Breastfeeding and overweight moms

Overweight and obese women often experience problems breastfeeding. Some issues are physiological and emotional - others are due to stigmatization.

While it is understood that being breastfed significantly lowers a child’s risk of becoming overweight or obese, mothers who are overweight (BMI greater than or equal to 25kg/m²) or obese (BMI greater than or equal to 30kg/m²) face a variety of issues when they want to breastfeed their infants.

This ranges from a higher frequency of nipple problems, to embarrassment when feeding in public and at home, among friends and family – as well as a lack of support from midwives and other healthcare professionals.

Even though these moms had the same feelings towards breastfeeding as “normal” weight women, they have lower rates of breastfeeding, and stop breastfeeding earlier on. With more of the right kind of support, they may have continued for longer – which in turn, would benefit them and their baby in the long run.

Looking at barriers

In a systematic review of research, Breastfeeding experience and support of women who are overweight or obese, researchers working in the fields of midwifery, psychiatry and life sciences looked at evidence of barriers for these mothers when it comes to breastfeeding and receiving support.

The research included 16 papers from developed countries around the world: the USA, UK, Singapore, France, Sweden, New Zealand. This type of research is especially important, as obesity rates are growing in these types of richer countries.

Birth by caesarean

It all starts with birth. Overweight and obese women have a higher chance of giving birth by caesarian section. Research showed that this often delayed the start of breastfeeding. This was not only due to the recovery period after the procedure – but also because of a lack of practical support and advice by the hospital staff.

In fact, being an overweight or obese mom made these women feel stigmatized. Health care professionals’ attitudes towards overweight and obese moms meant that these new mothers tended to receive less information about breastfeeding, and less help – especially within an hour of her infant’s birth. This in spite of the fact that their doctors and other health care professionals were in favor of exclusive breastfeeding.

A lack of privacy in the hospital also caused issues. Often rooms are shared, and visitors and hospital staff are coming and going. For women who already report having a lack of confidence in their overweight body, it’s understandable that breastfeeding under such conditions can feel quite uncomfortable.

Larger breasts and areolas

Overweight and obese women aren't just larger in general, they also have bigger breasts and areolas. Not only does this make it more difficult to find a well-fitting nursing bra, it also makes it harder (and time-consuming) to find a comfortable way for mom to position her baby during breastfeeding.

The babies of obese women also had more trouble suckling and latching on. Some mothers were even worried about smothering their babies with their heavy breasts.

It doesn’t help that these moms reported higher rates of problems initiating breastfeeding while in the hospital – and felt more fatigued. They also suffered more often from problems with sore, cracked or bleeding nipples. And, as mentioned earlier, these moms received less positive support from hospital staff in their breastfeeding attempts.

Too little milk

One of the most common reasons overweight and obese moms stopped breastfeeding was the feeling that they were unable to provide enough milk. The researchers pointed out that this was most likely not backed up by fact, but was a socially-acceptable way of camouflaging other reasons for stopping. Additional research would be needed to determine if this is due to physiological reasons, or influenced by a lack of personalized support from healthcare professionals.

A mother should feel comfortable about her decision to breastfeed, and experience positive and timely support from those around her. At this point, there is limited research into the support that overweight and obese moms receive, and their experience of this support.

Personal support

These studies did reveal that a woman's self-confidence increases when they are treated by healthcare professionals with care and patience - and as genuine individuals. So, until we know more about the physiological effects of obesity during motherhood, midwives and other healthcare professionals have the power to make a difference - by offering tailored, personal support to these new moms. This can go a long way towards helping them and their babies to enjoy all the benefits of breastfeeding, for as long as mom desires.