Features of lactation in puerperal women with obesity

Abstract

The objective: to determine the features of lactation in obese puerperas, depending on the body mass index and the therapeutic and preventive measures. Materials and methods. The analysis and evaluation of quantitative and qualitative indicators (lactose, casein, total protein, lipids, lactoferrin, transferrin, ceruloplasmin, vitamins C and E, immunoglobulins of G, A, M classes) of maternal milk in the dynamics of the postpartum period in 386 puerperas was conducted. The main group consisted of 115 women with obesity, the management of the preconception period, pregnancy and the postpartum period was carried out according to the proposed by us program, including non-drug and drug methods. The comparison group included 103 puerperas with obesity, the management of which was carried out in accordance with the Order No. 417 of the Ministry of health of Ukraine dated 15.07.2011. The control group consisted of 53 primiparous with normal body weight. Results. Analysis of the state of lactation revealed hypogalactia and pathological changes in the qualitative composition of breast milk, manifested in women with obesity and lower levels of lactose and lactoferrin by 1.6 times, total protein, ceruloplasmin by 2.2 times, lipids by 2.1 times, transferrin by 1.4 times, casein by 1,5 times, vitamin C by 1,8 times and E by 1,5 times, and the content of IgG by 2.1 times, IgM by 1.9 times, IgA by 2.2 times. The stage of hypogalactia severity and pathological changes in the quality of breast milk increase due to the body mass index growth. Conclusion. The proposed pathogenetically justified program of therapeutic and preventive measures contributed to the increase in the volume of breast milk and its quality improve. Key words: postpartum period, lactation, obesity.