Clinically overweight and obese mothers and low rates of breastfeeding: Exploring women's perspectives

Abstract

Background: It is universally recognised that breastmilk is the best food for babies and that breastfeeding provides significant health benefits for both mothers and babies. Women who are overweight or obese have lower rates of initiation and duration of breastfeeding. There is a need to understand the woman's perspective, and any additional factors that may contribute to breastfeeding difficulties for overweight or obese women.Objective: The aims of this research were to explore the breastfeeding experiences and perspectives of a specifically recruited group of clinically overweight and obese women and to gain an understanding of what influenced their infant feeding decisions.Method: This study used a qualitative methodology. In-depth interviews were conducted with six mothers who were overweight or obese and initiated breastfeeding, but then did not continue to exclusively or fully breastfeed their babies. Using a thematic analysis the researcher identified seven themes which captured the breastfeeding experiences of these women. Findings:The women believed in the importance of breastfeeding for their babies' health, but experienced challenges with latching and perceived their breast milk supply to be insufficient. The physical challenges of large breasts and body image issues when feeding in public also contributed to early cessation of exclusive breastfeeding. This study adds to the body of knowledge on this subject and to our understanding of the association between maternal overweight and obesity and early cessation of breastfeeding. Conclusion:It is important to recognise the unique needs of overweight and obese women and provide support antenatally and postnatally. This support is crucial if we are to achieve the public health aim of reaching World Health Organization (WHO) and national targets for exclusive and full breastfeeding.

Breastfeeding experiences and support for women who are overweight or obese: A mixed‐methods systematic review

“…Quantitative and qualitative studies reported physical barriers including larger breasts, bigger areolas, and additional body tissue made infant handling and breastfeeding positions such as cradle or cross cradle more difficult (Claesson, Larsson, Steen, & Alehagen, ; Garner et al, ; Jarlenski et al, ; Massov, ). Jarlenski et al () found that significantly more women with obesity (26.5%) than without obesity (21.0%; p < .05) reported “baby had trouble sucking or latching on” as a reason for not breastfeeding to 6 months (Jarlenski et al, ).…”

“…Finding nursing bras to fit was also identified as a problem for them. Additionally, Massov () reported women's concerns that as their breasts were heavy, they were worried they would suffocate their infant by “squishing” them.…”

“…Being overweight or obese was an independent risk factor for delayed onset of lactation (Nommsen‐Rivers et al, ), with “delayed” defined as breasts being “noticeably fuller” after 72‐hr postpartum. Women's perceptions of insufficient breastmilk supply have been reported as a key factor for stopping breastfeeding (Jarlenski et al, ; Kair & Colaizy, ; Massov, ; Mok et al, ; O'Sullivan et al, ). For example, Jarlenski et al () reported perceptions of low breastmilk supply as a reason for early cessation among women with and without obesity, with more women with obesity (55.5%) reporting this than women without obesity (48.3%; p < .05).…”

“…“Did not have enough milk” was the second most common reason provided in both groups, but significantly more women with obesity (51.3%) reported this than women without obesity (45.0%; p < .05). The women in Massov's () study described perceived insufficient breast milk supply as a reason for switching to formula feeding. Claesson et al's () qualitative study described how women thought that having larger breasts might impair milk production.…”

“…Embarrassment about breastfeeding in public was a key issue affecting breastfeeding behaviour (Claesson et al, ; Keely et al, ; Massov, ; McKenzie et al, ; Mok et al, ). Mok et al () reported that at 1‐month postpartum, a higher proportion of women with obesity (47%, n = 20) reported feeling uncomfortable when breastfeeding in the presence of others than women with normal weight (26%, n = 13), but this was not statistically significant.…”