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Lactation Complicated by Overweight and Obesity: Supporting the Mother and Newborn

Authors

  • Cecilia Jevitt CNM, PhD,

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    • Cecilia Jevitt, CNM, PhD, is an Assistant Professor from the University of South Florida whose research focus is obesity management and prevention in women's health.

  • Ivonne Hernandez MS, RN, IBLC,

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    • Ivonne Hernandez, MS, RN, IBLC, is a University of South Florida doctoral student and a certified lactation consultant.

  • Maureen Groër RN, PhD

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    • Maureen Groër, RN, PhD, FAAN, is the Gordon Keller Endowed Professor, University of South Florida with 30 years of research expertise in lactation, stress, and immunology.


University of South Florida College of Nursing, MDC Box 22, 12901 Bruce B. Downs Blvd., Tampa, FL 33612. E-mail: cjevitt@hsc.usf.edu

Abstract

Research shows that mothers who are obese (with a BMI >30) are less likely to initiate lactation, have delayed lactogenesis II, and are prone to early cessation of breastfeeding. Black women, with the highest rates of American obesity, have the lowest rates and shortest duration of breastfeeding compared to Hispanic and white women. Women who are overweight and obese have lowered prolactin responses to suckling. Women who are obese are at risk for prolonged labors, excessive labor stress, and cesarean birth, all of which delay lactogenesis II. Lactation has a small but significant role in preventing future obesity in the mother and child. Midwifery management of obesity-related lactation problems begins with education about optimal prenatal weight gain and regular weight assessment to avoid excessive gain. Support of physiologic birth processes to avoid stress, prolonged labor, and surgical birth and limit maternal-newborn separation enhances the onset of lactogenesis II. Massage or pumping may soften and extend the obese nipple for easier latch. Infants of lactating women with prior bariatric surgery are at risk for B12 deficiency and require regular nutrition and growth assessment. Five hundred calorie per day restriction paired with aerobic exercise for intentional postpartum weight loss does not affect milk quality or infant growth.

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