Many obese mothers are also insulin resistant which can also have a significant impact on milk production.

Holly McSpadden IBCLC

Sent from my iPhone

> On Nov 11, 2014, at 12:02 PM, "Pat Young" <[log in to unmask]> wrote:
> 
> obese BMI is risk factor for delayed onset lactogensis II. Nommsen-Rivers 2010
> 
> lower prolactin response to suckling - Kjolhed
> 
> emergency C-Sec lacked significant rise  in prolactin @ 20-30 hours PP. after onset of BF (average 240 minutes PP) & fewer pulses  of oxytocin on day 2. (mode of birth & time to 1st BF were significant. Also with c-sec they is incomplete stage 2 hormonal progression (stage 2 happens with vag. del. Delayed initiation of BF and decreased STS and increased pain meds all impacted Lactation. Nissen et al 
> 
> Obese women are hyperliptenemic.  possibly leptin resistant - inhibits oxytocin, decreased MER. Rasmussen 2004
> 
> prenatal weight gain affects Lact .  Li, 2003 Hilson 2004 & 2006  JHL
> 
> BF initiation lower, weight gain lower in babies of obese moms Mok 2008
> 
> Varying reports on Hormones, without significance.  Most articles dealt with physical barriers.  Repeatedly noted that obese women choose BF less frequently.  Association with embarrassment ?  Also amount of milk and quality of milk questioned.
> 
> So like everything else - the causes are multiple, complex and interrelated (learned that in  one  of my early college classes - sort of my motto for everything :-)  Pat in SNJ
> 
> 
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