressure and pregnancy-related diabetes,
which can delay milk production. These women are
also more likely to have babies with health problems
that require intensive care immediately after birth, a
factor that can hinder early initiation of breastfeeding.
Previous studies have indicated that women who are
most likely to breastfeed are white, well-educated and
middle-class. Underprivileged women are much less
likely to breastfeed because the cultural context
surrounding these women often is not supportive of
breastfeeding, the authors wrote. However, in this
study, 68% of women classified as being in the lower
socioeconomic class attempted to breastfeed at
delivery. The study also found that a
higher-than-expected number of obese and
overweight women attempted to breastfeed after
delivery, possibly due to strong encouragement and
support on the part of the researchers. Hilson and
colleagues conclude that although obesity can
significantly impede the chances of successful
breastfeeding, these women should be encouraged
and educated about the benefits of breastfeeding.
``Given the high prevalence of obesity and overweight
in the United States, coupled with the known benefits
of breastfeeding and human milk for infants, it is
important to know what limitations to breastfeeding
women face. This is particularly important for obese
women and their infants because breast milk may
protect children from obesity itself and from
developing a variety of childhood illnesses,'' the
researchers wrote.
SOURCE: American Journal of Clinical Nutrition
(1997;66:1371-1378)
Reut13:55 12-10-97
(10 Dec 1997 13:54 EST)
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Cindy , RN, IBCLC ***** Virginia , USA
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