Poor positioning, decreased prolactin levels, and low milk output associated with early cessation of exclusive breastfeeding in obese women

Abstract

High prepregnant maternal body mass index (BMI) is associated with reduced breastfeeding duration. The objective of this research was to examine how maternal obesity might impact early cessation of exclusive breastfeeding (EBF) by exploring key aspects of early breastfeeding success: prolactin values, milk output, and mother‐infant positioning during the first week postpartum. In this prospective study, data were collected from 51 primiparous women from Minnesota. Multivariate models were used to determine relationships between maternal obesity and early cessation of EBF via a variety of breastfeeding outcome variables. Among overweight and obese women, 35% stopped breastfeeding exclusively by 2 weeks postpartum compared to 4% of normal BMI women (P < 0.05). Greater milk output at 1 week postpartum reduced the risk of early cessation of EBF (OR 0.41, P < 0.05). Milk output was significantly associated with the predictor variables of basal prolactin concentration within 48 hours postpartum (P < 0.05) and Mother‐Baby Assessment (MBA) score (a measure of efficient positioning) at 1 week postpartum (P < 0.0001). Prolactin levels (P < 0.05) and MBA scores (P < 0.05) were in turn negatively associated with maternal obesity. These findings suggest that low milk output, influenced by decreased prolactin levels and especially poor positioning, may play a role in early cessation of EBF among obese women. Funded by NSF.