Maternal obesity is associated with short duration of breastfeeding, and many obese women also have large breasts. To determine if health professionals who support lactating women can distinguish between these maternal characteristics as obstacles to breastfeeding, the authors conducted a mail survey of 242 Danish health professionals. They thought that initiating was more difficult (P < .0001) than continuing breastfeeding for women with large breasts and/or obesity. These difficulties were thought to be lowest for women with large breasts, higher for obese women, and highest for obese women with large breasts (P < .0001). These difficult ratings were significantly related in a complex manner to the respondents’ personal characteristics and type of training. These findings indicate the importance of recognizing and treating large breasts and maternal obesity as separate obstacles to successful breastfeeding and that interventions to reduce these obstacles should be designed to account for characteristics of the person providing them.
Rasmussen KMAssociation of maternal obesity before conception with poor lactational performance. Annu Rev Nutr. 2007;27:103-121.
2.
Rasmussen KMMaternal obesity and the outcome of breastfeeding . In: Hale TW, Hartmann PE, eds. Textbook of Human Lactation. Amarillo, TX: Hale Publishing; 2007:387-402.
3.
World Health Organization.Prevalence of obesity, females, aged 30+, 2005. https://apps.who.int/infobase/publicfiles/Obesity_Female_2005.png. Accessed May 18, 2009.
4.
Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KMPrevalence of overweight and obesity in the United States, 1999-2004 . JAMA. 2006;295:1549-1555.
5.
US Department of Health and Human Services.Healthy People 2010. Washington, DC : Department of Health and Human Services; 2000.
6.
World Health Organization and UNICEF.Global Strategy for Infant and Young Child Feeding. Geneva , Switzerland: World Health Organization; 2003.
7.
Dewey KG, Nommsen-Rivers LA, Heinig MJ, Cohen RJRisk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. Pediatrics . 2003;112:607-619.
8.
Hilson JA, Rasmussen KM, Kjolhede CLHigh prepregnant body mass index is associated with poor lactation outcomes among white, rural women independent of psychosocial and demographic correlates . J Hum Lact. 2004;20:18-29.
9.
Rasmussen KM , Kjolhede CLPrepregnant overweight and obesity diminish the prolactin response to suckling in the first week postpartum. Pediatrics. 2004;113:e465-e471.
10.
Jevitt C., Hernandez I., Groër M.Lactation complicated by overweight and obesity: supporting the mother and newborn. J Midwifery Womens Health. 2007 ;52:606-613.
11.
Lovelady CAIs maternal obesity a cause of poor lactation performance? Nutr Rev. 2005;63:352-355.
12.
Hoover KLMaternal obesity: problems of breastfeeding with large breasts. Womens Health Rept. Winter 2008:6-10.
13.
Coates M-M.Assisting the newborn to latch on to the very large breast: HELP!J Hum Lact. 1989;5:131-132.
14.
Renfew M., Fisher C., Arms S.Breastfeeding: Getting Breastfeeding Right for You. Berkeley, CA: Celestial Arms; 1990 .
15.
McAllan A.Breastfeeding With Large Breasts. http://www.breastfeeding.asn.au/bfinfo/large.html. 2005. Accessed August 7, 2007.
16.
Tilson B.Helping large-breasted mothers: Tips from leaders who have helped large-breasted mothers enjoy breastfeeding. LEAVEN. May-June1989:35-37. http://www.llli.org/llleaderweb/LV/LVMayJun89p35.html
17.
Handbook on Successful Breastfeeding [in Danish]. Copenhagen: National Board of Health; 2006.
18.
Rasmussen KM , Lee VE, Ledkovsky TB, Kjolhede CLA description of lactation counseling practices that are used with obese mothers . J Hum Lact. 2006;22:322-327.
19.
Baker JL, Michaelsen KF, Sørensen TIA, Rasmussen KMHigh prepregnant body mass index is associated with early termination of full and any breastfeeding among Danish women. Am J Clin Nutr. 2007; 86:404-411.
20.
Nohr EA, Vaeth M., Baker JL, Sørensen TIA, Olsen J., Rasmussen KMCombined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. Am J Clin Nutr . 2008;87:1750-1759.
21.
Wadden TA, Didie E.What’s in a name? Patients’ preferred terms for describing obesity . Obes Res. 2003;11:1140-1146.
22.
Stunkard AJ, Sørensen T., Schulsinger F.Use of the Danish Adoption Register for the study of obesity and thinness . In: Kety SS, Rowland LP, Sidman RL , Matthysse SW, eds. Genetics of Neurological and Psychiatric Disorders. New York: Raven;1983:115-20.
23.
Greenbaum AR , Heslop T., Morris J., Dunn KWAn investigation of the suitability of bra fit in women referred for reduction mammoplasty . Br J Plast Surg. 2003;56:230-236.
24.
WHO Expert Committee on Physical Status.Physical Status: The Use and Interpretation of Anthropometry. Geneva, Switzerland: World Health Organization; 1995. WHO Technical Report Series No. 854.
Harris CV, Bradlyn AS, Coffman J., Gunel E., Cottrell L.BMI-based body size guides for women and men: development and validation of a novel pictorial method to assess weight-related concepts. Int J Obes. 2008;32:336-342.
27.
Wood K., Cameron M., Fitzgerald K.Breast size, bra fit and thoracic pain in young women: a correlational study . Chiropr Osteopat. 2008;16:1.
28.
Kronborg H. , Vaeth M., Olsen J., Harder I.Health visitors and breastfeeding support: influence of knowledge and self-efficacy. Eur J Public Health . 2007;18:283-288.
