Obese women are, as a group, less likely to initiate or continue breastfeeding than normal weight new mothers. In some instances, because of their size, these women find it difficult to properly position their newborns for breastfeeding. Due to the mother's large breast size, newborns may find latching onto the nipple difficult.
The initiation of breast milk production is due to maternal hormonal changes. Immediately after the baby is delivered, the mother experiences a rapid fall in her progesterone level. This fall is the trigger for the sudden onset of copious milk secretion. This reaction is generally normal in obese mothers.
The infant's sucklng stimulates the mother's body to make prolactin, a hormone, which then stimulates the flow of breast milk. The end result is that the more the baby nurses, the more breast milk the mother makes. As breastfeeding continues, the importance of this response lessens.
In obese women, the initial prolactin response is lessened, so they produce less breast milk. Most obese women who discontinue breastfeeding do so when the prolactin stimulation should be its greatest.
Obese mothers who want to breastfeed their newborns need extra help. They should meet with a lactation consultant early in their hospital stay for support and counseling. Once these women go home from the hospital, they may need early and extra contact and visits with lactation consultants or visiting nurses. They need to be told there are biological reasons for their breastfeeding problems and continuing to breastfeed is the best solution.
Pediatrics, 5/04.
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