1

Obesity and Breastfeeding RatesKaren Ady and Hawa Al-Hassan

(OECD, 2011) 2

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Obesity and Breastfeeding

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Media Portrayal of Ideal Body Image

• Obese and Overweight women feel self-conscious about exposing their bodies during breastfeeding.

• Caregivers can be judgmental about women who do not fit the ideal media image.

Obese Pregnant Women

• Women who begin pregnancy with a BMI > 26 had almost 4 times the risk of not initiating breastfeeding when compared to underweight or normal weight women.

6(Mehta, Siega-Riz, Herring, Adair, & Bentley, 2011)

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Breastfeeding and the Obese Woman

Biologic Factors:• Prepregnant BMI was

negatively associated with the timing of lactogenesis II (the onset of copious production of milk)

• Mechanical difficulty latching onto large breasts

(Rasmussen & Kjolhede, 2004; Riordan, ,2005)

(Rasmussen & Kjolhede, 2004) 8

Overcoming Breastfeeding Disparities in the Obese Population

• Identify this high-risk population

• Targeted intervention in early pregnancy

• Lactation consultation before discharge

• Support – telephone call early postpartum

• Multidisciplinary approach

(Riordan, 2005; Smith, 2012) 9

Helping the Large-breasted Woman Breastfeed Successfully

•Address concerns about smothering the baby with very large breasts by teaching positioning, especially football hold and lying down to nurse.•Provide privacy•A good nursing bra•Support the breasts•Massage the breasts•Breast hygiene•Use a breast pump that comes with a large flange

•BE POSITIVE•Generally nipples that are larger are viewed as an anatomical gift that will make breastfeeding easier. •Praise Mother and Baby

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Karin Cadwell PhD, RN, FAAN, ANLC, IBCLC

• Healthy Children Project• Baby-Friendly USA• Center for

Breastfeeding• US National

Breastfeeding Committee

• Author

Retrieved from http://www.myunion.edu/academics/bachelor-of-science/faculty-pages/cadwell.html

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ReferencesMcDowell, W. K.-S. (2008). Breastfeeding in the United States: Findings from the

National Health and Nutrition Examination Surveys 1999 - 2006. NCHS Data Briefs.Mehta, U., Siega-Riz, A., Herring, Adair, A., & Bentley, M. (2011). Maternal obesity,

psychological factors, and breastfeeding initiation. Breastfeeding Medicine, 6(6).Organization for Economic Cooperation and Development. (2011). Obesity and the

Economics of Prevention: Fit not Fat – United States Key Facts. Health at a Glance – 2011 Edition. Retrieved from http://www.oecd.org/document/57/0,3343,en_2649_33929_46038969_1_1_1_1,00.html

Rasmussen, K., & Kjolhede, C. (2004). Prepregnant overweight and obesity diminish the prolactin response to suckling in the first week postpartum. Pediatrics, 113(5), e465 - e471.

Riordan, J. (2005). Breastfeeding and Human Lactation. Sudbury, MA: Jones and Bartlett.

Smith, Anne. (2012). Nursing Tips for the Large Breasted Woman. Retrieved from http://www.breastfeedingbasics.com/articles/nursing-tips-for-the-large-breasted-woman