My baby left me for the bottle

Overweight women don't produce enough
milk when breastfeeding

By Brian Hoyle

Overweight new mom Sherri Holloway, age 34, has a bigger problem than trying to find a nursing bra in her size. First, her daughter Kristina had problems 'latching on' to being breastfed, and then there just wasn't enough milk. Three-day-old Kristina was getting hungry and cranky at feeding times and Sherri was becoming more and more frustrated. Eventually, despite her previous convictions about breastfeeding, Sherri turned to the milk bottle.

Sherri isn't alone. Many overweight or obese mothers have problems breastfeeding, but until now no one's been sure why. Kathleen Rasmussen of Cornell University and Dr Chris Kjolhede of Bassett Healthcare's Research Institute in New York have changed all that. Their report in the May online issue of Pediatrics showed that heavier women respond weakly to their baby's suckling. In particular, production of the hormone prolactin doesn't kick in during the critical first days after birth. The resulting milk shortage makes for a very hungry, grumpy baby at meal times.

The take-home message, according to Ms Rasmussen, is that "heavier women need even more support to be successful breastfeeders. In practical terms, this means encouraging [the women] to seek help from lactation counsellors and scheduling early followup appointments in the first days and weeks after birth."

Before coming to this conclusion, the researchers charted the blood levels of prolactin and progesterone in 40 mothers just before and 30 minutes after breastfeeding, at 48 hours after delivery and a week after birth. Before conception, some of the new moms were overweight or clinically obese with a body mass index of at least 26, while others were normal in weight.

The overweight and obese women produced less prolactin 48 hours after birth compared to the normal-weight women. The researchers didn't determine why this was, but they felt it was probably due to something as simple as the mother's bulk making it tricky to position the little tyke properly at the breast, making it tough for the infant to latch on.

By seven days, the prolactin response had rebounded to the normal range. But by then it was too late, as most of the overweight or obese moms had abandoned breastfeeding.

"This is just another reason why women should conceive their babies at a healthy weight," Ms Rasmussen told HealthDay News. Barring that, lots of support in the hospital is a must. For example, in the study, breastfeeding was monitored by nurses during each shift and lactation consultants were on call.

Ms Rasmussen and Dr Kjolhede suggested that pediatricians can aid overweight and obese new moms by having them see a lactation consultant before leaving the hospital and making sure a followup call is made a few days later to check on breastfeeding success.