Laurie Wheeler <[log in to unmask]> wrote:

> I have come to the conclusion (and I hope I don't get flames) that obesity
> has a major impact on breastfeeding. It seems that research is showing a
> connection between obesity and delayed or failed lactation, but I am
> talking about the mechanics of breastfeeding.

I think a lot more research is needed on this, but it needs to be very
high quality research. The confounders are many and can be difficult to
sort out statistically, as it's not just a matter of pressing the "age"
or "race" or "SES" button.  Just a handful of examples off the top of my
head:

Larger woman are far more likely to be subjected to all sorts of labour
interventions; interventionally-minded OBs will C section them at the
drop of the hat. 

In the Australian environment, women over a certain weight are also
escalated to tertiary hospitals automatically, meaning they're more
likely to feel dislocated and less likely to have local family support
(particularly for rural and remote women, but also for suburban women in
some cases).

In addition, larger women have been told for a long time (and at much
higher intensity during pregnancy) that their bodies are faulty,
dysfunctional and prone to fail at the drop of a hat. Confidence in
one's body ability to function normally and provide for a baby is key to
breastfeeding in an environment where we are told over and over that it
is a fragile, easily disrupted process that goes wrong at least half the
time.

At the same time, large women are made to feel ashamed of their body
appearance, making exposure while establishing breastfeeding
additionally difficult, especially in a situation where you are likely
to be interrupted every few minutes (hospital). It's hard to concentrate
on manipulating your baby/breasts/etc if you're also feeling mindful
that your side fat/belly fat might be showing.

It would be great if there were moves to mitigate some of these extra
degree-of-difficulty factors, but I don't see it happening at the moment
unfortunately.

Lara Hopkins

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