Early Milk Production Compromised in Overweight/Obese Mothers By Megan Rauscher NEW YORK (Reuters Health) May 03 - The prolactin response to suckling, which is responsible for stimulating milk production early in lactation, is diminished in the first postpartum week in new mothers who are overweight or obese. This finding provides a biological basis for why overweight and obese women often give up on breastfeeding earlier than do normal-weight women, two researchers from New York suggest in the May issue of Pediatrics. "Our study shows that heavier women need even more support to be successful breastfeeders," Dr. Kathleen M. Rasmussen from Cornell University in Ithaca told Reuters Health. "In practical terms, this means encouraging heavier women to seek help from lactation counselors and scheduling early follow-up appointments in the first days and weeks after birth." Previously, Dr. Rasmussen and colleagues observed that being overweight or obese negatively affects lactational performance. While overweight and obese women are as likely as normal-weight women to initiate breastfeeding, they are less likely continue. (see Reuters Health report January 2, 1998) "In our other research, psychosocial characteristics such as self-efficacy for breastfeeding in heavier women did not seem to explain their short duration of breastfeeding," Dr. Rasmussen said. "We proposed in our study that the normal increase in prolactin concentration in response to infant feeding might be affected by obesity," she said. Dr. Rasmussen and Dr. Chris L. Kjolhede from Bassett Healthcare Research Institute in Cooperstown, measured serum prolactin and progesterone concentrations before and 30 minutes after the beginning of a suckling episode at 48 hours and 7 days after delivery. In unadjusted analysis, women who were overweight or obese (BMI >26) before conception had a lower prolactin response to suckling than normal-weight women at 48 hours but not 7 days postpartum. In multivariate analysis, overweight/obesity, primiparity, and birth weight correlated negatively with the 48-hour prolactin response to suckling. In further analyses adjusting for time since delivery and the duration of the suckling episode, "only overweight/obesity remained a significant negative predictor" of prolactin response to suckling at day 7 postpartum. This diminished prolactin response to suckling "would be expected" to compromise the ability of overweight/obese women to produce milk, and may contribute to early cessation of breastfeeding, the researchers suggest. It is "important" to note, Dr. Rasmussen said, that "heavier women can be successful breastfeeders, but they need more support than normal-weight women." In this study, concentrations of progesterone were not markedly different between overweight and normal-weight women, a finding that does not support the hypothesis that higher progesterone concentrations in overweight/obese women might delay lactogenesis, the team notes. Pediatrics 2004;113:e465-e471. *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html